CagriSema

Graded B: multiple large phase 3 randomized trials, but not FDA-approved as of October 2026; no study used this research blend.

Strengths: 5 mg / 5 mg
Also known as: Cagrilintide + semaglutide, Cagrilintide/semaglutide blend
Contains: Cagrilintide 5 mg, Semaglutide 5 mg
Molecule: Two separate lipidated peptides in a fixed 1:1 mix

Origin

Novo Nordisk's investigational combination of cagrilintide (an amylin analog) and semaglutide (a GLP-1 agonist). Novo's version is a manufactured fixed-dose product; the catalog's is a 1:1 research blend.

How it works

Pairs two appetite pathways: semaglutide acts on GLP-1 receptors and cagrilintide on amylin receptors in brainstem appetite centers. Both slow stomach emptying and reduce food intake by different routes, so researchers tested the pairing for additive effects.

What the research shows

Large phase 3 trials (REDEFINE and REIMAGINE programs) studied it in obesity and type 2 diabetes. In adults without diabetes it reported about 20–23% average weight reduction over 68 weeks, more than either component alone. In a head-to-head trial it did not meet non-inferiority against tirzepatide at the top doses. A cardiovascular outcomes trial (REDEFINE 3) is ongoing, and several 2026 results are company toplines not yet peer reviewed.

Key studies

REDEFINE 1, NEJM 2025 (phase 3) 3,417 adults; −20.4% vs −3.0% placebo counting everyone randomized (−22.7% vs −2.3% among those who stayed on treatment); semaglutide alone −16.1%, cagrilintide alone −11.8%.
REDEFINE 2, NEJM 2025 (phase 3) 1,206 adults with type 2 diabetes; −15.7% vs −3.1%; 73.5% reached HbA1c ≤6.5%.
Frias et al., Lancet 2023 (phase 2) Type 2 diabetes: HbA1c −2.2 vs −1.8 (semaglutide) vs −0.9 (cagrilintide).
REDEFINE 4, Feb 2026 (topline) Head-to-head vs tirzepatide: −23.0% vs −25.5%; non-inferiority not met.

Safety findings

Gastrointestinal events occurred in about 80% of trial participants versus 40% on placebo, mostly mild to moderate. Because it contains semaglutide, that drug's thyroid C-cell boxed warning and pancreatitis and gallbladder cautions carry over. Two severe low-blood-sugar events in REDEFINE 2 occurred in people also taking sulfonylureas.

Regulatory status

Not approved as of October 2026; Novo Nordisk filed its FDA application in December 2025, and a decision is expected in Q4 2026. A blend containing cagrilintide has no lawful compounding pathway, and FDA warned a vendor promoting this pairing in December 2024. Semaglutide is permitted by WADA; cagrilintide's status is not confirmed.

Catalog notes

Offered as 5/5 mg in a fixed 1:1 ratio. No purity value, certificate, CAS, formula or molecular weight is published yet for the blend.