CagriSema
CagriSema — cagrilintide with semaglutide
Also called cagri sema, cagrilintide semaglutide, CagriSema stack, REDEFINE
The only stack on this site with phase 3 evidence behind the combination itself, not just its parts.
Combination evidence: Strong
Where every number on this page comes from
Each quantity carries one of these five labels. They are not interchangeable, and the difference between the first and the last is the difference between a regulated finding and a rumour with a number attached.
- FDA labelling
- This figure appears in FDA-approved product labelling for an approved indication. It is the strongest warrant on this site.
- Published study arm
- This figure is the quantity administered in a named arm of the linked study. It describes what was studied, not what is advised.
- Clinical guideline
- This figure appears in published clinical or professional guidance.
- Manufacturer protocol
- This figure comes from a manufacturer or investigator document rather than from peer-reviewed literature.
- Community practice — no trial
- No clinical trial has tested this figure. It reflects what is commonly reported in practice and carries no evidentiary weight. It is shown because it is what circulates, and because showing it with this label is more useful than pretending it does not exist.
The figure most often reported for each compound. Where a compound has no separately sourced figure at this level, its most commonly reported figure is used instead, and the citation beneath it says so.
Duration
68 weeks
2 phases
Administrations
136
about 2/week at peak
Vials required
60
2 compounds
Cost at this plan
$2,043.00
Pure Health Peptides, list price
Phase by phase
Weeks 1–16 · 16 weeks
Co-escalation
Both compounds start at 0.25 mg and step together every four weeks: 0.25, 0.5, 1.0, 1.7, then 2.4. The trial protocol allowed investigators to hold a step or step down for tolerability, which is worth knowing because the trial-product result assumes nobody did.
Cagrilintide
Once weekly, Sunday · Subcutaneous
Lowest sourced, per dose
250 mcgPublished study arm
CagriSema, escalation week 1–4 · REDEFINE 1, starting step of the co-escalation · in the study register
Most commonly reported, per dose
1 mgPublished study arm
CagriSema, escalation week 9–12 · REDEFINE 1, third step of the co-escalation · in the study register
Highest sourced, per dose
1.7 mgPublished study arm
CagriSema, escalation week 13–16 · REDEFINE 1, fourth step of the co-escalation · in the study register
Prepared at 5 mg in 2 mL
Every quantity above is one administration. At once weekly, sunday, that is 1.00 mg per week.
| Concentration | 2.50 mg/mL | Draw volume | 0.400 mL |
| Pull to (U-100) | 40.0 units | Doses per vial | 4 |
| This phase | 16 administrations | Vials, this phase | 4 |
Shelf life, not volume, is what limits this vial. It holds enough for more administrations than you can use inside roughly 30 days of being reconstituted, so the vial count above is driven by that window rather than by the arithmetic. Buying a larger vial would make this worse, not cheaper.
Why it is here
Long-acting amylin analogue. Acts on satiety through a pathway separate from the incretin receptors, which is the mechanistic argument for pairing the two.
What is not known
Cagrilintide's own dose-finding trial found 4.5 mg outperformed 2.4 mg on weight. The programme took 2.4 mg forward anyway. The published record does not settle whether that was tolerability, combination pharmacology, or manufacturing.
Semaglutide
Once weekly, Sunday · Subcutaneous
Lowest sourced, per dose
250 mcgPublished study arm
CagriSema, escalation week 1–4 · REDEFINE 1, starting step of the co-escalation · in the study register
Most commonly reported, per dose
1 mgPublished study arm
CagriSema, escalation week 9–12 · REDEFINE 1, third step of the co-escalation · in the study register
Highest sourced, per dose
1.7 mgPublished study arm
CagriSema, escalation week 13–16 · REDEFINE 1, fourth step of the co-escalation · in the study register
Prepared at 5 mg in 2 mL
Every quantity above is one administration. At once weekly, sunday, that is 1.00 mg per week.
| Concentration | 2.50 mg/mL | Draw volume | 0.400 mL |
| Pull to (U-100) | 40.0 units | Doses per vial | 4 |
| This phase | 16 administrations | Vials, this phase | 4 |
Shelf life, not volume, is what limits this vial. It holds enough for more administrations than you can use inside roughly 30 days of being reconstituted, so the vial count above is driven by that window rather than by the arithmetic. Buying a larger vial would make this worse, not cheaper.
Why it is here
GLP-1 receptor agonist with its own approved labelling and a large independent trial programme.
What is not known
In the trial the two arrived as one fixed-dose product. Administering them as two separate preparations is not what was studied, and nothing published addresses whether that changes anything.
