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Comparison

Cagrilintide vs Semaglutide

Both are GLP-1 & incretins, so the meaningful differences are in kinetics, evidence and regulatory status.

On published evidence alone, Semaglutide is the better documented of the two (regulator approved). That is a statement about the state of the literature, not a recommendation.

Cagrilintide Semaglutide
Class GLP-1 & incretins GLP-1 & incretins
Evidence Clinical trials Regulator approved
Human trials ~10 ~90
Half-life ~7-8 days ~7 days
Reported range 300 mcg - 2.4 mg 250 mcg - 2.4 mg
Frequency Once weekly (trial protocols) Once weekly, titrated over 16+ weeks
Routes Subcutaneous Subcutaneous, Oral
FDA approved No Yes
Research use only Yes No
Banned in sport No No
Studied for Investigational obesity treatment (usually combined with semaglutide) Type 2 diabetes, Chronic weight management, Cardiovascular risk reduction
Reported side effects Nausea, Vomiting, Decreased appetite, Injection-site reactions Nausea, Vomiting, Diarrhoea, Constipation, Abdominal pain, Injection-site reactions

Cagrilintide

Cagrilintide is an acylated analog of amylin, the pancreatic hormone co-secreted with insulin that promotes satiety and slows gastric emptying. It acts at both amylin and calcitonin receptors. Because amylin signalling reduces food intake through a pathway distinct from GLP-1, combining the two produces additive effects, which is the basis of the CagriSema programme pairing it with semaglutide. Standalone development has been limited.

Semaglutide

Semaglutide is a GLP-1 analog with roughly 94% homology to native GLP-1, modified by substituting alpha-aminoisobutyric acid at position 8 to resist DPP-4 cleavage and by attaching a C18 fatty diacid chain that binds albumin. Together these give a half-life of about a week, allowing once-weekly dosing. It lowers blood glucose through glucose-dependent insulin secretion and glucagon suppression, slows gastric emptying, and acts on hypothalamic appetite centres to reduce energy intake. The STEP trial programme reported mean weight reductions near 15% of body weight at 68 weeks on 2.4 mg weekly.

Cagrilintide vs Semaglutide: common questions

What is the difference between Cagrilintide and Semaglutide?

Both are GLP-1 & incretins. Cagrilintide: A long-acting amylin analog developed primarily as a combination partner for semaglutide rather than as a standalone agent. Semaglutide: A long-acting GLP-1 receptor agonist and the compound that reset expectations for pharmacological weight loss.

Which has stronger evidence, Cagrilintide or Semaglutide?

Semaglutide has the stronger evidence base (regulator approved, about 90 human studies) compared with Cagrilintide (clinical trials).

Are Cagrilintide and Semaglutide FDA approved?

Only Semaglutide is FDA approved (Type 2 diabetes mellitus (Ozempic, Rybelsus); Chronic weight management (Wegovy); Cardiovascular risk reduction in established CVD with overweight or obesity; Reducing the risk of kidney disease progression and cardiovascular death in adults with type 2 diabetes and chronic kidney disease (Ozempic, January 2025); Noncirrhotic MASH with moderate to advanced liver fibrosis in adults (Wegovy, accelerated approval August 2025)). Cagrilintide is not approved for any indication.

References

Regulatory and primary sources

  1. PubChem compound record (CID 171397054) ↗ · structure, identifiers, synonyms
  2. FDA: Unapproved drugs and "research use only" products ↗ · regulatory status of non-approved products
  3. PubChem compound record (CID 56843331) ↗ · structure, identifiers, synonyms
  4. DailyMed: FDA-approved labeling for Semaglutide ↗ · indications, dosing, warnings as approved
  5. FDA Drugs@FDA database ↗ · approval history
  6. CAS Registry Number 910463-68-2 ↗ · chemical identity

