What is the cagrilintide starting dose?

There is no approved starting dose. In the phase 2 dose-finding trial, the protocol started the 0.3 mg and 0.6 mg groups at their target dose and started every higher group at 0.6 mg, stepping up every other week to 1.2, 2.4 and then 4.5 mg. In the phase 1b CagriSema trial, cagrilintide and semaglutide were co-escalated every 4 weeks over 16 weeks. Those were supervised trial designs, not instructions for a retail vial.

Is there a cagrilintide dosing chart?

Only a chart of trial protocols, which is the table above. Doses studied alone were 0.3–4.5 mg once weekly for 26 weeks. Phase 3 used 2.4 mg once weekly, reached after a 16-week escalation, either alone or with semaglutide 2.4 mg. No regulator has approved any cagrilintide schedule.

How much weight did people lose on cagrilintide alone?

In phase 2, mean weight loss at 26 weeks was 6.0% to 10.8% across doses of 0.3 to 4.5 mg, against 3.0% on placebo. In REDEFINE 1, cagrilintide 2.4 mg alone produced 11.5% weight loss at 68 weeks under the treatment-policy estimand (11.8% assuming full adherence), against 14.9% for semaglutide 2.4 mg alone and 20.4% for the combination.

How many units is 1 mg of cagrilintide in a 5 mg vial?

It depends on how much water you add. 5 mg in 2 mL is 2.5 mg/mL, so 1 mg is 0.4 mL, or 40 units on a U-100 syringe. With 1 mL it is 5 mg/mL and 20 units. The 1 mg figure is an arithmetic example here, not a dose.

What is cagrilintide's half-life?

About a week. The phase 1b trial measured 159 to 195 hours across doses, roughly 6.6 to 8.1 days, and that is what supports once-weekly dosing in the trials. With a half-life that long, the drug takes several weeks to clear after the last injection.

Cagrilintide Dosing Chart and Vial Calculator

Investigational long-acting amylin analogue from Novo Nordisk, studied alone and in CagriSema with semaglutide. CagriSema is under FDA review; nothing containing cagrilintide is approved anywhere.

Written by Kashif Khan, who builds and maintains this site and is not a clinician. Every figure links to its primary source.

Not approved

Investigational — not approved in any country

Cagrilintide has no approval from any regulator, alone or in combination. Novo Nordisk filed a New Drug Application with the FDA in December 2025 for CagriSema — cagrilintide 2.4 mg with semaglutide 2.4 mg in one weekly injection — and has said it expects a decision by late 2026; a pending application is not an approval, and it would cover that fixed combination only. The FDA states that cagrilintide cannot be used in compounding under federal law, and in March 2026 it issued a warning letter to a seller offering cagrilintide as a research-use-only product.

No approved human dose exists for this compound in any country. The figures below are the doses used in named published studies, reproduced for reference only. Doses given to rats or mice do not convert to a human dose. The FDA has stated that labelling a product “research use only” or “not for human consumption” does not change its legal status when the seller's own marketing shows it is intended for people.

Anti-doping: Prohibited at all times. Falls under WADA class S0 (non-approved substances) by definition, because no regulator has approved it for human therapeutic use.

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The 1 mg default is an arithmetic example for the calculator, not a studied or recommended dose

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No approved human dose exists for this compound. The dose shown is only a calculator input, not a recommendation or starting point.

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40units(0.4 mL)

Concentration: 2.5 mg/mL
Water added: 2 mL
Doses in vial: 5

How the concentration is calculated

This divides the peptide by the water you add. The powder occupies a little volume of its own, which is negligible on a typical vial but not on one with a heavy bulking agent. When a product label states a concentration, use the label’s number.

