Cagrilintide dosage: what the trials used, and why there's no approved dose

Cagrilintide is a long-acting amylin analog that suppresses appetite, and it has produced real weight loss in clinical trials.^[1] But anyone searching for a cagrilintide dose runs into the same wall as with most peptides on this site: it is an investigational drug, not an approved one. There is no manufacturer label and no sanctioned consumer dose. What exists are the doses that trials used — under supervision, with monitoring — and that is a very different thing from a number you can act on at home. For what the drug actually does, see the CagriSema / cagrilintide evidence breakdown.

There is no approved dose

This is the load-bearing fact, so it goes first. Cagrilintide has not been approved by the FDA as a standalone weight-management drug. Its most advanced clinical use is as one half of a fixed-dose combination with semaglutide, and even that is still moving through the regulatory pipeline on the strength of the Phase 3 REDEFINE program.^[3] Because nothing has been approved, no regulator has signed off on a dose, a titration schedule, or a maximum. Every figure below describes a clinical trial, not a prescription.

The doses the trials used: 0.3 to 4.5 mg, once weekly

The clearest dosing picture comes from the Phase 2 dose-finding trial. Adults with overweight or obesity (without diabetes) were randomized to once-weekly subcutaneous self-injections of cagrilintide at 0.3, 0.6, 1.2, 2.4 or 4.5 mg, compared against liraglutide and placebo, over a 26-week treatment period.^[1] The drug is long-acting, which is why a single weekly injection was enough — one of its practical contrasts with shorter-acting peptides that have to be dosed more often. The weight loss was dose-dependent: across the dose range, mean reductions ran from about 6.0% to 10.8% of body weight, and the top 4.5 mg dose modestly outperformed liraglutide 3.0 mg.^[1]

Why it’s titrated: gastrointestinal tolerability

Cagrilintide was not started at its target dose. The Phase 2 trial built in a dose-escalation period of up to six weeks before participants reached their assigned dose.^[1] The reason is the same logic that governs the whole GLP-1/amylin class: gastrointestinal side effects — nausea, constipation, diarrhea — are common and dose-related. In the trial, the share of participants with GI adverse events rose with dose, reaching roughly 41% to 63% across the cagrilintide groups versus about 32% on placebo, with nausea the most frequent.^[1] Stepping the dose up slowly is how trials kept people on treatment. It is also a process designed to be managed by clinicians watching for problems, not improvised by the patient.

The CagriSema combination context

The dose most likely to reach the clinic isn’t loose cagrilintide at all — it’s cagrilintide inside the fixed-dose combination CagriSema, which pairs it with semaglutide in a single weekly injection. A Phase 1b study established that the two could be co-administered with a pharmacokinetic and tolerability profile that supported building a fixed-dose product.^[2] The Phase 3 REDEFINE trials then tested that combination in adults with overweight or obesity, with and without type 2 diabetes, producing substantial weight loss.^[3][4] The point for dosing is structural: in CagriSema, the cagrilintide amount is fixed by the manufacturer as part of a combination, not something a user dials in. There is no version of this where loose self-titration was the intended design.

What’s actually sold online

Because cagrilintide is generating headlines, it is showing up for sale as compounded or “research-grade” vials. None of that is an approved product. It has not cleared the quality controls that govern an approved drug, which means the dose on the label is not guaranteed to be the dose in the vial — the same problem that haunts every unregulated peptide we cover. That uncertainty sits underneath any milligram figure on this page and outweighs it. For the broader pattern, see where to get peptides safely.

The honest bottom line

If you reduce cagrilintide dosing to what the evidence supports: trials studied once-weekly subcutaneous doses from 0.3 to 4.5 mg, escalated slowly over weeks to manage gastrointestinal side effects, with weight loss rising across the dose range.^[1] But there is no FDA-approved standalone cagrilintide, no approved dose, and the doses that exist were delivered under supervision — or fixed inside the CagriSema combination, not self-dialed.^[2][3]Whether to use it, and at what dose, is a decision for a clinician working from the full dataset, not a figure lifted from a trial abstract or a vendor page.