Peptide profile
Cagrilintide: FDA Status, Research and Uses
Key takeaway
Cagrilintide is an experimental long-acting amylin analog. It is not part of any FDA-approved drug, and FDA says it cannot be used in compounding. It has been studied alone and with semaglutide, a mix called CagriSema, for weight loss and type 2 diabetes in phase 2 and phase 3 trials [1, 6, 7, 8].
At a glance
Where it stands
Checked
- FDA approvedNoNo approved product
- Pharmacy compounding (503A)Not nominatedNot listed in any 503A nomination category (list updated May 14, 2026). FDA states cagrilintide cannot be used in compounding under federal law and is not a component of an FDA-approved drug (page current Oct 1, 2026).
- Outsourcing facilities (503B)Not nominatedNot listed in FDA's 503B nomination categories (updated Mar 21, 2025). FDA says it cannot be used in compounding under federal law.
- WADA (sport)UnclearNot named on the 2026 or 2027 List. S0 (non-approved substances) may apply, since it covers substances no government has approved for human use. The 2027 List, in force January 1, 2027, adds peptides as an S0 example.
Same data as the Status Tracker. Checked against 8 sources
- FDA: Concerns with unapproved GLP-1 drugs used for weight loss
- FDA: Bulk drug substances nominated under section 503A (updated May 14, 2026)
- FDA: Bulk drug substances nominated under section 503B (updated Mar 21, 2025)
- FDA: Warning letter, cagrilintide products (Dec 10, 2024)
- WADA: 2026 Prohibited List
- openFDA Drugs@FDA query: cagrilintide (no matches)
- openFDA drug shortages query: cagrilintide
- DEA Diversion: Controlled Substances - Alphabetical Order
Key facts
- Class
- Long-acting amylin analog (investigational) [1, 3]
- Length
- Lipidated amylin analog built on the pramlintide backbone (residue count not stated in cited sources) [3, 4]
- Half-life
- About 159 to 195 hours (phase 1b study) [2]
- Route in studies
- Under the skin once weekly in studies [1]
How it works
Amylin is a hormone made by the pancreas. It helps people feel full after eating [1]. Natural amylin is hard to use as a drug because it tends to clump into amyloid fibrils. An older amylin drug, pramlintide, needs three injections a day because it lasts only a short time [3].
Cagrilintide was designed to fix both problems. It is a stable amylin analog with a fatty acid (lipid) attached, which makes it last much longer [3]. Researchers built it on the pramlintide backbone and changed a few building blocks [4]. A phase 1b study found a half-life of about 159 to 195 hours, which supports once-weekly dosing [2].
Cagrilintide binds to calcitonin receptors and amylin receptors. A 2025 structural study mapped how it attaches to these receptors [4]. Researchers have also tested cagrilintide together with semaglutide, a GLP-1 drug [6].
Because cagrilintide is still experimental, its effects come only from research studies. In the phase 2 trial, all doses lowered body weight more than placebo [1]. FDA says cagrilintide has not been found safe and effective for any condition [8].
What the research shows
5 human trials1 lab study
2025Human trial REDEFINE 1
Studied for weight loss
3,417 adults with obesity or overweight, without diabetes Phase 3a, randomized, double-blind, placebo and active controlled, 68 weeks; CagriSema, semaglutide alone, cagrilintide alone or placebo
Weight fell 20.4% with cagrilintide plus semaglutide vs 3.0% with placebo [6]
Read the study2025Human trial REDEFINE 2
1,206 adults with obesity or overweight and type 2 diabetes Phase 3a, randomized, double-blind, placebo-controlled, 68 weeks, cagrilintide 2.4 mg plus semaglutide 2.4 mg weekly
Weight fell 13.7% vs 3.4% with placebo [7]
Read the study2023Human trial Phase 2 trial in type 2 diabetes
92 adults with type 2 diabetes Phase 2, randomized, double-blind, active controlled, 32 weeks; CagriSema vs semaglutide vs cagrilintide, each 2.4 mg
Weight fell 15.6% with CagriSema, 5.1% with semaglutide and 8.1% with cagrilintide [5]
Read the study2021Human trial Phase 2 dose-finding trial
706 adults with obesity or overweight, without diabetes Phase 2, randomized, double-blind, placebo and liraglutide controlled, 26 weeks, 0.3 to 4.5 mg weekly
Weight fell 6.0% to 10.8% vs 3.0% with placebo; 4.5 mg exceeded liraglutide 3.0 mg (10.8% vs 9.0%) [1]
Read the study2021Human trial Phase 1b with semaglutide
96 adults with overweight or obesity, otherwise healthy Phase 1b, randomized, placebo-controlled, multiple ascending dose, with semaglutide 2.4 mg
Half-life 159 to 195 hours; most side effects were mild to moderate [2]
Read the study2021Lab study Development of cagrilintide
Lab and animal studies Medicinal chemistry and structure-activity studies
Selected as a stable, lipidated, long-acting amylin analog for clinical study [3]
Read the study
Doses used in studies
The phase 2 trial gave 0.3, 0.6, 1.2, 2.4 or 4.5 mg once weekly for 26 weeks [1]. The phase 1b study tested 0.16 mg to 4.5 mg once weekly, each given with semaglutide 2.4 mg [2].
