Cagrilintide and semaglutide blend (10 mg)
This is the rare blend whose combination has actually been tested: Novo Nordisk's CagriSema pairs these two peptides in large phase 3 trials. That is exactly why the research vial is worth examining. It borrows the trials' name and results without being the product the trials used.
As sold, one vial: Cagrilintide 5 mg, Semaglutide 5 mg. Statuses as of October 3, 2026. Reviewed by the Grey Peptides Editorial Board. Nothing here is a recommendation or a dose, and no seller is named or linked.
Each component at a glance
From our encyclopedia and FDA's July 2026 Pharmacy Compounding Advisory Committee record. Evidence grades follow the rubric on our methodology page.
| Component | Evidence | FDA status | PCAC, July 2026 | WADA 2026 | WADA 2027 | Interactions |
|---|---|---|---|---|---|---|
| Cagrilintide | Medium | In Clinical Trials | Not voted on | Prohibited under S0 (not named) | Prohibited under S0 (not named) | Studied |
| Semaglutide | High | FDA Approved | Not voted on | Not on the List | Not on the List | Fully reviewed |
What one vial contains: the ratio arithmetic
The vial holds 10 mg in total. Whatever volume of water is added and however much is drawn, every draw carries the components in the same proportions. The table expresses each as a share of the vial, as a multiple of the smallest component (Cagrilintide), and as a concentration if the whole vial were dissolved in 2 mL or 3 mL of water. These are arithmetic illustrations of what is in the vial, not suggested volumes or doses.
| Component | In the vial | Share | × Cagrilintide | In 2 mL | In 3 mL |
|---|---|---|---|---|---|
| Cagrilintide | 5 mg | 50.0% | 1 | 2.5 mg/mL | 1.67 mg/mL |
| Semaglutide | 5 mg | 50.0% | 1 | 2.5 mg/mL | 1.67 mg/mL |
The Blend & Stack Calculator runs the same arithmetic for any volume and draw, with this composition as a preset (Cagrilintide and semaglutide, 10 mg (5/5)).
Cagrilintide on its own
Cagrilintide is a long-acting analogue of amylin, a hormone released with insulin that signals fullness. It was engineered to resist the clumping that limits natural amylin and to last long enough for weekly injection1. On its own, in a 26-week phase 2 trial of 706 adults with obesity, weekly doses reduced weight by 6.0% to 10.8% against 3.0% on placebo, with the top dose beating liraglutide 3.0 mg (10.8% against 9.0%) and gastrointestinal events affecting about two in five people (randomised trial)2. Cagrilintide is not approved anywhere3.
The combination has been tested, as CagriSema
Novo Nordisk developed the pair as CagriSema, cagrilintide 2.4 mg with semaglutide 2.4 mg once weekly. An early study in 96 people found cagrilintide exposure rose with dose without changing semaglutide exposure4. In REDEFINE 1, 3,417 adults with obesity lost 20.4% of body weight over 68 weeks against 3.0% on placebo, with gastrointestinal events in 79.6% against 39.9%, mostly mild to moderate and transient (randomised trial)5. In REDEFINE 2, 1,206 adults with type 2 diabetes lost 13.7% against 3.4% (randomised trial)6. In February 2026 Novo announced that CagriSema 2.4/2.4 mg did not meet its primary goal of showing non-inferior weight loss to tirzepatide 15 mg at 84 weeks in REDEFINE 47.
Novo filed for FDA approval in December 2025. On September 30, 2026 it still described CagriSema as investigational, with an FDA decision expected in the fourth quarter of 20268. As of October 3, 2026 it is not approved3.
Why the research vial is not CagriSema
The trials used Novo's own manufactured product, at a defined weekly dose, escalated over months under medical supervision. A research vial labelled 'cagrilintide and semaglutide' is a different thing: unknown manufacture, unverified content and sterility, and a fixed 1:1 milligram ratio chosen by the seller. The trial results describe what happened with the trial product; they do not transfer to a vial that only shares the names. FDA's page on unapproved GLP-1 drugs says cagrilintide cannot be used in compounding under federal law9, so a 'compounded CagriSema' is not a lawful product either.
What the 1:1 ratio means
With 5 mg of each in the vial, every draw holds equal milligrams of both peptides, as the table above shows. That happens to mirror the trial product's equal 2.4 mg doses, but a blend removes the ability to escalate the two separately, which is how the trials introduced them to manage stomach side effects. Our Blend Calculator shows the arithmetic for any vial; it describes content, not a dose.
Side effects and interactions
Gastrointestinal effects were the main issue in the trials: four in five people on CagriSema reported them in REDEFINE 1, against two in five on placebo5. Semaglutide's own label warns of hypoglycaemia when combined with insulin or sulfonylureas, which our blood sugar guide covers, and advises against combining semaglutide with other GLP-1 drugs3. Anyone already taking a semaglutide product should not add a vial containing more of it.
Regulatory status in the United States
Semaglutide is approved alone as Ozempic, Rybelsus and Wegovy, for their labelled uses; our semaglutide brands guide explains each. Cagrilintide and the CagriSema combination are not approved, and FDA says cagrilintide cannot be compounded98.
For tested athletes
Semaglutide is not on the WADA Prohibited List. Cagrilintide, as an unapproved substance, falls under S0 by inference: our tracker records it as prohibited unless and until it gains approval somewhere3.
What to check before anything else
If the goal is weight management, approved options exist now, including semaglutide alone and tirzepatide; our Approved-Alternative Finder lists them. If CagriSema is approved, it will come as Novo's product through a prescriber. A research vial is neither, whatever its label says.
Sources
- Kruse, T., et al. (2021). Development of Cagrilintide, a Long-Acting Amylin Analogue. J Med Chem, 64. PubMed 34288673 ↗
- Lau, D. C. W., et al. (2021). 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. Lancet, 398. PubMed 34798060 ↗
- Grey Peptides encyclopedia entries for cagrilintide and semaglutide (FDA status, WADA status, label statements). Read October 3, 2026.
- Enebo, L. B., et al. (2021). 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. Lancet, 397. PubMed 33894838 ↗
- Garvey, W. T., et al. (2025). Coadministered Cagrilintide and Semaglutide in Adults with Overweight or Obesity. N Engl J Med, 393. PubMed 40544433 ↗
- Davies, M. J., et al. (2025). Cagrilintide-Semaglutide in Adults with Overweight or Obesity and Type 2 Diabetes. N Engl J Med, 393. PubMed 40544432 ↗
- Novo Nordisk announcement of REDEFINE 4 results (CagriSema 2.4/2.4 mg vs tirzepatide 15 mg, 84 weeks), February 23, 2026, as summarised by Drugs.com. Read October 3, 2026.
- Novo Nordisk. Company announcement of September 30, 2026 (EASD 2026 data), describing CagriSema as investigational with an FDA decision expected in Q4 2026. Read October 3, 2026.
- U.S. Food and Drug Administration. FDA's Concerns with Unapproved GLP-1 Drugs Used for Weight Loss (retatrutide and cagrilintide cannot be used in compounding). Updated June 15, 2026; read October 3, 2026. Source ↗
Related: the blends and stacks hub, the Name Decoder, the COA Decoder and the Interaction Matrix. Last updated October 3, 2026.