Key facts

Molecular weight: 4,409 DaPubChem CID 171397054, formula C194H312N54O59S2. A lipidated peptide, so salt forms and counter-ions on a retail vial are not accounted for.
Half-life: About 7–8 days (159–195 hours across doses in the phase 1b trial)
Also sold as: NNC0174-0833, cagri, CagriSema component, long-acting amylin analogue

Doses used in published studies

These are reproduced for reference. They are not recommendations, and an animal dose in mg/kg does not convert to a human dose.

humansubcutaneous, once weekly for 26 weeks

0.3, 0.6, 1.2, 2.4 or 4.5 mg. Per the trial protocol, the 0.3 mg and 0.6 mg groups started at their target dose; the higher groups started at 0.6 mg and stepped up every other week (1.2 mg at week 2, 2.4 mg at week 4, 4.5 mg at week 6), within a dose-escalation period of up to 6 weeks.

Lau et al., phase 2 dose-finding trial NCT03856047, published in The Lancet in 2021; 706 adults without diabetes randomised to cagrilintide, with liraglutide 3.0 mg and placebo comparators. Mean weight loss at 26 weeks was 6.0% to 10.8% across cagrilintide doses against 3.0% on placebo, and 10.8% at 4.5 mg against 9.0% on liraglutide 3.0 mg.

humansubcutaneous, once weekly, co-administered with semaglutide 2.4 mg

Target cagrilintide doses of 0.16, 0.30, 0.60, 1.2, 2.4 or 4.5 mg, co-escalated with semaglutide in 4-week intervals over 16 weeks, then 4 weeks at the target dose.

Enebo et al., phase 1b trial NCT03600480, published in The Lancet in 2021; 96 otherwise-healthy adults with a BMI of 27–39.9. At week 20, weight fell 15.7% with cagrilintide 1.2 mg and 17.1% with 2.4 mg, against 9.8% for pooled placebo (all groups also on semaglutide 2.4 mg). Measured half-life of cagrilintide was 159–195 hours.

humansubcutaneous, once weekly for 68 weeks

Cagrilintide 2.4 mg with semaglutide 2.4 mg (CagriSema), either component alone, or placebo, each reached after a 16-week dose-escalation period. The protocol was flexible and allowed participants to modify their dose; at week 68, 57.3% of the CagriSema group and 82.5% of the cagrilintide-alone group were on the highest dose.

REDEFINE 1, NCT05567796, published in the New England Journal of Medicine in 2025; 3,417 adults with obesity or overweight without diabetes (302 on cagrilintide alone). Treatment-policy weight change at 68 weeks: −20.4% with CagriSema, −14.9% with semaglutide alone, −11.5% with cagrilintide alone and −3.0% with placebo. Assuming full adherence, the figures were 22.7%, 16.1% and 11.8%.

humansubcutaneous, once weekly for 68 weeks

Cagrilintide 2.4 mg with semaglutide 2.4 mg (CagriSema), or placebo.

REDEFINE 2, NCT05394519, published in the New England Journal of Medicine in 2025; 1,206 adults with type 2 diabetes and a BMI of 27 or more. Mean weight change at 68 weeks was −13.7% with CagriSema against −3.4% with placebo, and 73.5% reached an HbA1c of 6.5% or less against 15.9%.

How good is the evidence?

Substantial and recent for the combination — two phase 3 NEJM trials of CagriSema with 3,417 and 1,206 participants, plus a head-to-head phase 3 against tirzepatide — but thinner for cagrilintide on its own: a 26-week phase 2 dose-finding trial and a 302-person monotherapy arm inside REDEFINE 1. None of it concerns retail vials, whose identity and purity are unverified.

Cagrilintide dosing chart: what the trials actually did

The only trial that tested cagrilintide on its own across a range of doses is the phase 2 study published by Lau and colleagues in The Lancet in 2021: 706 adults on 0.3, 0.6, 1.2, 2.4 or 4.5 mg once weekly for 26 weeks. The trial protocol set the starting point. The 0.3 mg and 0.6 mg groups began at their target dose; every higher group began at 0.6 mg and stepped up every other week, reaching 4.5 mg at week 6. Mean weight loss ran from 6.0% at the lowest dose to 10.8% at 4.5 mg, against 3.0% on placebo.