Weeks 17–68 · 52 weeks
Maintenance
2.4 mg of each, once weekly, for the remaining 52 weeks. This is the arm that produced −20.4% against −3.0% for placebo.
Cagrilintide
Once weekly, Sunday · Subcutaneous
Most commonly reported, per dose
2.4 mgPublished study arm
CagriSema 2.4 mg / 2.4 mg maintenance · REDEFINE 1, maintenance amount from week 16 · in the study register
Prepared at 5 mg in 2 mL
Every quantity above is one administration. At once weekly, sunday, that is 2.40 mg per week.
| Concentration | 2.50 mg/mL | Draw volume | 0.960 mL |
| Pull to (U-100) | 96.0 units | Doses per vial | 2 |
| This phase | 52 administrations | Vials, this phase | 26 |
Why it is here
Maintenance amount carried through the remaining 52 weeks of the trial.
What is not known
Sixty-eight weeks is the longest published exposure. What happens at 100 weeks, and what happens on stopping, are both unstudied for this pairing.
Semaglutide
Once weekly, Sunday · Subcutaneous
Most commonly reported, per dose
2.4 mgPublished study arm
CagriSema 2.4 mg / 2.4 mg maintenance · REDEFINE 1, maintenance amount from week 16 · in the study register
Prepared at 5 mg in 2 mL
Every quantity above is one administration. At once weekly, sunday, that is 2.40 mg per week.
| Concentration | 2.50 mg/mL | Draw volume | 0.960 mL |
| Pull to (U-100) | 96.0 units | Doses per vial | 2 |
| This phase | 52 administrations | Vials, this phase | 26 |
Why it is here
Maintenance amount carried through the remaining 52 weeks of the trial.
What is not known
Semaglutide's own discontinuation data show most weight returns. Nothing suggests adding an amylin analogue changes that.
What you would need to buy
Vial counts are computed by simulating consumption, not by dividing total milligrams. Those two disagree whenever a vial cannot be finished, which is most of the time, and dividing under-buys.
| Compound | Vial | Administrations | Total material | Vials |
|---|---|---|---|---|
| CagrilintideCo-escalation · Maintenance | 5 mg | 68 | 140.80 mg | 30 |
| SemaglutideCo-escalation · Maintenance | 5 mg | 68 | 140.80 mg | 30 |
| Total | 136 | 60 | ||
What it would cost
List prices from each vendor’s own product pages, with the date each figure was read. Quantity tiers are applied where a vendor publishes them.
Loti Labs
Prices as of 2026-08-24
$4,695.16
$9.86/day · $300.25/month
| CagrilintideCagrilintide 5mg · 5 mg$14.40/mg listed · $15.34/mg after what expires unused | 30 × $71.99 | $2,159.70 |
| SemaglutideSema 5mg (GLP-1) · 5 mg$16.00/mg listed · $17.04/mg after what expires unused | 30 × $79.99 | $2,399.70 |
| Bacteriostatic water30ML Reconstitution Solution · 30 mLThis plan uses 120.0 mL across every reconstitution.Sold as a reconstitution solution rather than under the name bacteriostatic water. The page describes 0.9% benzyl alcohol as the preservative. | 4 × $33.94 | $135.76 |
| Syringes136 administrations, so 136 syringes. None of the vendors priced on this site sells syringes, alcohol pads or a sharps container. They are ordinary pharmacy items in most places and restricted in some. The count below is what the plan requires; where to obtain them is outside what this site can tell you. | 136 × — | Not sold here |
| Total, compounds and water | $4,695.16 | |
Above this vendor's published $99 free-shipping threshold.
We earn nothing from this link. Loti Labs has no affiliate programme.
Pure Health Peptides
Prices as of 2026-08-24
$2,152.90
$4.52/day · $137.68/month
| CagrilintideGLP-1 (C) · 10 mg$6.90/mg listed · $8.33/mg after what expires unusedPriced at the 10 mg size rather than the 5 mg this plan assumes, because across the sizes this vendor stocks it works out cheapest for the whole course. Vial count re-simulated at that strength. | 17 × $69.00 | $1,173.00 |
| SemaglutideGLP-1 (S) · 5 mg$5.80/mg listed · $6.18/mg after what expires unusedThis listing is sold in several vial sizes and the figure shown is the cheapest one, so the real price is higher. | 30 × $29.00 | $870.00 |
| Bacteriostatic waterBacteriostatic Water · 10 mLThis plan uses 94.0 mL across every reconstitution. 6.0 mL is left over, because bottles do not divide.The only size this vendor sells. Stock was reported as one unit remaining when read. | 10 × $10.99 | $109.90 |
| Syringes136 administrations, so 136 syringes. None of the vendors priced on this site sells syringes, alcohol pads or a sharps container. They are ordinary pharmacy items in most places and restricted in some. The count below is what the plan requires; where to obtain them is outside what this site can tell you. | 136 × — | Not sold here |
| Total, compounds and water | $2,152.90 | |
Above this vendor's published $175 free-shipping threshold.
