Overview
Cagrilintide is a long-acting synthetic acylated analogue of the natural satiety hormone amylin, developed for substantial weight loss and metabolic control.
What problem it targets: It targets severe obesity, intense food cravings, loss of mealtime satiety, and insulin resistance, especially in combination with GLP-1 receptor agonists.
What It Does
• Acts on central appetite centers: Crosses the blood-brain barrier to activate calcitonin and amylin receptors in the area postrema, sending powerful signals of fullness to the brain.
• Delays gastric emptying: Slows the rate at which food leaves the stomach, prolonging feelings of fullness after meals and smoothing out post-meal blood sugar spikes.
• Suppresses inappropriate glucagon secretion: Prevents the liver from dumping excess stored glucose into the bloodstream after eating, improving whole-body insulin sensitivity.
• Realistic expectations: Produces robust appetite suppression and gradual weight loss; mild nausea or delayed digestion are common initially and ease as the body adjusts over several weeks.
Reconstitution
| Vial size | BAC water / Solvent | Concentration |
|---|---|---|
| 2 mg | + 0.4 mL | 5 mg/mL |
| 5 mg | + 1 mL | 5 mg/mL |
| 10 mg | + 2 mL | 5 mg/mL |
Protocol
| Phase (4 wks each) | Frequency | Dose | Units (3.33 mg/mL) | Notes |
|---|---|---|---|---|
| Weeks 1–4 | Once weekly | 0.25 mg | 7.5u | Titrate slowly, nausea is dose-dependent. |
| Weeks 5–8 | Once weekly | 0.5 mg | 15u | |
| Weeks 9–12 | Once weekly | 1.0 mg | 30u | |
| Weeks 13–16 | Once weekly | 1.7 mg | 51u | |
| Week 17+ | Once weekly | 2.4 mg | 72u | Research-target maintenance. Do not exceed ~4.5 mg/week. Cycle: titrate over 16–20 weeks to the 2.4 mg maintenance dose; escalate only when the current dose is well tolerated. Timing: same day each week, any time, with or without food. Rotate injection sites. Stack: commonly combined with semaglutide (CagriSema), titrate the two together and expect stronger GI effects. Women: Women lose more than men at the same dose but report more GI (start lower). In PCOS they improve cycles, lower free testosterone and raise ovulation; a real unplanned-pregnancy risk. Stop before conceiving. Men: In men, excess fat lowers testosterone; GLP-1 raises testosterone, SHBG and gonadotropins as weight drops, improves sperm and erectile function, and preserves fertility (unlike TRT). |
Handling & Stacking
- Freeze-dried: -4°F.
- Reconstituted: 36–46°F.
- Best used within ~2–4 weeks, kept cold (structure-based estimate, no published data); that is close to the 28- day sterility limit, so use whichever comes first.
- Earlier satiety and smaller portions within weeks; steady weight loss over months (strongest with a GLP-1).
- Supply math 2mg → 7 vials | 5mg → 3 vials | 10mg → 2 vials (16-wk titration to 2.4 mg/wk)
Safety & Patient Education
- Fasting glucose / HbA1c (baseline + periodic), especially if diabetic Renal function if significant vomiting/diarrhea Weight, blood pressure, heart rate trend Out of range?
- Rising glucose/HbA1c = creeping toward diabetes (recheck, tighten diet); falling eGFR = kidney strain, usually dehydration (hydrate, hold).