The dose carried into phase 3 was 2.4 mg, not 4.5 mg. In REDEFINE 1, the 302 people on cagrilintide alone lost 11.5% of body weight at 68 weeks under the treatment-policy estimand, against 14.9% on semaglutide alone and 20.4% on the combination. So when a “cagrilintide starting dose” of 0.6 mg or a 2.4 mg “maintenance dose” is quoted, it comes from one of these protocols, run under medical supervision. No regulator has approved a cagrilintide schedule, and this site publishes none.

CagriSema is not cagrilintide

Almost all of the large-trial evidence is for CagriSema, a fixed combination of cagrilintide 2.4 mg and semaglutide 2.4 mg. Novo Nordisk filed it with the FDA in December 2025. In REDEFINE 4, an open-label 84-week trial in 809 people, CagriSema produced 20.2% weight loss against 23.6% for tirzepatide 15 mg under the treatment-regimen estimand, and it failed its primary endpoint of non-inferiority to tirzepatide.

An FDA decision on CagriSema, whichever way it goes, would concern that pen and that combination. It would not approve cagrilintide as a stand-alone drug, and it would not change the status of vials sold online as cagrilintide. The FDA has said that cagrilintide cannot be used in compounding under federal law, that it is not a component of any FDA-approved drug, and that it has not been found safe and effective for any condition.

Why a research-use-only label does not help

In March 2026 the FDA warned Prime Sciences, a seller offering cagrilintide alongside retatrutide, semaglutide, tirzepatide, mazdutide and bacteriostatic water. The product pages carried “laboratory research purposes only” and “not for human consumption” statements. The agency found that the website's own claims about weight loss and glucose control showed the products were intended for people, which makes them unapproved new drugs whatever the label says.

Common questions

Sources

Every number on this page comes from one of the documents below. Where no reliable source exists, the page says so instead of filling the gap.

Published studyThe Lancet· 2021-12-11
Lau DCW et al. Once-weekly cagrilintide for weight management in people with overweight and obesity: a multicentre, randomised, double-blind, placebo-controlled and active-controlled, dose-finding phase 2 trial
ReferenceNovo Nordisk / ClinicalTrials.gov· 2018-10-02
NCT03856047 (NN9838-4433) — cagrilintide phase 2 clinical trial protocol, version 2.0
Published studyThe Lancet· 2021-05-08
Enebo LB et al. Safety, tolerability, pharmacokinetics, and pharmacodynamics of concomitant administration of multiple doses of cagrilintide with semaglutide 2·4 mg for weight management: a randomised, controlled, phase 1b trial
Published studyNew England Journal of Medicine· 2025-08-14
Garvey WT et al. Coadministered Cagrilintide and Semaglutide in Adults with Overweight or Obesity (REDEFINE 1)
ReferenceClinicalTrials.gov
NCT05567796 — REDEFINE 1 phase 3 trial of CagriSema, cagrilintide and semaglutide in obesity
ReferenceNovo Nordisk A/S· 2024-12-20
CagriSema demonstrates superior weight loss in adults with obesity or overweight in the REDEFINE 1 trial
Published studyNew England Journal of Medicine· 2025-08-14
Davies MJ et al. Cagrilintide–Semaglutide in Adults with Overweight or Obesity and Type 2 Diabetes (REDEFINE 2)
ReferenceNovo Nordisk A/S· 2026-02-23
CagriSema demonstrated 23% weight loss in an open-label head-to-head REDEFINE 4 trial in people with obesity, the primary endpoint was not achieved
ReferenceNovo Nordisk· 2025-12-18
Novo Nordisk files for FDA approval of CagriSema, the first once-weekly combination of GLP-1 and amylin analogues for weight management
RegulatorFDA· 2026-09-01
FDA's Concerns with Unapproved GLP-1 Drugs Used for Weight Loss
RegulatorFDA· 2026-03-31
Warning Letter — Prime Sciences (cagrilintide sold as a research-use-only product)
RegulatorWorld Anti-Doping Agency· 2026
WADA 2026 Prohibited List
ReferenceNIH / National Center for Biotechnology Information
PubChem compound records (molecular weights and formulae)