We earn nothing from this link. No affiliate programme was found for this vendor.
Peptira
Prices as of 2026-08-25
$2,646.05
$5.56/day · $169.21/month
| CagrilintideCAG-4 | 10MG · 10 mg$9.52/mg listed · $11.49/mg after what expires unusedIdentity inferred. This vendor sells it as “CAG-4 | 10MG” and does not write the compound name anywhere on the page. The mapping is ours, not theirs.Priced at the 10 mg size rather than the 5 mg this plan assumes, because across the sizes this vendor stocks it works out cheapest for the whole course. Vial count re-simulated at that strength. | 17 × $95.20 | $1,618.40 |
| SemaglutideSEMA-1 | 10MG · 10 mg$5.52/mg listed · $6.66/mg after what expires unusedIdentity inferred. This vendor sells it as “SEMA-1 | 10MG” and does not write the compound name anywhere on the page. The mapping is ours, not theirs.Priced at the 10 mg size rather than the 5 mg this plan assumes, because across the sizes this vendor stocks it works out cheapest for the whole course. Vial count re-simulated at that strength. | 17 × $55.20 | $938.40 |
| Bacteriostatic waterBAC Water 10ML · 10 mLThis plan uses 68.0 mL across every reconstitution. 2.0 mL is left over, because bottles do not divide. | 7 × $12.75 | $89.25 |
| Syringes136 administrations, so 136 syringes. None of the vendors priced on this site sells syringes, alcohol pads or a sharps container. They are ordinary pharmacy items in most places and restricted in some. The count below is what the plan requires; where to obtain them is outside what this site can tell you. | 136 × — | Not sold here |
| Total, compounds and water | $2,646.05 | |
Above this vendor's published $250 free-shipping threshold.
Peptira runs an affiliate programme. This site has not applied to it, so no commission is earned on this link today.
List price is not the price anyone pays
What usually goes wrong
Ranked by how often it happens rather than by how serious it sounds.
Quoting −22.7% instead of −20.4%
The larger figure is the trial-product estimand, which models what would have happened had everyone taken every dose. The primary result, the one that reflects the trial as it actually ran, is −20.4%. Vendor pages consistently quote the larger number without saying which it is.
Expecting the REDEFINE 1 result if you have diabetes
REDEFINE 2 ran the same schedule in people with type 2 diabetes and produced −13.7%. Same compounds, same amounts, two-thirds of the effect.
Compressing the escalation
Sixteen weeks of stepping is not caution, it is the protocol. The gastrointestinal burden of two mechanisms escalating together is the reason it exists.
Assuming it beats tirzepatide
REDEFINE 4 compared this pairing head to head against tirzepatide 15 mg and did not meet non-inferiority. That result has been reported by the sponsor but not yet published in a peer-reviewed journal, which is why it is not in this site's study register.
What is worth measuring
Markers that would actually tell you something, and what each one tells you. Nothing here is a requirement, and none of it substitutes for a clinician who knows your history.
| Marker | When | What it tells you |
|---|---|---|
| Weight and waist | Weekly, same conditions | The trial's primary endpoint was percentage weight change; it is the measure with evidence behind it. |
| Fasting glucose and HbA1c | Baseline and periodically | Both classes act on glucose handling, and the diabetic population responded differently. |
| Gastrointestinal tolerance during escalation | Each step | This is where the trial's discontinuations concentrated. |
| Gallbladder symptoms | Ongoing | Rapid weight reduction is associated with gallstone formation across this drug class. |
Populations this was not studied in
An absence of evidence in a group is not evidence of safety in that group. These are listed because the gap itself is the finding.
- Personal or family history of medullary thyroid carcinoma or MEN 2 — labelled contraindication for the GLP-1 component
- Pregnancy and breastfeeding
- History of pancreatitis
- Type 1 diabetes
- Anyone under 18
Related protocols
Semaglutide
The 16-week step-up written into the approved label, with the arithmetic done for each step.
Tirzepatide
Labelled 2.5 mg steps to a 5, 10, or 15 mg maintenance, with 176-week follow-up behind it.
Retatrutide
What the published phase 2 arms actually administered. Not approved, and not a label.
Protocol last reviewed 2026-08-25. Every quantity on this page carries its own source. If you find one that does not, that is a bug and the build should have caught it.