Published literature

  1. Yao H, Zhang A, Li D, et al.. Comparative effectiveness of GLP-1 receptor agonists on glycaemic control, body weight, and lipid profile for type 2 diabetes: systematic review and network meta-analysis.BMJ 2024.PubMed 38286487 · doi:10.1136/bmj-2023-076410
  2. Garvey WT, Blüher M, Osorto Contreras CK, et al.. Coadministered Cagrilintide and Semaglutide in Adults with Overweight or Obesity.N Engl J Med 2025.PubMed 40544433 · doi:10.1056/NEJMoa2502081
  3. Davies MJ, Bajaj HS, Broholm C, et al.. Cagrilintide-Semaglutide in Adults with Overweight or Obesity and Type 2 Diabetes.N Engl J Med 2025.PubMed 40544432 · doi:10.1056/NEJMoa2502082
  4. Eržen S, Tonin G, Jurišić Eržen D, et al.. Amylin, Another Important Neuroendocrine Hormone for the Treatment of Diabesity.Int J Mol Sci 2024.PubMed 38338796 · doi:10.3390/ijms25031517
  5. Rubio-Herrera MA, Mera-Carreiro S. Weight management treatment in obesity.Med Clin (Barc) 2025.PubMed 40865172 · doi:10.1016/j.medcli.2025.107152
  6. Lau DCW, Erichsen L, Francisco AM, et al.. 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 2021.PubMed 34798060 · doi:10.1016/S0140-6736(21)01751-7
  7. Frias JP, Deenadayalan S, Erichsen L, et al.. Efficacy and safety of co-administered once-weekly cagrilintide 2·4 mg with once-weekly semaglutide 2·4 mg in type 2 diabetes: a multicentre, randomised, double-blind, active-controlled, phase 2 trial.Lancet 2023.PubMed 37364590 · doi:10.1016/S0140-6736(23)01163-7
  8. Son JW, le Roux CW, Blüher M, et al.. Novel GLP-1-based Medications for Type 2 Diabetes and Obesity.Endocr Rev 2026.PubMed 41054801 · doi:10.1210/endrev/bnaf036
  9. Wilding JPH, Batterham RL, Davies M, et al.. Weight regain and cardiometabolic effects after withdrawal of semaglutide: The STEP 1 trial extension.Diabetes Obes Metab 2022.PubMed 35441470 · doi:10.1111/dom.14725
  10. Rubino DM, Greenway FL, Khalid U, et al.. Effect of Weekly Subcutaneous Semaglutide vs Daily Liraglutide on Body Weight in Adults With Overweight or Obesity Without Diabetes: The STEP 8 Randomized Clinical Trial.JAMA 2022.PubMed 35015037 · doi:10.1001/jama.2021.23619
  11. Wilding JPH, Batterham RL, Calanna S, et al.. Once-Weekly Semaglutide in Adults with Overweight or Obesity.N Engl J Med 2021.PubMed 33567185 · doi:10.1056/NEJMoa2032183
  12. Rubino D, Abrahamsson N, Davies M, et al.. Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance in Adults With Overweight or Obesity: The STEP 4 Randomized Clinical Trial.JAMA 2021.PubMed 33755728 · doi:10.1001/jama.2021.3224
  13. Aronne LJ, Horn DB, le Roux CW, et al.. Tirzepatide as Compared with Semaglutide for the Treatment of Obesity.N Engl J Med 2025.PubMed 40353578 · doi:10.1056/NEJMoa2416394
  14. Wharton S, Freitas P, Hjelmesæth J, et al.. Once-weekly semaglutide 7·2 mg in adults with obesity (STEP UP): a randomised, controlled, phase 3b trial.Lancet Diabetes Endocrinol 2025.PubMed 40961952 · doi:10.1016/S2213-8587(25)00226-8
  15. Lincoff AM, Brown-Frandsen K, Colhoun HM, et al.. Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes.N Engl J Med 2023.PubMed 37952131 · doi:10.1056/NEJMoa2307563
  16. Frías JP, Davies MJ, Rosenstock J, et al.. Tirzepatide versus Semaglutide Once Weekly in Patients with Type 2 Diabetes.N Engl J Med 2021.PubMed 34170647 · doi:10.1056/NEJMoa2107519

Literature retrieved from PubMed on October 16, 2026, favouring human studies and reviews. Numbered markers in the text show which paper supports which statement; uncited entries are background reading.

Read this first This page compares published reference data. It is not medical advice and not a recommendation to use either compound. Several compounds documented on this site are not approved for human use.