Cagrilintide Dosing Protocol: 5 mg Vial — Week-by-Week Titration & Supplies
Amylin analogue cagrilintide titration schedule using the 5 mg vial, based on Phase 2 CagriSema trial titration data.
Quickstart highlights
Cagrilintide is a fatty acid-modified, long-acting amylin analogue (Novo Nordisk, AM833) that activates amylin/calcitonin receptors in the hypothalamus (area postrema and ARC), producing satiety, slowing gastric emptying, and suppressing glucagon.
- Concentration: 2.5 mg/mL (5 mg vial + 2 mL bacteriostatic water).
- At 2.5 mg/mL: 0.25 mg = 10 units, 0.5 mg = 20 units, 1 mg = 40 units, 2.4 mg = 96 units.
- Phase 3 REDEFINE trial maintenance dose: 2.4 mg once weekly (combined with semaglutide 2.4 mg).
- One 5 mg vial provides 20 doses at 0.25 mg or 2 doses at 2.4 mg maintenance.
- Refrigerate; use within 28 days.
Dosing table
For educational reference only. Your prescribing provider may adjust doses based on your clinical profile and response.
| Week | Dose (µg) | Units | Frequency | Notes |
|---|---|---|---|---|
| 1-4 | 250 | 10 | Once weekly | 0.25 mg starting dose — 10 units; one 5 mg vial provides 20 doses at this level |
| 5-8 | 500 | 20 | Once weekly | 0.5 mg — 20 units |
| 9-12 | 1000 | 40 | Once weekly | 1 mg — 40 units |
| 13-16 | 1700 | 68 | Once weekly | 1.7 mg — 68 units; use 100-unit syringe |
| 17+ | 2400 | 96 | Once weekly | 2.4 mg maintenance — 96 units; target dose from REDEFINE Phase 3 trials |
Your free Cagrilintide tracker
- Dose reminders
- Injection logging
- Cycle progress
Reconstitution steps
- Draw 2 mL bacteriostatic water; inject slowly down the vial wall.
- Swirl gently until lyophilized cake dissolves; do not shake.
- Final concentration: 2.5 mg/mL (5 mg / 2 mL). At 2.5 mg/mL: 1 unit = 25 µg.
- Label with date and concentration; refrigerate at 2–8 °C immediately.
Supplies needed
8-week plan
- 1 vial
- 8 syringes
- 2 mL bac water
- 8 alcohol swabs
16-week plan
- 2 vials
- 16 syringes
- 4 mL bac water
- 16 alcohol swabs
24-week plan
- 3 vials
- 24 syringes
- 6 mL bac water
- 24 alcohol swabs
Protocol overview & cycle notes
Titrate cagrilintide from 0.25 mg to the 2.4 mg maintenance dose over 16 weeks to achieve sustained amylin-mediated appetite suppression and complement GLP-1 agonist therapy in the CagriSema combination protocol.
Cycle length: 20 weeks on.
Off-cycle: 8 weeks off; monitor weight and appetite during off-cycle.
Storage & handling
Injection & tracking tips
- Cagrilintide is typically co-administered with semaglutide (CagriSema protocol); if combining, use separate syringes and sites.
- Rotate injection sites weekly: abdomen, thigh, upper arm.
- Nausea is most common in weeks 1–8; take injections in the evening to minimize daytime discomfort.
Tracking
Logging helps you and your provider spot patterns and adjust dose or timing.
- Log body weight weekly; cagrilintide produces slower initial weight loss than GLP-1 agonists — full effects emerge at 8–12 weeks.
- Record nausea and satiety level daily during the first 12 weeks.
- Track caloric intake during the first month to calibrate dose timing relative to meals.
How this works & references
Sources
- Source: SCALE Phase 2 (NCT04755959) — CagriSema: 15.6% weight loss vs. 5.1% cagrilintide alone
- REDEFINE Phase 3 trials (NCT04982575) — CagriSema ongoing Phase 3
- Safety, tolerability, pharmacokinetics, and pharmacodynamics of concomitant administration of multiple doses of cagrilintide with semaglutide 2·4 mg for weight management: a randomised, controlled, phase 1b trial. Enebo LB et al. — Lancet — 2021
- Once-weekly cagrilintide for weight management in people with overweight and obesity: a multicentre, randomised, double-blind, placebo-controlled and active-controlled, dose-finding phase 2 trial. Lau DCW et al. — Lancet — 2021
Frequently asked questions
Is cagrilintide effective as a monotherapy?
How is cagrilintide different from pramlintide (Symlin)?
When is the CagriSema combination available?
Do I need to combine cagrilintide with semaglutide?
What side effects should I watch for during titration?
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