Cagrilintide Dosage: What the Trials Used

Key takeaways

• Cagrilintide has no approved dose. The trials gave it once a week under the skin: 0.3 to 4.5 mg on its own, and 2.4 mg with semaglutide 2.4 mg as CagriSema, the dose Novo Nordisk submitted to FDA.
• CagriSema was escalated over 16 weeks. The posted phase 2 schedule raised both drugs every four weeks: 0.25, 0.5, 1.0 and 1.7 mg, then 2.4 mg from week 17.
• More cagrilintide bought less than you might expect: alone, 4.5 mg removed about 10.8% of body weight in 26 weeks against 9.5% at 2.4 mg, with nausea rising to 47%. In REDEFINE 1 only 57.3% of the CagriSema group were on the full dose at 68 weeks.
• Lower CagriSema doses (1.0 mg/1.0 mg) produced about 21% weight loss at 68 weeks in a company-reported trial. That is a studied dose, not a microdosing protocol.
• We give no reconstitution example and no units table: no legal cagrilintide product exists, and seller dosing charts are claims, not doses.

The direct answer: there is no cagrilintide dose to prescribe, because cagrilintide is not approved. What exists are the doses Novo Nordisk's trials used: 0.3 to 4.5 mg once weekly on its own, and 2.4 mg combined with semaglutide 2.4 mg in CagriSema after a 16-week climb. Our cagrilintide and CagriSema hub covers what the drug is and where FDA review stands, and CagriSema vs tirzepatide compares its trial results with the approved alternative.

The studied doses

Two patterns stand out. Apart from the lowest fixed doses, every trial stepped the dose up rather than starting at the target, the way approved GLP-1 and amylin drugs are started to limit nausea. And every result above comes with the trials' screening, verified trial supply and clinical follow-up attached.

The CagriSema escalation schedule used in trials

This is the schedule posted on ClinicalTrials.gov for the phase 2 type 2 diabetes trial (NCT04982575 results). The semaglutide steps are the same as the Wegovy label's, set out in our semaglutide dosage chart. The phase 3 registries describe the same 16-week escalation but do not list every step.

In REDEFINE 1 the protocol let investigators hold people at a lower dose when they judged it best. At week 68, 57.3% of the CagriSema group were on the highest dose, against 82.5% of the cagrilintide-only group and 70.2% of the semaglutide-only group (HCPLive, December 2024). Put plainly, the famous 20% result came from a group in which more than four in ten people were not on the full dose at the end.

Dose and response: what a higher dose bought

The phase 2 trial is the only one that tested cagrilintide alone across a range of doses. Its posted registry results show the trade-off directly (NCT03856047 results):

These are the observed means posted on the registry; the published trial-product estimates are 6.0% to 10.8% (Lau 2021). Going from 2.4 to 4.5 mg added about a point of weight loss and roughly half again as much nausea. With semaglutide on board, the curve was flatter still: in the phase 1b trial, 1.2 mg, 2.4 mg and 4.5 mg of cagrilintide gave similar results (Enebo 2021). Novo took 2.4 mg into phase 3, and its newer trials test lower combinations: in early type 2 diabetes, 1.0 mg/1.0 mg gave 11.8% weight loss against 13.8% at the full dose (Aroda 2026). A higher-dose CagriSema is in phase 3, with results expected in 2028 (Novo Nordisk 2026).

The charts sellers circulate

These are claims, not doses. A schedule copied correctly from a trial still lacks everything else the trial had, and FDA's March 31, 2026 warning letters to research-peptide websites included a seller of cagrilintide; dosing guides and reconstitution help were part of the evidence that the vials were drugs for people, as our legal tracker records.

Why there is no reconstitution example

People searching for a cagrilintide dosage usually want the next step too: how much bacteriostatic water to add and how many units to draw. We do not give that, for three reasons.

• There is no legal product to reconstitute. Cagrilintide is not approved, and no 503A pharmacy or 503B facility may compound it, because it is not part of an approved drug, has no USP monograph and is not on FDA's bulks list.
• The arithmetic would describe an unknown. Reconstitution math assumes the vial holds what its label says, and nobody has checked a research vial. Even the mechanics go wrong: when 20 adults were handed grey-market semaglutide vials and supplies and left to follow online information, they completed 15 of 34 steps correctly on average (44%), with errors that could cause wrong doses, needle sticks or infections (Sedensky 2026).
• Mixing help is what FDA cites. Reconstitution calculators and bundled bacteriostatic water are the evidence FDA uses to show a research vial is a drug for people.

Our peptide calculator and the explainer on how many units are in 1 mL exist for medications a pharmacy has dispensed with a labeled concentration. Cagrilintide has neither.

Microdosing and lower doses

The lowest cagrilintide dose ever given in a trial was 0.16 mg, alongside full-dose semaglutide, in a 20-week safety study; the lowest given alone was 0.3 mg, which produced about 6% weight loss in 26 weeks. No trial has tested a microdosing schedule. The lower CagriSema doses now in trials, 1.0 mg/1.0 mg and 1.7 mg/1.7 mg, are fixed doses with clinical follow-up, not microdoses. The general case is in our GLP-1 microdosing guide.

Bottom line

A truthful cagrilintide dosage chart has no prescribing row. Above it sit trial doses: 0.3 to 4.5 mg alone, 2.4 mg with semaglutide 2.4 mg after a 16-week climb, and lower 1.0 and 1.7 mg combinations, all given once weekly with screening and follow-up. Below it sit seller charts that copy those numbers onto vials nobody has verified. If FDA approves CagriSema, its label will set the dose; until then, the approved GLP-1 drugs have labels, pens and doses you can actually follow.

