Cagrilintide Reconstitution: Water, mg/mL and Units

Cagrilintide is a long-acting analogue of amylin, the pancreatic hormone released with insulin, developed by Novo Nordisk on its own and in the fixed pairing with semaglutide known as CagriSema. No product is approved, so there is no label, no approved concentration and no labelled water volume. The lyophilized vial sold on the research market comes in 5 mg and 10 mg sizes on this site's calculator preset, and the only sourced amounts are the ones its trials used. This page does the arithmetic for those two vials and sets the trial amounts beside it. It recommends nothing.

The cagrilintide calculator runs the same sums for any vial and volume; the cagrilintide dosage page reports the figures and their sources in full; the reconstitution hub indexes every compound.

The arithmetic in one line

Concentration in mg/mL is the vial amount divided by the water volume. Units on a U-100 syringe are the amount in milligrams divided by the concentration, times 100, because a U-100 syringe holds 100 units in 1 mL and each small notch on a standard 1 mL insulin syringe is 1 unit (MedlinePlus, "Giving an insulin injection", reviewed 2024-07-21).

Water volume per vial size

Units for the trial amounts

The amounts are the ones the trials name. The phase 2 dose-finding trial used 0.3, 0.6, 1.2, 2.4 and 4.5 mg once weekly for 26 weeks (The Lancet, 2021-12-11, PMID 34798060); REDEFINE 1 used 2.4 mg once weekly for 68 weeks, alone and with semaglutide 2.4 mg (New England Journal of Medicine, 2025-08-14, PMID 40544433).

Anything over 100 units exceeds one U-100 syringe. Cagrilintide's trial amounts are whole and half milligrams, so the dilute end of the table runs out of syringe first: at 1.67 mg/mL, a 5 mg vial in 3 mL, 2.4 mg is already 144 units. At the concentrated end the smallest trial amount stays readable, since 0.3 mg is 3 units even at 10 mg/mL. The vial runs out on its own schedule: a 5 mg vial holds two 2.4 mg amounts with 0.2 mg left, sixteen 0.3 mg amounts with 0.2 mg left, or one 4.5 mg amount; a 10 mg vial holds four 2.4 mg amounts with 0.4 mg left or two 4.5 mg amounts with 1 mg left, whatever the water volume.

Two vials, one syringe

CagriSema is two peptides, and a reader who reproduces its arithmetic with research vials is dealing with two vials. Each is reconstituted and calculated on its own, since each has its own milligrams and its own water volume. The trials gave 2.4 mg of each once weekly (PMID 40544433), which at 5 mg/mL for both vials is 48 units of each, or 96 units if the two draws are combined in one syringe. The blend calculator on this site adds the volumes of two separately reconstituted vials and reports the combined draw; it does not decide the amounts.

Mixing steps, as labels describe them

No cagrilintide label describes mixing, because none exists. The steps that approved lyophilized peptide labels describe are consistent: the diluent is added to the vial, the vial is rolled gently rather than shaken, and the solution is inspected and used only if clear and free of particles (Egrifta SV label, DailyMed, revised 03/2024, read 2026-09-18). The general procedure, with supplies and order of operations, is Medibact's how to reconstitute peptides; this page does not repeat it.

Storage after mixing

No label states a storage period for a reconstituted cagrilintide vial, because no label exists; storage after mixing is covered by Medibact's how to store peptides, which this page links rather than expands.

What the figures omit

Every trial amount carries a route (subcutaneous), a frequency (once weekly), an escalation period (up to six weeks in the phase 2 trial) and a population (adults without diabetes in the phase 2 and REDEFINE 1 trials; adults with type 2 diabetes in the REIMAGINE trials published in 2026). The phase 2 trial reported gastrointestinal adverse events in 41% to 63% of cagrilintide participants against 32% on placebo, mainly nausea (PMID 34798060); REDEFINE 1 reported them in 79.6% of the combination group against 39.9% on placebo (PMID 40544433). ClinicalTrials.gov listed 44 interventional registrations and PubMed 97 records, 15 tagged as clinical trials, on 2026-09-18. The 2026 papers widen the populations without adding a new amount: REIMAGINE 1, 2 and 3 tested the combination in adults with type 2 diabetes, on diet and exercise alone, against each component, and as an add-on to basal insulin (The Lancet Diabetes and Endocrinology and The Lancet, 2026, PMIDs 42251860, 42251859 and 42251856), and REDEFINE 5 tested it against semaglutide alone in Japan and Taiwan (PMID 42009015). A thorough QT study in healthy participants reported no clinically relevant QTc prolongation (Diabetes, Obesity and Metabolism, 2024-12, PMID 39279639), and a 2026 pharmacokinetic study reported that renal or hepatic impairment did not affect cagrilintide exposure (Clinical Pharmacokinetics, 2026-07, PMID 42228334). None of it states a concentration for a research vial; the table converts milligrams to units and stops. The mechanism, evidence and sourcing belong to Medibact's cagrilintide guide.

Sources and dates

Opened 2026-09-18: DailyMed, cagrilintide search (no record); ClinicalTrials.gov v2 API (44 interventional registrations); PubMed (97 records; the abstracts of PMIDs 34798060 and 40544433 read in full, PMID 33894838 by title); MedlinePlus, "Giving an insulin injection" (reviewed 2024-07-21); the Egrifta SV label on DailyMed for the mixing description. Vial sizes are the ones the calculator preset uses.

This page does not recommend a dose, a water volume, a syringe or a schedule, and it does not say what any figure means for a particular person. It reports what the trials state and converts milligrams into millilitres and units.