CagriSema is not one drug — it is two peptides combined in a single weekly injection. One is cagrilintide, which acts on the amylin system; the other is semaglutide, the familiar GLP-1 drug behind Ozempic and Wegovy. The pairing (from Novo Nordisk) aims to attack appetite from two directions at once. It is investigational, with its main evidence from the phase-3 REDEFINE trials.
In plain terms: semaglutide you may already know, plus a second appetite peptide bolted on — sold as a pair.
(The figure shows how semaglutide, one of the two components, builds to steady levels with weekly dosing.)
What it is
CagriSema is a fixed combination of two separate molecules:
- Semaglutide — a GLP-1 receptor agonist. GLP-1 (glucagon-like peptide-1) is a gut hormone that lowers appetite, slows how fast the stomach empties, and helps release insulin. On its own, semaglutide is an approved weight and diabetes medicine.
- Cagrilintide — an amylin receptor agonist. Amylin is a hormone the pancreas releases *alongside* insulin at meals; it signals fullness and slows digestion. Cagrilintide is a long-acting, engineered version of it. (An "agonist" is a molecule that switches a receptor on.)
So CagriSema is best understood as an explainer of a strategy: combine two different fullness pathways — amylin and GLP-1 — rather than push a single one harder.
The mechanism: two appetite systems, not one
Semaglutide and cagrilintide reduce appetite through different biology, which is the whole point of combining them.
- GLP-1 (semaglutide) works largely through gut-brain appetite signalling and slowed stomach emptying.
- Amylin (cagrilintide) works through its own receptors in the brainstem that promote satiety — a separate route.
In plain terms: two different "I'm full" signals, layered together, in the hope the combination does more than either alone. Early human work supported that the two can be given together safely and that the pairing added to weight loss3.
Pharmacokinetics: why once a week
Both halves are built to last about a week, so the combination fits a once-weekly schedule. Semaglutide's half-life — the time for half a dose to clear — is roughly 7 days; cagrilintide's is similar, around 8 days. Both use albumin-binding chemistry (they cling to a blood protein) to slow their breakdown, the same trick behind most weekly incretin drugs.
| Component | Target | Reported half-life | Role |
|---|---|---|---|
| Semaglutide | GLP-1 receptor | ~7 days | Appetite + insulin |
| Cagrilintide | Amylin receptor | ~8 days | Fullness / satiety |
| Combined (CagriSema) | GLP-1 + amylin | Once-weekly | Two appetite pathways |
What the trials actually found: the REDEFINE program
The REDEFINE trials are CagriSema's phase-3 evidence — large, late-stage trials of the kind used to support approval. Note the model in each row.
| Trial | People | Key result | Year |
|---|---|---|---|
| Enebo et al. — phase 1b3 | Small healthy/overweight cohort | Cagrilintide + semaglutide could be co-administered safely; added weight loss over semaglutide alone | 2021 |
| Garvey et al. — REDEFINE 1 (phase 3)1 | 3,417 adults with obesity, no diabetes | ~22.7% weight loss at 68 weeks (full-adherence estimate) vs 16.1% semaglutide, 11.8% cagrilintide, 2.3% placebo | 2025 |
| REDEFINE 2 (phase 3)2 | Adults with obesity + type 2 diabetes | Significant weight loss vs placebo in a diabetes population (diabetes usually blunts weight loss) | 2025 |
In plain terms: in the big obesity trial, the average person on CagriSema lost close to 23% of body weight over about 16 months under the full-adherence estimate1. About 60% lost 20% or more. Crucially, CagriSema beat semaglutide alone (~16%) in the *same* trial — evidence the amylin partner genuinely adds something.
How it compares with tirzepatide
This is the question everyone asks. CagriSema's ~22.7% sits close to the ~20-21% tirzepatide reached in its separate SURMOUNT-1 trial. But those are different trials, different participants, measured different ways — so the numbers cannot be lined up head-to-head. No direct CagriSema-vs-tirzepatide trial had settled the question as of 2026. The honest summary: CagriSema is in the same top tier, not clearly ahead.
In plain terms: same ballpark as tirzepatide, but no referee has called the match.
Practical notes and handling
CagriSema was studied as a subcutaneous once-weekly injection combining both peptides, with doses raised gradually — the standard approach to reduce early nausea. This describes the trials for education only, not how to use anything. The most common reported side effects were gastrointestinal (nausea, vomiting, diarrhoea), consistent with both drug classes.
Honest limitations
The key line: CagriSema is not yet a broadly approved medicine. As of 2026 the REDEFINE program supports its regulatory filings, but it was still investigational for general use. One nuance from the trials: an earlier company study (REDEFINE-related readouts) came in below the most optimistic expectations, a reminder that combination drugs do not always add up as neatly as hoped. This page explains what it is and what the trials showed — not how to use it — and takes no position on sourcing.
Latest research
- REDEFINE 1 (2025) is the anchor: ~22.7% weight loss at 68 weeks under the full-adherence estimate, beating semaglutide alone in the same trial and confirming the amylin partner adds real effect1.
- REDEFINE 2 (2025) extended the evidence to people with type 2 diabetes, a group in whom weight loss is usually harder to achieve2.
- Regulatory filings are in progress. The open questions are long-term safety, how it performs against tirzepatide directly, and real-world tolerability. We update this section as approvals or head-to-head data report.
The short version
CagriSema is a combination of cagrilintide (an amylin drug) and semaglutide (a GLP-1 drug) in one weekly injection, pairing two appetite pathways. In the phase-3 REDEFINE 1 trial it produced about 22.7% weight loss, beating semaglutide alone and landing near tirzepatide's numbers — though no direct comparison exists. It is investigational. Educational overview only, not medical advice.