Frequently asked questions

+−What is the cagrilintide dosage?

There is no approved dose, because cagrilintide is not approved. The trials used weekly injections under the skin: 0.3 to 4.5 mg on its own in a 26-week phase 2 trial, 2.4 mg in the phase 3 trials, and 1.0 or 1.7 mg in lower-dose CagriSema trials. Those are studied doses, not a protocol, and none of them applies to a vial bought online.

+−What dose of cagrilintide is used with semaglutide in CagriSema?

The dose Novo Nordisk submitted to FDA is cagrilintide 2.4 mg plus semaglutide 2.4 mg once weekly, reached after a 16-week escalation. Lower combinations of 1.0 mg/1.0 mg and 1.7 mg/1.7 mg have been tested in later trials. In REDEFINE 1, only 57.3% of the CagriSema group were on the full dose at 68 weeks, because the protocol let investigators keep people on lower doses.

+−How is CagriSema dose escalated?

In the phase 2 trial whose schedule is posted on ClinicalTrials.gov, both drugs started at 0.25 mg once weekly and rose every four weeks through 0.5, 1.0 and 1.7 mg to 2.4 mg from week 17, the same steps as Wegovy's semaglutide schedule. The phase 3 registries describe the same 16-week escalation length. This is a trial schedule, not a protocol to follow.

+−What is the highest dose of cagrilintide studied?

4.5 mg once weekly. It was the top dose in the phase 2 dose-finding trial, where it produced 10.8% weight loss at 26 weeks against 3.0% on placebo with nausea in 47%, and in the phase 1b trial with semaglutide, where it did no better than 1.2 or 2.4 mg. Novo chose 2.4 mg for phase 3.

+−Is there a cagrilintide dosage chart for research vials?

Sellers circulate them, but they are claims. Most copy the trial escalation from 0.25 mg to 2.4 mg and add mixing instructions for 5 mg, 10 mg or premixed vials. No trial used those vials, nobody has verified what is in them, and FDA treats research-labeled cagrilintide sold with dosing guidance as an unapproved drug.

+−How much bacteriostatic water do I mix with cagrilintide?

We do not give that figure. Reconstitution math is for a medication a pharmacy has dispensed with a labeled concentration, and no cagrilintide product can legally be dispensed in the US. A research vial's contents are unverified, so a precise volume would be precise about an unknown amount, and reconstitution help is part of what FDA cited in its 2026 warning letters.

+−Does a lower dose of CagriSema work?

Yes, in trials. CagriSema 1.0 mg/1.0 mg produced about 21% weight loss at 68 weeks in REDEFINE 9 (efficacy estimand, company-reported), and 11.8% against 13.8% for the full dose over 40 weeks in early type 2 diabetes in REIMAGINE 1. Lower doses were studied as fixed trial doses with clinical follow-up, not as microdoses.

+−Can you microdose cagrilintide?

There is no evidence for it. The lowest dose ever given in a trial was 0.16 mg, alongside full-dose semaglutide, in a 20-week safety study, and the lowest dose given alone was 0.3 mg, which produced about 6% weight loss in 26 weeks. No trial has tested a cagrilintide microdosing schedule.

Sources

1. StudyLau 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. Lancet 2021;398:2160-72. (2021)
2. StudyClinicalTrials.gov. NCT03856047, phase 2 dose-finding trial of cagrilintide (NNC0174-0833) in overweight and obesity: posted results (escalation by arm, change in body weight, adverse events). (2021)
3. StudyEnebo 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. Lancet 2021;397:1736-48. (2021)
4. StudyFrias JP et al. Efficacy and safety of co-administered once-weekly cagrilintide 2.4 mg with once-weekly semaglutide 2.4 mg in type 2 diabetes: a multicentre, randomised, double-blind, active-controlled, phase 2 trial. Lancet 2023;402:720-30. (2023)
5. StudyClinicalTrials.gov. NCT04982575, phase 2 trial of cagrilintide 2.4 mg with semaglutide 2.4 mg in type 2 diabetes: posted results (dose escalation by week). (2023)
6. StudyGarvey WT et al. Coadministered cagrilintide and semaglutide in adults with overweight or obesity (REDEFINE 1). N Engl J Med 2025;393:635-47. (2025)
7. NewsHCPLive. CagriSema achieves 22.7% weight loss in phase 3 REDEFINE 1 trial (Novo Nordisk topline release: flexible dosing protocol; 57.3% on the highest dose at week 68). December 20, 2024. (2024)
8. StudyAroda VR et al. Efficacy and safety of once-weekly cagrilintide-semaglutide (CagriSema) in adults with type 2 diabetes inadequately controlled on diet and exercise (REIMAGINE 1): a randomised, double-blind, placebo-controlled, phase 3a study. Lancet Diabetes Endocrinol 2026;14:649-61. (2026)
9. SourceNovo Nordisk. Capital Markets Day 2026: obesity presentation (REDEFINE 9 lower-dose results; CagriSema high-dose readout expected in the first half of 2028). September 21, 2026. (2026)
10. StudySedensky A et al. Ability of adults to correctly use grey market peptide semaglutide GLP-1 receptor agonists acquired without a prescription. Public Health Rep 2026; published online August 1, 2026. (2026)