# Cagrilintide vs semaglutide

- Canonical: https://residue.info/vs/cagrilintide-vs-semaglutide/
- Compounds: Cagrilintide (https://residue.info/c/cagrilintide/), Semaglutide (https://residue.info/c/semaglutide/)
- Updated: 2026-10-19 · Reviewed by: Residue Editorial Team

Cagrilintide is an investigational long-acting amylin analog; semaglutide is an FDA-approved GLP-1 receptor agonist [1]. Studied together as CagriSema in REDEFINE 1, the combination reduced weight by 20.4% versus 3.0% with placebo at 68 weeks [2]. Alone, cagrilintide reduced weight by 6.0–10.8% in phase 2 [3]; semaglutide 2.4 mg alone reduced it by 14.9% in STEP 1 [4].

## Side by side
| | Cagrilintide | Semaglutide |
|---|---|---|
| Mechanism | Long-acting amylin receptor agonist [3] | GLP-1 receptor agonist [5] |
| FDA status | Investigational; no Drugs@FDA application | Approved [6][7] |
| Half-life | 159–195 hours [8] | About 7 days [9] |
| Weight, alone | −6.0% to −10.8% vs −3.0% (phase 2, 26 wk) [3] | −14.9% vs −2.4% (STEP 1, 68 wk) [4] |
| Combined (CagriSema) | REDEFINE 1: −20.4% vs −3.0% [2] | REDEFINE 2 (T2D): −13.7% vs −3.4% [10] |
| Interaction | Did not alter semaglutide exposure [8] | — |
| Evidence grade | B | A |

## Which hormone systems do they act on?

Semaglutide mimics GLP-1, an incretin hormone [11]. Cagrilintide is a long-acting analog of amylin, a different satiety-related hormone [3]. Because they act on separate receptor systems, they were developed as a fixed combination. In the phase 1b study that first paired them, cagrilintide's half-life was 159–195 hours and it did not change semaglutide exposure [8].

## What did each drug do alone?

In a phase 2 trial with 706 participants randomized to cagrilintide, weight fell 6.0–10.8% across doses of 0.3–4.5 mg versus 3.0% with placebo, with nausea in 20–47% versus 18%; the 4.5 mg dose outperformed the active comparator liraglutide 3.0 mg (10.8% vs 9.0%) [3]. Semaglutide 2.4 mg produced −14.9% versus −2.4% in STEP 1 at 68 weeks [4]. These were separate trials of different durations, so they do not rank the two.

## What did the CagriSema combination do?

REDEFINE 1 randomized 3,417 adults with overweight or obesity; the combination produced −20.4% versus −3.0% with placebo at 68 weeks [2]. Participants were randomized 21:3:3:7, so the trial also included 302 people on cagrilintide 2.4 mg alone and 302 on semaglutide 2.4 mg alone — the closest thing to a direct comparison of the two molecules. The abstract reports only the combination-versus-placebo result, so we do not quote the single-agent figures here. REDEFINE 2, in 1,206 adults with type 2 diabetes, found −13.7% versus −3.4%, and 73.5% reached HbA1c ≤6.5% versus 15.9% [10].

## How do their safety records compare?

Gastrointestinal adverse events affected 79.6% on cagrilintide–semaglutide versus 39.9% on placebo in REDEFINE 1, mostly transient and mild to moderate [2]. Semaglutide alone in STEP 1 most commonly caused nausea and diarrhea, with 4.5% discontinuing for gastrointestinal events [4].

## Are they FDA-approved?

Semaglutide is FDA-approved in injectable and oral forms [6][7][12]. Cagrilintide, alone or in combination, had no Drugs@FDA application at our fetch.

## Can you take cagrilintide and semaglutide together?

That combination is CagriSema. In REDEFINE 1 (3,417 adults with overweight or obesity) it reduced weight by 20.4% versus 3.0% with placebo at 68 weeks [2]. Cagrilintide alone is not FDA-approved; semaglutide is [6][7].

## Frequently asked questions
**What is CagriSema?**
A once-weekly combination of cagrilintide and semaglutide 2.4 mg. In REDEFINE 1 (3,417 adults with overweight or obesity) it reduced weight by 20.4% versus 3.0% with placebo at 68 weeks [2].

**Is cagrilintide approved?**
No. Drugs@FDA listed no cagrilintide application at our fetch. Semaglutide is approved as Ozempic, Rybelsus and Wegovy [6][7].

**Do they have the same side effects?**
Gastrointestinal events are prominent with both. In REDEFINE 1, 79.6% on the combination reported gastrointestinal adverse events versus 39.9% on placebo, mainly transient and mild to moderate [2].

**Can you take cagrilintide and semaglutide together?**
Yes, that combination is CagriSema. In REDEFINE 1 it reduced weight by 20.4% versus 3.0% with placebo at 68 weeks [2]. Cagrilintide alone is not FDA-approved; semaglutide is [6][7].

**Is cagrilintide better than semaglutide for weight loss?**
Alone, phase 2 cagrilintide reduced weight by 6.0–10.8% [3], less than semaglutide 2.4 mg in STEP 1 (−14.9%) [4]. Combined as CagriSema the reduction was larger than either alone in REDEFINE 1 [2].


## Sources
[1] WEGOVY prescribing information: Indications and Usage. FDA-approved labeling via openFDA/DailyMed, version effective 2024-04-23. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=f5e548d0-cc79-4c34-a3f5-e20a5b8b6564
[2] Coadministered Cagrilintide and Semaglutide in Adults with Overweight or Obesity. Garvey WT et al. N Engl J Med. 2025. https://pubmed.ncbi.nlm.nih.gov/40544433/
[3] 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. Lau DCW et al. Lancet. 2021. https://pubmed.ncbi.nlm.nih.gov/34798060/
[4] Once-Weekly Semaglutide in Adults with Overweight or Obesity. Wilding JPH et al. N Engl J Med. 2021. https://pubmed.ncbi.nlm.nih.gov/33567185/
[5] OZEMPIC prescribing information: Indications and Usage. FDA-approved labeling via openFDA/DailyMed, version effective 2026-07-30. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=42bdd912-2393-44c4-b7e0-47672ca28991
[6] Drugs@FDA: OZEMPIC (NDA209637). NOVO; original approval 2017-12-05; Prescription, Discontinued. https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=209637
[7] Drugs@FDA: WEGOVY, WEGOVY HD, WEGOVY FLEXTOUCH (NDA215256). NOVO; original approval 2021-06-04; Prescription. https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=215256
[8] 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. Enebo LB et al. Lancet. 2021. https://pubmed.ncbi.nlm.nih.gov/33894838/
[9] Pharmacokinetics and Clinical Implications of Semaglutide: A New Glucagon-Like Peptide (GLP)-1 Receptor Agonist. Hall S et al. Clin Pharmacokinet. 2018. https://pubmed.ncbi.nlm.nih.gov/29915923/
[10] Cagrilintide-Semaglutide in Adults with Overweight or Obesity and Type 2 Diabetes. Davies MJ et al. N Engl J Med. 2025. https://pubmed.ncbi.nlm.nih.gov/40544432/
[11] Absorption, metabolism and excretion of the GLP-1 analogue semaglutide in humans and nonclinical species. Jensen L et al. Eur J Pharm Sci. 2017. https://pubmed.ncbi.nlm.nih.gov/28323117/
[12] Drugs@FDA: OZEMPIC, RYBELSUS (NDA213051). NOVO; original approval 2019-09-20; Prescription. https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=213051

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