How CagriSema Works: Mechanism and Pharmacology
How CagriSema works: its target and mechanism as the sources state them, how long it acts, and what is still unknown.
- Class
- Amylin + GLP-1 combination
- FDA status
- Not approved
- Investigational · filed with FDA
- Routes studied
- subcutaneous
- Half-life
- 159-195 h (with semaglutide 2.4 mg co-administered)
- subcutaneous, in people · Lancet 2021, PMID 33894838
How long it acts
Half-life values from FDA labels and published studies, by route. Animal values are labelled and do not describe people.
| Route | Half-life | Measured in | Source |
|---|---|---|---|
| subcutaneous | 159-195 h (with semaglutide 2.4 mg co-administered) | People | Lancet 2021, PMID 33894838 |
| subcutaneous (semaglutide, co-administered with cagrilintide) | 145-165 h | People | Lancet 2021, PMID 33894838 |
Two agonists in one injection
The REIMAGINE 1 authors describe CagriSema as a once-weekly combination of an amylin receptor agonist (cagrilintide) and a GLP-1 receptor agonist (semaglutide).[2]
The REIMAGINE 2 authors say the two drugs have complementary effects on glycaemic control and bodyweight.[3]
The sponsor's phase 1b trial gave both drugs together and described the drug pair as an amylin analogue plus a GLP-1 analogue.[1]
What happens to drug levels when they are combined
In that phase 1b trial cagrilintide exposure rose in proportion to dose and did not change semaglutide exposure or elimination.[1]
Half-lives were 159-195 h for cagrilintide and 145-165 h for semaglutide.[1]
Effects that differ from either drug alone
In the phase 2 diabetes trial, weight fell by 15.6% with the combination, 5.1% with semaglutide and 8.1% with cagrilintide.[4]
A meta-analysis found the combination produced greater percentage weight loss than semaglutide, with cagrilintide alone comparable to semaglutide.[5]
What no label can tell us
Drugs@FDA returned no match for an active ingredient called cagrisema on 2026-10-02, so there is no label mechanism-of-action section to quote.[6]
Common questions
How long does CagriSema act in the body?
The half-life values we found are 159-195 h (with semaglutide 2.4 mg co-administered) (subcutaneous); 145-165 h (subcutaneous (semaglutide, co-administered with cagrilintide)). A half-life is how long the amount in the body takes to fall by half; it is not the same as how long an effect lasts.
More on CagriSema
Sources
- 1Safety, 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.Lancet (London, England) · 2021PMID 33894838Accessed 2 Oct 2026
- 2Efficacy and safety of once-weekly cagrilintide-semaglutide (CagriSema) in adults with type 2 diabetes inadequately controlled on diet and exercise (REIMAGINE 1): a randomised, double-blind, placebo-controlled, phase 3a study.The lancet. Diabetes & endocrinology · 2026PMID 42251860Accessed 2 Oct 2026
- 3Cagrilintide-semaglutide (CagriSema) versus semaglutide or cagrilintide in people with type 2 diabetes (REIMAGINE 2): a double-blind, randomised, controlled, phase 3 study.The lancet. Diabetes & endocrinology · 2026PMID 42251859Accessed 2 Oct 2026
- 4Efficacy and safety of co-administered once-weekly cagrilintide 2·4 mg with once-weekly semaglutide 2·4 mg in type 2 diabetes: a multicentre, randomised, double-blind, active-controlled, phase 2 trial.Lancet (London, England) · 2023PMID 37364590Accessed 11 Oct 2026
- 5Efficacy and Safety of Cagrilintide and Cagrisema Versus Semaglutide as Anti-Obesity Medications: A Systematic Review, Meta-Analysis and Meta-Regression.Diabetes, obesity & metabolism · 2026PMID 41834765Accessed 2 Oct 2026
- 6Drugs@FDA (openFDA) search: active ingredient "cagrisema"U.S. Food and Drug Administration · 2026api.fda.govAccessed 2 Oct 2026
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