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CagriSema Side Effects: What Studies and Users Report

What FDA labels, clinical studies and people who use CagriSema report, how strong that evidence is, and what is still unknown.

Medical review pendingAmylin + GLP-1 combinationUpdated

Side effects reported in studies

Side effects reported in published studies, strongest design first. Frequencies are quoted as the source gives them; animal results are labelled.

Side effects of CagriSema in labels and published studies
Side effectHow commonStudy typeSource
Gastrointestinal events79.6% vs 39.9% with placeboHuman RCTn = 3417The New England journal of medicine 2025, PMID 40544433
Gastrointestinal events72.5% vs 34.4% with placeboHuman RCTn = 1206The New England journal of medicine 2025, PMID 40544432
Gastrointestinal events and hypoglycaemiamost commonHuman RCTn = 92Lancet 2023, PMID 37364590
Adverse events (combined with semaglutide)“Most adverse events were mild to moderate in severity and the proportion of participants with one or more adverse event was similar across treatment groups.”Frequency not statedHuman RCTn = 96Lancet 2021, PMID 33894838
Administration-site conditions and nauseaRR 3.27 administration-site conditions; RR 1.64 nauseaMeta-analysisn = 3545Diabetes, obesity & metabolism 2026, PMID 41834765

Overall safety findings

What studies said about safety as a whole, without naming a specific effect.

Overall safety findings for CagriSema in published studies
FindingHow commonStudy typeSource
Any adverse event143 (87%) of 164 vs 141 (84%) of 167 on semaglutideHuman RCTn = 331The lancet. Diabetes & endocrinology 2026, PMID 42009015
Any adverse event524 (86·9%) of 603 vs 491 (81·2%) of 605 on semaglutide 2·4 mgHuman RCTn = 2713The lancet. Diabetes & endocrinology 2026, PMID 42251859
Severe hypoglycaemia“No severe hypoglycaemia was reported.”Frequency not statedHuman RCTn = 274Lancet 2026, PMID 42251856

What users report

Anecdotal evidence, 0 of 4

Side effects people describe from their own use of CagriSema, quoted from 19 Reddit threads we read in r/Peptides and r/Retatrutide (searched 11 Oct 2026). Each count is the number of different people in those threads, not how common the effect is. These reports are unverified: products bought outside a pharmacy are often mislabelled or impure, and many people take several compounds at once.

Side effects people report from using CagriSema
What people noticedPeople reporting itIn their words
Tiredness or lethargy2“Started with cagrisema in early December but couldn't deal with the side effects (mostly exhaustion)” r/Retatrutide, Mar 2025“Cagri makes me so tired” r/Retatrutide, May 2025
Constipation1“Only major side effect I’ve experienced is slowed digestion in the intestines. So I might only have a bowel movement every 2-3 days.” r/Retatrutide, Feb 2026Also taking other compounds
Dizziness1“I am experiencing some low blood sugar dizziness on cagrisemi, nothing problematic” r/Peptides, Aug 2024
Strong aversion to food1“I couldn’t even look at food for two weeks after the first dose. Literally couldn’t even smell it.” r/Retatrutide, Nov 2025

1 person in the same threads said they noticed no side effects:

“No side affects. It definitely a winner.” r/Retatrutide, Jan 2025

A symptom others mention is not proof that it is harmless. If you have anything on the urgent list below, get care whatever others report.

What is not known

  • How common each effect is at the doses people use outside of studies.
  • Effects that take longer to appear than the length of the published studies.
  • How CagriSema interacts with other medicines and supplements.
  • Whether research-grade products, which are not checked by the FDA, behave like the material used in studies.

When to get medical help

Get urgent care for: trouble breathing, swelling of the face or throat, a widespread rash, severe or lasting stomach pain, fainting, or an injection site that becomes hot, red and spreading.

This is not a complete list. A doctor or pharmacist can help you judge whether a symptom is related.

