Cagrilintide with semaglutide as the REDEFINE trials report it, the tirzepatide pairing as trials use it (head to head, not combined), and the units.
This page reports the pairing of cagrilintide with a GLP-1 drug: what the two are, what the trials of cagrilintide with semaglutide report, how trials actually use tirzepatide alongside cagrilintide, what the promoting pages state, and how the vials sold for research are drawn. It presents no protocol and ranks nothing. Every figure carries its source and the date it was read.
Cagrilintide is a long-acting synthetic analogue of amylin, the hormone the pancreas releases with insulin that slows stomach emptying and signals fullness; it is investigational, with no label anywhere. Semaglutide is a GLP-1 receptor agonist and tirzepatide a GIP and GLP-1 receptor agonist, both approved and labelled for weight management. The combination of cagrilintide with semaglutide is a single development programme, Novo Nordisk's CagriSema; the combination with tirzepatide exists on protocol pages and in one rat study. Medibact's cagrilintide guide, semaglutide guide and tirzepatide guide cover each compound.
The registry, counted
ClinicalTrials.gov held 44 registrations naming cagrilintide as an intervention on 2026-09-18, every one sponsored by Novo Nordisk: 35 with semaglutide, two withdrawn with zero enrolment (formulation comparisons, NCT07357766 and NCT07357740), phase 1 studies of appetite, gastric emptying, heart rhythm, drug interactions and bone, a phase 2 kidney study, monotherapy phase 3 studies started in late 2025 (NCT07220642, NCT07220759), a paediatric study recruiting, and the REDEFINE, REIMAGINE and REDEFINE 3 cardiovascular-outcome programme. One phase 1 study, NCT04940078, compared cagrilintide and semaglutide given as separate injections against a combined device in 40 adults, which is the closest the registry comes to the question of drawing two vials.
The combination with trials: cagrilintide with semaglutide
| Study |
Registration |
Participants |
Duration |
Doses |
Body-weight result |
| Phase 1b (Enebo et al., Lancet 2021) |
NCT03600480 |
96 |
20 weeks |
cagrilintide 0.16, 0.30, 0.60, 1.2, 2.4 or 4.5 mg with semaglutide 2.4 mg, co-escalated in four-week steps over 16 weeks |
safety and pharmacokinetics were the endpoints |
| Phase 2, type 2 diabetes (Frias et al., Lancet 2023) |
NCT04982575 |
92 |
32 weeks |
2.4 mg each; semaglutide 2.4 mg; cagrilintide 2.4 mg |
15.6% against 5.1% and 8.1%; HbA1c 2.2 against 1.8 and 0.9 points |
| REDEFINE 1 (Garvey et al., NEJM 2025) |
NCT05567796 |
3,417 |
68 weeks |
2.4 mg each; each alone; placebo; 16-week escalation |
20.4% against 3.0% on placebo |
| REDEFINE 2 (Davies et al., NEJM 2025) |
NCT05394519 |
1,206 |
68 weeks |
2.4 mg each against placebo, type 2 diabetes |
13.7% against 3.4% |
| REDEFINE 5 (Yamauchi et al., Lancet Diabetes and Endocrinology 2026) |
NCT05813925 |
331 |
68 weeks |
2.4 mg each against semaglutide 2.4 mg, Japan and Taiwan |
18.4% against 11.9% |
| REIMAGINE 2 (Buse et al., Lancet Diabetes and Endocrinology 2026) |
NCT06065540 |
2,713 |
68 weeks |
2.4 mg each; semaglutide 2.4; cagrilintide 2.4; 1.0 mg each; semaglutide 1.0; placebo |
HbA1c was the primary endpoint, type 2 diabetes |
| Cagrilintide alone, dose-finding (Lau et al., Lancet 2021) |
NCT03856047 |
706 |
26 weeks |
0.3, 0.6, 1.2, 2.4 or 4.5 mg weekly; liraglutide 3 mg; placebo |
dose-response; the source of the 2.4 mg figure |
Two details from the abstracts. The gastrointestinal adverse-event rate in REDEFINE 1 was 79.6% on CagriSema against 39.9% on placebo, mainly transient (Garvey et al.). The 2.4 mg cagrilintide figure was one of five arms in the dose-finding trial and not the highest, which ran to 4.5 mg (Lau et al.). Novo Nordisk filed CagriSema with FDA in December 2025 on REDEFINE 1 and 2; no regulator had approved it on 2026-09-18.
The tirzepatide pairing, as trials actually use it
Three registrations name both cagrilintide and tirzepatide (ClinicalTrials.gov, 2026-09-18), and every one of them is a comparison, not a combination: REDEFINE 4 (NCT06131437), 809 adults with obesity, CagriSema 2.4/2.4 mg after a 16-week escalation against tirzepatide 15 mg after a 20-week escalation, for 84 weeks; NCT06221969, 1,024 adults with type 2 diabetes, CagriSema 2.4/2.4 mg against tirzepatide 15 mg for 68 weeks; and NCT06534411, 1,023 adults with type 2 diabetes, CagriSema 1.0/1.0 mg against tirzepatide 5 mg. All three are complete, and only the first has a reported result: Novo Nordisk announced on 2026-02-23 that CagriSema lost 20.2% of body weight against 23.6% on tirzepatide and did not meet the non-inferiority endpoint (as reported by STAT and HCPLive, read 2026-09-18).
