Cagrilintide Dosage Chart: 250mcg 3x/Week Protocol

Cagrilintide is Novo Nordisk's long-acting amylin analog currently under investigation for chronic weight management. As one half of the CagriSema combination (paired with semaglutide 2.4 mg), it represents a new approach to obesity pharmacotherapy. Cagrilintide is not FDA-approved and remains investigational as of 2026. This is not medical advice.

Research-context information only. Cagrilintide is an investigational drug not currently approved alone by the FDA. Protocols, doses, and reactions reported below come from published clinical trials and self-reported community sources. This article reports what has been documented, not what should be done. Possession or use of investigational drugs outside an authorized clinical trial may be illegal in your jurisdiction. Consult a licensed physician for personal medical decisions.

Quick Reference: Standard Protocol

Community-documented protocol: 250 mcg subcutaneous in the morning, 3 days per week, for 8-week cycles -- far below the 2.4 mg weekly clinical trial dose, reflecting conservative research-peptide practice.

Cycling: 8 Weeks On, 8 Weeks Off

Community protocols run 250 mcg three times per week for 8 weeks, then 8 weeks off. Cagrilintide's ~160-hour half-life means it accumulates with repeated dosing, so the 3x/week schedule is described as providing sustained receptor activation.

The community cycle length is much shorter than clinical trial durations (26-68 weeks continuous), reflecting the conservative approach typical of research peptide protocols.

Enhanced Protocol: REDEFINE Clinical Titration

The clinical trial program uses a structured 16-week titration to the full therapeutic dose:

This clinical protocol is the evidence-based approach used in REDEFINE trials. The 250 mcg community protocol above is the conservative standard.

Routes of Administration

Subcutaneous injection (standard): Protocols describe injection in the abdomen, thigh, or upper arm, rotating sites between injections, using standard SC technique with a 29-31 gauge insulin syringe.

Clinical pen device: In trials, cagrilintide was delivered via Novo Nordisk's prefilled pen. Research-grade lyophilized powder requires manual reconstitution.

Reconstitution Quick Reference

Math: 5,000 mcg / 2 mL = 2,500 mcg/mL. For 250 mcg: 250 / 2,500 = 0.1 mL = 10 units. One vial lasts 20 doses.

Swirl gently -- do not shake. Refrigerate at 2-8°C and use within 28 days. For step-by-step instructions, see the Reconstitution Calculator.

These figures reflect dilutions documented in community reconstitution protocols for research purposes only.

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Where These Numbers Come From

Cagrilintide has a robust clinical trial program with published phase 2 and phase 3 data.

Phase 2 monotherapy (Lau et al., 2021): 706 adults with overweight/obesity across 57 sites. Cagrilintide 4.5 mg produced 10.8% mean weight loss at 26 weeks, comparable to liraglutide 3.0 mg. Clear dose-response relationship observed from 0.3 mg to 4.5 mg.

REDEFINE 1 -- CagriSema phase 3 (Aronne et al., 2025): CagriSema 2.4/2.4 mg produced 22.7% mean weight loss at 68 weeks vs 2.1% placebo. 60% of participants achieved 20% or more weight loss -- a threshold historically associated with bariatric surgery outcomes.

REDEFINE 2 -- CagriSema in T2D (Lingvay et al., 2025): Significant weight loss and glycemic improvement in adults with overweight/obesity and type 2 diabetes.

Phase 2 CagriSema in T2D (Frias et al., 2023): CagriSema produced superior weight loss and glycemic improvement vs either monotherapy over 32 weeks.

Stacking Protocols

CagriSema is the primary stack: The combination targets complementary pathways -- amylin receptors (satiety, gastric emptying, glucagon suppression) and GLP-1 receptors (insulin secretion, appetite, hedonic eating). Clinical data shows the combination produces significantly greater weight loss than either agent alone.

Side Effects & Safety

Per REDEFINE 1 and the Lau (2021) phase 2 program, trial-reported adverse events include:

• Nausea -- most common (25-40%); peaks during dose escalation, typically mild-moderate
• Diarrhea -- 10-20%, usually transient
• Constipation -- 8-15%
• Vomiting -- 5-15%, more frequent at higher doses
• Injection site reactions -- 5-10%, mild erythema and pruritus
• Decreased appetite -- 5-12%, related to mechanism of action
• Pancreatitis -- rare but monitored (as with all GLP-1/amylin agents)
• Gallbladder events -- cholelithiasis reported, consistent with rapid weight loss

Trial data describes dose titration as central to tolerability -- the 16-week escalation protocol substantially reduced GI adverse events. Not studied in pregnancy.

mg to Units Conversion

On a standard 100-unit insulin syringe, each "unit" equals 0.01 mL (so 100 units = 1 mL). Once cagrilintide is reconstituted, the conversion from a target dose to syringe units depends on the chosen dilution.

The two reconstitution ratios most often described in community protocols are below.

Reconstitution A: 5 mg vial + 2 mL BAC water (2.5 mg/mL) — the standard dilution from the Quick Reference above.

Reconstitution B: 5 mg vial + 3 mL BAC water (1.67 mg/mL) — more BAC water for larger, easier-to-measure draws.

These conversions reflect the dilutions documented in community reconstitution protocols. They report how the math is described, not a recommended dosing schedule.