What CagriSema Is
CagriSema is an investigational once-weekly injection from Novo Nordisk, the maker of Ozempic and Wegovy. It combines two medicines in one pen: semaglutide 2.4 mg, the same dose used in Wegovy, and cagrilintide, a long-acting version of the hormone amylin. The goal is more weight loss than semaglutide alone, by acting on two different fullness signals at once.
As of November 2026, CagriSema is not FDA-approved. Novo Nordisk submitted it to FDA in late 2025 and has said it expects a U.S. decision around the end of 2026. Until FDA acts, it cannot be prescribed outside of clinical trials.
How the Combination Works
Semaglutide
Semaglutide copies GLP-1, a gut hormone released after meals. It lowers appetite, slows stomach emptying and helps the pancreas release insulin when blood sugar is high.
Cagrilintide and Amylin
Amylin is a hormone released by the pancreas together with insulin after you eat. It slows stomach emptying, lowers the after-meal rise in glucagon and signals fullness to the brain through a different pathway than GLP-1. People with diabetes often make less of it. One short-acting amylin drug, pramlintide, has been approved for years for people with diabetes who use mealtime insulin, but it must be injected before every meal.
Cagrilintide is a long-acting amylin analog that lasts a week. Combining it with semaglutide is meant to add a second, complementary "I'm full" signal, so people eat less without having to push the GLP-1 dose higher.
What the REDEFINE Trials Showed
REDEFINE 1: Adults Without Diabetes
In REDEFINE 1, a 68-week trial of about 3,400 adults with obesity or overweight, published in the New England Journal of Medicine, people on CagriSema lost about 20 percent of their body weight on average, compared with about 3 percent on placebo. The trial also tested semaglutide alone and cagrilintide alone, and the combination produced more weight loss than either part by itself.
REDEFINE 2: Adults With Type 2 Diabetes
In REDEFINE 2, adults with type 2 diabetes and overweight or obesity lost about 14 percent on CagriSema compared with about 3 percent on placebo, with improvements in A1c, as reported in the New England Journal of Medicine. As with every weight loss medicine, people with diabetes lost less than people without it.
Those results put CagriSema in a similar range to tirzepatide, which produced about 20 percent average weight loss at its highest dose in its main trial. The trials were not head-to-head, so it is not yet clear whether one is better.
Side Effects
The side effects in the REDEFINE trials were mostly the familiar ones from GLP-1 medicines: nausea, vomiting, constipation and diarrhea, especially while the dose was being increased. Gastrointestinal side effects were more common than with placebo, and most were mild to moderate. Because semaglutide is one of its parts, CagriSema would be expected to carry the same warnings about pancreatitis, gallbladder disease and thyroid C-cell tumors seen in rodents, and the same rule against use with a personal or family history of medullary thyroid cancer or MEN 2.
Who Might Be a Candidate if It Is Approved
If FDA approves CagriSema for weight management, it would most likely be labeled for the same adults as other weight loss medicines: a body mass index of 30 or higher, or 27 or higher with at least one weight-related condition such as high blood pressure, high cholesterol or type 2 diabetes. It would be meant for use alongside a reduced-calorie diet and more physical activity.
Some groups may find it especially worth discussing:
- People already on semaglutide who have reached a plateau, since one ingredient is the same and the second adds a different fullness signal
- People with type 2 diabetes, since both ingredients improve blood sugar after meals
- People who had trouble with side effects at high GLP-1 doses, though the combination still causes the same kinds of stomach symptoms, and that question needs real-world experience to answer
It would not be appropriate for anyone who cannot take semaglutide, including people with a personal or family history of medullary thyroid cancer or MEN 2, people who are pregnant, and people with a history of pancreatitis without a careful discussion first. Cost and coverage are unknown until it is approved and priced.
Watch Out for Compounded Versions
Some clinics and websites have advertised "compounded CagriSema" or cagrilintide vials. Cagrilintide is not part of any FDA-approved drug, and FDA has stated that it cannot legally be used in compounding. Products sold this way have not been tested, and their content and sterility are unknown. The same concerns FDA has raised about compounded semaglutide apply, with even less known about the product.
What This Means for You Today
If you are interested in CagriSema, you do not need to wait to start effective treatment. FDA-approved choices today include the Wegovy injection and pill, Zepbound, and the daily pill orforglipron (Foundayo). If CagriSema is approved, people already on semaglutide may be natural candidates to discuss a switch, since one of its two ingredients is the same.
How We Help Patients Choose
At your visit we review your weight history, health conditions such as obesity, sleep apnea and fatty liver, your medications and your insurance coverage. We check baseline labs and set realistic goals, and we plan for protein and strength training so the weight you lose is mostly fat, not muscle.
To talk with a physician about medical weight loss in St. Petersburg, visit our GLP-1 medication program or schedule a visit.
