What it is
CagriSema combines cagrilintide and semaglutide in a single weekly injection for additive satiety and weight-loss effects. The combo has human evidence, but product handling and use are study-specific.
Evidence boundary
Human evidence exists, but approval and studied indication are compound-specific. Research-vial handling is not equivalent to a licensed product label.
Trial evidence
- PMID 42207966 — Comparative Effectiveness of CagriSegma, Semaglutide, Cagrilintide and Tirzepatide in the Management of Overweight and Obesity: A Network Meta-Analysis of Randomized Clinical Trials.
- PMID 41759565 — CagriSema Versus Semaglutide Monotherapy or Placebo for Obesity: A Systematic Review and Meta-Analysis of Randomized Controlled Trials with GRADE Assessment.
- PMID 42452898 — Amylin Analogs: The Next Major Class of Weight Loss Therapy: A Review of Experimental Data and Early-Phase Clinical Trials.
Preparation and measurement
Reconstitution: 5 mg vial + 2 mL BAC = 2.5 mg/mL.
Concentration matches.
Reference schedule
| Phase | Dose | Draw / measure | Frequency | Weekly total |
|---|---|---|---|---|
| Weeks 1–4 | 500 mcg | 20 U (0.2 mL) | Once weekly | 500 mcg/week |
| Weeks 5–8 | 1 mg | 40 U (0.4 mL) | Once weekly | 1 mg/week |
| Weeks 9+ (maintenance) | 2.4 mg | 96 U (0.96 mL) | Once weekly | 2.4 mg/week |
Weeks 1–4
- Dose
- 500 mcg
- Draw / measure
- 20 U (0.2 mL)
- Frequency
- Once weekly
- Weekly total
- 500 mcg/week
Weeks 5–8
- Dose
- 1 mg
- Draw / measure
- 40 U (0.4 mL)
- Frequency
- Once weekly
- Weekly total
- 1 mg/week
Weeks 9+ (maintenance)
- Dose
- 2.4 mg
- Draw / measure
- 96 U (0.96 mL)
- Frequency
- Once weekly
- Weekly total
- 2.4 mg/week
Weekly totals apply only during the active phase.
Titration rules
- Combined titration — both components escalate together:
- Weeks 1–4: 0.50 mg combined (each component at 0.25 mg).
- Weeks 5–8: 1.00 mg combined.
- Weeks 9+ (maintenance): 2.40 mg combined. Phase 2 maintenance.
- GI burden: Combined nausea/vomiting can be greater than either component alone during titration. An alternative schedule adds antiemetic support (ginger, ondansetron PRN) for the first 2–4 weeks.
- Once-weekly dosing; same day each week; half-life ~7 days.
Cycle length and breaks
Use only the defined schedule window and reassess before extending it.
What to monitor
- Weight-loss response
- Nausea, vomiting, and diarrhea during titration
- Decreased appetite
- Fluid intake and protein intake
- Injection-site reactions
Practical rules
- Hydrate well.
- Prioritize protein.
- Use smaller meals if GI effects build.
- Rotate sites weekly.