CagriSema (Cagrilintide + Semaglutide) (5 mg Vial) Dosage Protocol
CagriSema combines cagrilintide (amylin analog) and semaglutide (GLP-1 agonist) in a single research formulation. Phase 2 trials demonstrate additive weight-loss effects beyond either component alone.
⚡ Quickstart Highlights
Dosing & Reconstitution Guide
Route: Subcutaneous | Frequency: Once weekly | Half-life: ~7 days
Standard Approach (3 mL = 1.67 mg/mL)
Reconstituting with 3 mL bacteriostatic water produces a concentration of 1.67 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 1–4 | 500 mcg | 30 units | 0.30 mL | 10 doses |
| Weeks 5–8 | 1 mg | 60 units | 0.60 mL | 5 doses |
| Weeks 9+ (maintenance) | 2.4 mg | 144 units | 1.44 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 2.4 mg per dose, once weekly (1 dose/week).
| Item | 8-Week Cycle | 12-Week Cycle |
|---|---|---|
| CagriSema (Cagrilintide + Semaglutide) (5 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
CagriSema combines two complementary mechanisms — amylin (cagrilintide) and GLP-1 (semaglutide) — in a single weekly injection. Phase 2 reported 15.6% weight loss at 22 weeks vs ~10% for either component alone, suggesting genuinely additive (not just redundant) effect.
Most published research protocols use the 2.4 mg + 2.4 mg dose pairing. Titration takes 8–12 weeks before reaching maintenance.
Dosing Protocol
Combined titration — both components escalate together:
- Weeks 1–4: 0.50 mg combined (each component at 0.25 mg).
- Weeks 5–8: 1.00 mg combined.
- Weeks 9+ (maintenance): 2.40 mg combined. Phase 2 maintenance.
GI burden: Combined nausea/vomiting can be greater than either component alone during titration. Some users add antiemetic support (ginger, ondansetron PRN) for the first 2–4 weeks.
Once-weekly dosing; same day each week; half-life ~7 days.
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
CagriSema combines two complementary mechanisms: cagrilintide acts on amylin receptors in the area postrema; semaglutide acts on GLP-1 receptors in the hypothalamus, gut, and pancreas. The two pathways together produce additive satiety and metabolic effects.
Potential Benefits & Side Effects
Potential Benefits
- Phase 2: 15.6% weight loss at 22 weeks vs 5–10% for either component alone.
- Complementary mechanisms — additive rather than redundant.
- Once-weekly dosing for both components.
Side Effect Profile
- Nausea (most common — additive between the two components).
- Vomiting and diarrhea during titration.
- Decreased appetite (intended).
Lifestyle Factors
- Hydrate well, prioritize protein, resistance train, smaller meals — same playbook as either component alone, but with potentially greater GI burden during titration.
Injection Technique
- Subcutaneous into abdomen, thigh, or upper arm. Rotate sites weekly.
- 90° angle with short insulin needle.