What cagrilintide does, and what the trials have shown so far

Cagrilintide is a long-acting amylin analog, and it is being developed in two ways: alone for weight management, and as the fixed-dose combination with semaglutide known as CagriSema. Its published human data come mostly from short early-phase studies and from combination trials, so the case for cagrilintide by itself rests on less evidence than the case for the GLP-1 drugs. This profile covers what the molecule is, how long it persists in the body, and what the trials do and do not show.

What is cagrilintide?

Amylin is a hormone released by the pancreas alongside insulin. Alhazmi and le Roux's 2026 narrative review describes its actions as slowing gastric emptying, suppressing glucagon secretion and promoting meal termination through central mechanisms. Cagrilintide is one of the long-acting amylin-based agents that the review covers. Pramlintide, the first approved amylin analog, established the principle but was limited by modest efficacy and frequent dosing. For a side-by-side look at how amylin and GLP-1 differ, see our amylin and GLP-1 comparison.

How long does cagrilintide stay in the body?

The most informative pharmacokinetic data we found come from a randomized, placebo-controlled, phase 1b trial by Enebo and colleagues in The Lancet (2021). It enrolled adults aged 18 to 55 with a BMI between 27.0 and 39.9 kg/m² at a single US centre. Of 96 randomized participants, 95 received at least one dose, with cagrilintide combined with semaglutide. Cagrilintide had a half-life of 159 to 195 hours and a median time to peak concentration of 24 to 72 hours. Exposure rose in proportion to the cagrilintide dose and did not change semaglutide exposure.

A half-life of that length means plasma levels fall by half roughly every six to eight days. The trial dosed once weekly. The sources we opened cover only short treatment periods, so they say nothing about what happens to the drug over years of use.

Does kidney or liver function change exposure?

Nielsen and colleagues addressed that question in 2026, in two single-dose studies. The renal study included 33 participants and the hepatic study 32, each split into normal function and mild, moderate or severe impairment. Compared with normal function, the ratio of mean total exposure in renal impairment ranged from 1.18 to 1.23, with 90% confidence intervals from 0.87 to 1.68. In hepatic impairment the ratios ran from 0.99 to 1.11. Every confidence interval included 1. The authors found no clinically relevant difference and no increase in adverse events with worsening impairment. The groups were small, and the authors say so.

What do the weight-loss data show?

The 2024 meta-analysis by Dutta and colleagues pooled three randomized trials of cagrilintide alone or with semaglutide, covering 430 people. Against semaglutide or liraglutide, cagrilintide alone showed weight loss that was similar at 26 to 32 weeks, and its adverse events were comparable overall, with vomiting lower. Two cautions apply. The heterogeneity was very high, and the abstract reports a confidence interval that excludes zero alongside a p-value above 0.05, so the precision of the pooled estimate is unclear. The result should be read as directional rather than settled.

A 2026 network meta-analysis by Kamrul-Hasan and colleagues compared long-acting amylin-based therapies in six trials with 4,642 participants, running 12 to 68 weeks. The authors rank high-dose amycretin, eloralintide and CagriSema as producing the largest weight reductions against placebo. They also report more gastrointestinal adverse events with those high-dose arms, and more discontinuations only with high-dose CagriSema. The authors call their findings preliminary, given sparse and low-certainty data.

Where the evidence is thin

• Most of the human data are phase 1 safety and pharmacokinetic studies, or combination trials in which cagrilintide cannot be separated from semaglutide.
• The 2021 trial enrolled otherwise healthy adults without a lifestyle intervention, which limits what it says about people with diabetes or with a long history of weight regain.
• The gastrointestinal burden is real. In the phase 1b trial, 207 of 566 adverse events were gastrointestinal disorders.
• The head-to-head comparisons with semaglutide and liraglutide come from short trials, and the pooled estimates have very high heterogeneity.

What is the regulatory status?

The 2026 pharmacokinetics paper describes cagrilintide as under development, both alone and in combination with semaglutide. On December 18, 2025, Novo Nordisk announced that it had submitted a New Drug Application to the FDA for once-weekly CagriSema, the cagrilintide and semaglutide combination. None of the sources we opened, checked on October 7, 2026, reports an approval, and we did not find a filing for cagrilintide on its own. Check the FDA's website and the sponsor's announcements for the current position before assuming any product is available.

Bottom line

Cagrilintide is a long-acting amylin analog with a half-life of about seven days in the 2021 phase 1b trial, and its exposure looks similar in kidney and liver impairment in small single-dose studies. Its gastrointestinal effects are common, and its monotherapy weight-loss evidence is limited to short, heterogeneous trials. Most of the stronger data come from the combination with semaglutide, covered in our CagriSema trial article. Research-grade material is not an approved product. Anyone seeking treatment for weight should speak to a physician about approved options.