Cagrilintide (10 mg Vial) Dosage Protocol
Cagrilintide is a long-acting amylin analog studied for weight management, often combined with semaglutide in Phase 2 (CagriSema) trials reporting 15%+ weight loss.
⚡ Quickstart Highlights
Dosing & Reconstitution Guide
Route: Subcutaneous | Frequency: Once weekly | Half-life: ~7 days
Standard Approach (3 mL = 3.33 mg/mL)
Reconstituting with 3 mL bacteriostatic water produces a concentration of 3.33 mg/mL. Volume per dose changes with concentration; mg dose itself does not change between vial sizes.
| Phase / Protocol | Dose | U-100 Units | Volume | Doses per vial |
|---|---|---|---|---|
| Weeks 1–2 (titration) | 600 mcg | 18 units | 0.18 mL | 16 doses |
| Weeks 3–4 | 1.2 mg | 36 units | 0.36 mL | 8 doses |
| Weeks 5–6 | 2.4 mg | 72 units | 0.72 mL | 4 doses |
| Weeks 7–16+ (maintenance) | 4.5 mg | 135 units | 1.35 mL | 2 doses |
Reconstitution Steps
- Wipe the vial stopper and BAC water vial with alcohol; let dry.
- Draw 3 mL of bacteriostatic water into a sterile syringe.
- Inject slowly down the inside glass wall of the peptide vial. Do not aim at the powder.
- Gently swirl until fully dissolved. Do not shake.
- Label with reconstitution date. Refrigerate at 2–8°C; use within 28 days.
Supplies Needed
Estimates for an 8-week and 12-week cycle at 4.5 mg per dose, once weekly (1 dose/week).
| Item | 8-Week Cycle | 12-Week Cycle |
|---|---|---|
| Cagrilintide (10 mg) vials | 4 vials | 6 vials |
| Insulin syringes (U-100) | 8 | 12 |
| Bacteriostatic water (10 mL) | 2 × 10 mL | 2 × 10 mL |
| Alcohol swabs | 1 × 100-pack | 2 × 100-pack |
Protocol Overview
Cagrilintide is most commonly studied as part of the CagriSema combination, but monotherapy protocols also exist. The amylin-analog mechanism complements GLP-1 agonists rather than replacing them — solo cagrilintide produces ~10% weight loss vs ~15%+ for the combination.
Trial protocols use a 4-week-per-step titration similar to GLP-1 titration. Once-weekly dosing fits alongside the GLP-1 schedule when used in combination.
Cycle length: Phase 2 trials ran 26 weeks; Phase 3 ongoing. Long-term protocols are not yet established.
Dosing Protocol
Standard titration mirrors the GLP-1 class:
- Weeks 1–4: 0.30 mg once weekly.
- Weeks 5–8: 0.60 mg once weekly.
- Weeks 9–12: 1.20 mg once weekly.
- Weeks 13+ (maintenance): 2.40 mg once weekly. Phase 2 maintenance dose.
Combination dosing: When stacked with semaglutide (CagriSema), both peptides are titrated together on the same weekly schedule.
Half-life: ~7 days, supports flexible day-of-week timing.
Storage Instructions
| State | Temperature | Duration |
|---|---|---|
| Lyophilized | −20°C (−4°F) | Up to 24 months, dry & dark |
| Reconstituted | 2–8°C (35–46°F) | Up to 28 days, protect from light |
Important Notes
How This Works
Cagrilintide is a long-acting analog of human amylin — a hormone co-secreted with insulin from pancreatic beta cells. Native amylin slows gastric emptying, suppresses glucagon secretion, and enhances satiety, but has a half-life of minutes. Cagrilintide is fatty-acid acylated for albumin binding, giving once-weekly dosing.
It binds amylin receptors in the hindbrain area postrema, producing satiety and reducing food intake through a mechanism complementary to GLP-1.
Potential Benefits & Side Effects
Potential Benefits
- Phase 2 monotherapy: ~10% weight loss at 4.5 mg weekly over 26 weeks.
- Combination with semaglutide (CagriSema): 15.6% weight loss in Phase 2.
- Complementary mechanism to GLP-1 — synergy when combined.
- Once-weekly dosing supports adherence.
Side Effect Profile
- Nausea (most common, dose-dependent).
- Vomiting at higher doses.
- Decreased appetite (intended).
- Injection-site reactions.
Lifestyle Factors
- Hydrate well — amylin slows gastric emptying.
- Protein-prioritized diet preserves lean mass.
- Resistance training during weight loss.
- Smaller meal sizes are better tolerated.
Injection Technique
- Subcutaneous into abdomen, thigh, or upper arm — rotate weekly.
- 90° angle with short insulin needle.
- Room-temperature solution reduces sting.