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Reviewed by MyPeptideMatch Editorial TeamLast reviewed February 2026Updated February 2026

Cagrilintide Dosing Protocol: 10 mg Vial — Week-by-Week Titration & Supplies

Higher-volume cagrilintide protocol guide for the 10 mg compounded vial — ideal for patients advancing through mid-to-high dose titration.

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Quickstart highlights

Cagrilintide 2.4 mg once weekly combined with semaglutide 2.4 mg (CagriSema) produced 22.7% body weight reduction at 68 weeks in the Phase 3 REDEFINE-1 interim analysis, surpassing both monotherapies.

  • Concentration: 5 mg/mL (10 mg vial + 2 mL bacteriostatic water).
  • At 5 mg/mL: 0.25 mg = 5 units, 0.5 mg = 10 units, 1 mg = 20 units, 2.4 mg = 48 units.
  • REDEFINE-1 Phase 3: CagriSema (cagrilintide 2.4 mg + semaglutide 2.4 mg) produced 22.7% weight loss at 68 weeks.
  • One 10 mg vial provides ~4 maintenance doses at 2.4 mg weekly.
  • Refrigerate; use within 28 days.

Dosing table

For educational reference only. Your prescribing provider may adjust doses based on your clinical profile and response.

WeekDose (µg)UnitsFrequencyNotes
1-42505Once weekly0.25 mg — 5 units at 5 mg/mL; one 10 mg vial provides 40 starting doses
5-850010Once weekly0.5 mg — 10 units
9-12100020Once weekly1 mg — 20 units
13-16170034Once weekly1.7 mg — 34 units
17+240048Once weekly2.4 mg maintenance — 48 units; 10 mg vial provides ~4 maintenance doses

Reconstitution steps

  1. Draw 2 mL bacteriostatic water; inject slowly down the vial wall.
  2. Swirl gently until lyophilized powder dissolves fully.
  3. Final concentration: 5 mg/mL (10 mg / 2 mL). At 5 mg/mL: 1 unit = 50 µg.
  4. Label with date and 5 mg/mL notation; refrigerate at 2–8 °C.

Supplies needed

12-week plan

  • 1 vial
  • 12 syringes
  • 2 mL bac water
  • 12 alcohol swabs

20-week plan

  • 1 vial
  • 20 syringes
  • 2 mL bac water
  • 20 alcohol swabs

24-week plan

  • 2 vials
  • 24 syringes
  • 4 mL bac water
  • 24 alcohol swabs
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Protocol overview & cycle notes

Provide an efficient 20+ week supply of cagrilintide from the 10 mg vial for patients advancing through the full 2.4 mg titration protocol, particularly when used as part of the CagriSema combination.

Cycle length: 20 weeks on.

Off-cycle: 8 weeks off; monitor weight and metabolic parameters.

Storage & handling

Lyophilized: store below 25 °C. Reconstituted at 5 mg/mL: refrigerate 2–8 °C; use within 28 days. Note: 5 mg/mL concentration — different unit values than the 5 mg vial (2.5 mg/mL).

Injection & tracking tips

  • At 5 mg/mL, units are halved compared to the 5 mg vial (2.5 mg/mL). The 2.4 mg maintenance dose is 48 units (not 96 units).
  • The 10 mg vial provides approximately 4 maintenance doses at 2.4 mg — plan reconstitution every 4 weeks.
  • Store vial upright in the refrigerator door; avoid temperature fluctuations from frequent door opening.

Tracking

Logging helps you and your provider spot patterns and adjust dose or timing.

  • Track weekly body weight at the same time of day (fasted, morning).
  • Record GI symptom severity using a 0–10 scale for the first 16 weeks.
  • Monitor blood glucose weekly if using alongside semaglutide for the CagriSema protocol.
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How this works & references

Cagrilintide 2.4 mg once weekly combined with semaglutide 2.4 mg (CagriSema) produced 22.7% body weight reduction at 68 weeks in the Phase 3 REDEFINE-1 interim analysis, surpassing both monotherapies. Amylin receptor activation in the area postrema and hypothalamic ARC reduces meal size, delays gastric emptying, and suppresses meal-stimulated glucagon independently of GLP-1 receptor pathways.

Sources

Frequently asked questions

How does the 10 mg vial compare to the 5 mg vial for dosing accuracy?
The 10 mg vial at 5 mg/mL uses smaller unit volumes for low doses (5 units for 0.25 mg versus 10 units), requiring more precision on the syringe. A 30-unit or 50-unit syringe is preferable for doses below 0.5 mg with this vial.
How long does a 10 mg vial last at 2.4 mg/week maintenance?
Approximately 4 weeks — 10 mg ÷ 2.4 mg/dose = 4.17 doses. Always use within 28 days of reconstitution, aligning well with the 4-week life of a single vial at this dose.
Is CagriSema more effective than tirzepatide?
Phase 3 interim data suggests comparable or superior efficacy: CagriSema achieved ~22.7% at 68 weeks versus tirzepatide's 20.9% at 72 weeks (SURMOUNT-1). No head-to-head trials exist.
Can I use cagrilintide with tirzepatide instead of semaglutide?
No clinical trial data supports cagrilintide + tirzepatide combination. The CagriSema trials specifically studied semaglutide as the GLP-1 partner. Off-label combinations should only be considered under close medical supervision.
What happens if I miss a weekly cagrilintide dose?
Inject as soon as possible if within 5 days of the scheduled dose; otherwise skip and resume the next week. Do not double-dose. The 7-day half-life means missing one injection produces only modest plasma level decline before the next scheduled dose.

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This content is for informational purposes only and does not constitute medical advice. Consult a licensed healthcare provider before starting any peptide therapy. Dosing and protocols may vary by formulation and prescriber.

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