The only data on giving the two together come from rats. An abstract at the American Diabetes Association's 2024 Scientific Sessions (Diabetes 2024;73, supplement 1, 300-OR) dosed diet-induced obese male Sprague Dawley rats once daily for 12 days with 3 and 10 nmol/kg of cagrilintide and tirzepatide, alone or combined at sub-maximal doses; the journal page refused this site's request on 2026-09-18, so its results are not quoted. A 2026 Nature Metabolism paper (Petersen et al., PMID 42744908) combined cagrilintide with retatrutide in obese male rats and reports weight loss exceeding both monotherapies and matched-dose combinations built on semaglutide or tirzepatide. Protocol and telehealth pages state a human pairing of tirzepatide 2.5 mg with cagrilintide 0.3 mg weekly, escalating (read 2026-09-18); that figure is theirs, and one of the same pages states that no approved or evidence-based protocol for the combination exists.
The labelled doses in the stack
Semaglutide and tirzepatide carry the only labels in this article. WEGOVY (revised 6/2026): 0.25 mg weekly for weeks 1 to 4, then 0.5, 1 and 1.7 mg in four-week steps, to a maintenance dose of 1.7 or 2.4 mg, with 7.2 mg as a maximum for patients who tolerate 2.4 mg for at least four weeks. ZEPBOUND (revised 8/2026): 2.5 mg weekly for four weeks, then 2.5 mg increments after at least four weeks at each step, to 5, 10 or 15 mg. Both read on DailyMed on 2026-09-18. Cagrilintide has no label; its trial range is above.
Reconstitution and the units per draw
Concentration is the milligrams in the vial divided by the millilitres of water; the draw on a U-100 syringe is the quantity in mg divided by that concentration, times 100. The vial sizes are the ones the site's calculators carry: cagrilintide 5 and 10 mg, semaglutide 5 and 10 mg, tirzepatide 10, 15 and 30 mg.
| Vial |
Water |
Concentration |
Quantity |
Units (U-100) |
| Cagrilintide 5 mg |
1 mL |
5 mg/mL |
0.3 mg |
6 units |
| same vial |
1 mL |
5 mg/mL |
1.2 mg |
24 units |
| same vial |
1 mL |
5 mg/mL |
2.4 mg |
48 units |
| Cagrilintide 10 mg |
2 mL |
5 mg/mL |
4.5 mg |
90 units |
| Semaglutide 5 mg |
2 mL |
2.5 mg/mL |
0.25 mg |
10 units |
| same vial |
2 mL |
2.5 mg/mL |
1 mg |
40 units |
| same vial |
2 mL |
2.5 mg/mL |
2.4 mg |
96 units |
| Tirzepatide 10 mg |
2 mL |
5 mg/mL |
2.5 mg |
50 units |
| same vial |
2 mL |
5 mg/mL |
5 mg |
100 units |
| Tirzepatide 15 mg |
1 mL |
15 mg/mL |
15 mg |
100 units |
| Tirzepatide 30 mg |
2 mL |
15 mg/mL |
7.5 mg |
50 units |
Two vials mean two draws and two calculations, and in the trials both drugs came from pens rather than vials. The blend calculator works two vials side by side; the cagrilintide calculator, semaglutide calculator and tirzepatide calculator cover each vial at any water volume, and the retatrutide calculator covers the compound in the 2026 rat paper. The scale and barrels are on the insulin syringe units page.
The CagriSema figures omit the research vial: they were measured with pen devices, a 16-week escalation, lifestyle intervention in every arm and a sponsor's programme behind them. The tirzepatide figures omit the combination: the trials compared, they did not combine, and the one combination report is twelve days in rats. The circulating figure for tirzepatide with cagrilintide omits any human source. Route, frequency, duration and population are therefore known for CagriSema in its trials and for nothing else on this page.
Related pages
The weight-loss stack page sets this combination beside the compounds sold with it that have no trials; the stacks hub indexes every combination page; the dosage pages for cagrilintide, semaglutide, tirzepatide and retatrutide hold each compound's reported range with its source, indexed on the dosage hub; the subcutaneous injection how-to reports the subcutaneous procedure as the semaglutide and tirzepatide labels describe it.
This page does not recommend a combination, a dose, a schedule or a vendor. It reports what one registry, seven trial abstracts, two labels, one company announcement and the promoting pages state, each with its date, and it does the arithmetic on the vials.
Sources and dates
Opened 2026-09-18: the ClinicalTrials.gov v2 API for cagrilintide (44 records), with semaglutide (35) and with tirzepatide (3), and the records NCT05567796, NCT05394519, NCT06131437, NCT06221969, NCT06534411, NCT04982575, NCT03856047 and NCT04940078; the abstracts of PMID 40544433, 40544432, 37364590, 33894838, 34798060, 42009015, 42251859 and 42744908 via the NCBI E-utilities; the DailyMed SPL search API for cagrilintide (zero records) and the WEGOVY and ZEPBOUND labels; the REDEFINE 4 result as reported by STAT (2026-02-23) and HCPLive; the CagriSema filing as carried by drugs.com (2025-12-22); the ADA 2024 abstract listing (Diabetes 73, supplement 1, 300-OR), whose page refused the request; the 2026 network meta-analysis by its PubMed record (PMID 42207966); protocol and telehealth pages carrying the circulating figures. Corrections go to the contact page.