The phase 3 REDEFINE trials used cagrilintide 2.4 mg plus semaglutide 2.4 mg once weekly for 68 weeks, and REDEFINE 1 also had a cagrilintide 2.4 mg alone group [6, 7]. There is no FDA-approved dose, because cagrilintide is not part of an approved drug [8].
Dosing is set by a licensed provider.
Side effects and safety
In the phase 2 trial, the most frequent side effects were stomach problems, such as nausea, constipation and diarrhea, and reactions at the injection site. Stomach side effects affected 41% to 63% on cagrilintide vs 32% on placebo, mostly nausea [1].
With cagrilintide plus semaglutide in REDEFINE 1, stomach side effects affected 79.6% vs 39.9% on placebo. They were mainly short-lived and mild to moderate [6]. In REDEFINE 2, the rate was 72.5% vs 34.4% [7].
FDA says cagrilintide cannot be used in compounding under federal law, is not a component of any FDA-approved drug, and has not been found safe and effective for any condition [8]. FDA has sent a warning letter to an online seller of cagrilintide products labeled for research, calling them unapproved new drugs [12].
Legal and regulatory history
FDA's GLP-1 concerns page states that cagrilintide cannot be used in compounding under federal law and is not a component of any FDA-approved drug [8]. Source
Cagrilintide does not appear in any category of FDA's list of bulk substances nominated for 503A compounding (list updated May 14, 2026) [9]. Source
The WADA 2026 Prohibited List took effect. Its S0 class bans drugs in clinical development with no approval for human use. WADA does not name cagrilintide, so its status rests on that general wording [11]. Source
FDA issued a warning letter over cagrilintide and cagrilintide-semaglutide products sold online as research products, calling them unapproved new drugs [12]. Source
Common questions
Is cagrilintide FDA approved?
No. FDA says cagrilintide is not a component of any FDA-approved drug and has not been found safe and effective for any condition [8].
What is CagriSema?
Is CagriSema approved?
No. FDA's page, current as of October 1, 2026, says cagrilintide is not a component of any FDA-approved drug [8].
Can cagrilintide be compounded?
How much weight loss was seen with cagrilintide?
How is cagrilintide different from semaglutide?
What side effects were reported with cagrilintide?
Nausea, constipation, diarrhea and injection-site reactions were most frequent in the phase 2 trial [1].
Is cagrilintide banned in sports?
Unclear. WADA's S0 class bans substances with no approval for human use. WADA does not name cagrilintide, so this status is not explicit [11].
Sources
- Lau et al. 2021, Lancet: Once-weekly cagrilintide phase 2 trial (PubMed)
- Enebo et al. 2021, Lancet: Cagrilintide with semaglutide phase 1b (PubMed)
- Kruse et al. 2021, J Med Chem: Development of cagrilintide (PubMed)
- Nature Communications 2025: Cagrilintide binding to calcitonin and amylin receptors (PMC)
- Frias et al. 2023, Lancet: CagriSema phase 2 in type 2 diabetes (PubMed)
- Garvey et al. 2025, NEJM: REDEFINE 1 (PubMed)
- Davies et al. 2025, NEJM: REDEFINE 2 (PubMed)
- FDA: Concerns with unapproved GLP-1 drugs used for weight loss
- FDA: Bulk drug substances nominated for use in compounding under section 503A (updated May 14, 2026)
- FDA: Bulk drug substances nominated for use in compounding under section 503B (updated Mar 21, 2025)
- WADA: 2026 Prohibited List
- FDA: Warning letter, cagrilintide products (Dec 10, 2024)