Gastrointestinal events

In REDEFINE 1 gastrointestinal events affected 79.6% of the combination group and 39.9% of the placebo group, mostly transient and mild to moderate.[1]

REDEFINE 2 in type 2 diabetes reported gastrointestinal events in 72.5% on the combination and 34.4% on placebo.[2]

In REDEFINE 5, gastrointestinal disorders were the most common events: 53% on the combination and 51% on semaglutide.[6]

Stopping treatment and serious events

In REDEFINE 5, 17 participants (10%) discontinued the combination and ten (6%) discontinued semaglutide.[6]

A meta-analysis found cagrilintide on its own carried a higher risk of serious adverse events than semaglutide, with a risk ratio of 1.83.[5]

The REIMAGINE 3 insulin add-on trial recorded one death in a 1.0 mg group, judged not related to treatment (due to malignancy).[8]

How authors describe the safety profile

The REIMAGINE 2 authors say the safety profile was consistent with the GLP-1 receptor agonist class and previous cagrilintide data.[7]

The phase 1b trial counted 566 adverse events in 92 participants, 37% of them gastrointestinal.[4]

Common questions

What are the side effects of CagriSema?

Studies we summarise reported gastrointestinal events, gastrointestinal events, gastrointestinal events and hypoglycaemia. The table on this page gives how often each happened and links each source.

What side effects do people who use CagriSema report?

In the 19 Reddit threads we read (11 Oct 2026), people most often described tiredness or lethargy (2 people), constipation (1 person), dizziness (1 person). These are unverified personal reports, often from products of unknown purity, and the counts are not rates.

Is CagriSema safe?

Its safety has not been established by an FDA review. CagriSema is investigational and not approved for any use. Research-chemical products are not checked for purity or dose.

Is CagriSema banned in sport?

Yes. Prohibited by WADA (S0). Tested athletes should not use it.

More on CagriSema

DosageDoses used in published studies, with the source for each.ResultsStudy outcomes and when they were measured.Legal statusFDA, compounding and WADA status with dates.How to injectSites, syringe types and hygiene, step by step.For weight lossWhat research says about CagriSema for weight loss.How it worksTarget, mechanism and how long it acts, from the label or studies.

Sources

  1. 1Coadministered Cagrilintide and Semaglutide in Adults with Overweight or Obesity.The New England journal of medicine · 2025PMID 40544433Accessed 2 Oct 2026
  2. 2Cagrilintide-Semaglutide in Adults with Overweight or Obesity and Type 2 Diabetes.The New England journal of medicine · 2025PMID 40544432Accessed 2 Oct 2026
  3. 3Efficacy 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 2 Oct 2026
  4. 4Safety, 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
  5. 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
  6. 6Efficacy and safety of co-administered cagrilintide and semaglutide versus semaglutide alone in adults with overweight or obesity with or without type 2 diabetes in Japan and Taiwan (REDEFINE 5): a multicentre, randomised, active-controlled, phase 3a trial.The lancet. Diabetes & endocrinology · 2026PMID 42009015Accessed 2 Oct 2026
  7. 7Cagrilintide-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
  8. 8Cagrilintide-semaglutide (CagriSema) as an add-on to basal insulin in adults with type 2 diabetes (REIMAGINE 3): a randomised, double-blind, placebo-controlled, multicentre, phase 3 study.Lancet (London, England) · 2026PMID 42251856Accessed 2 Oct 2026
  9. 9Reddit thread in r/Retatrutide (user reports, unverified)Reddit, via the Arctic Shift archive · 2025reddit.comAccessed 11 Oct 2026
  10. 10Reddit thread in r/Retatrutide (user reports, unverified)Reddit, via the Arctic Shift archive · 2025reddit.comAccessed 11 Oct 2026
  11. 11Reddit thread in r/Retatrutide (user reports, unverified)Reddit, via the Arctic Shift archive · 2026reddit.comAccessed 11 Oct 2026
  12. 12Reddit thread in r/Peptides (user reports, unverified)Reddit, via the Arctic Shift archive · 2024reddit.comAccessed 11 Oct 2026
  13. 13Reddit thread in r/Retatrutide (user reports, unverified)Reddit, via the Arctic Shift archive · 2025reddit.comAccessed 11 Oct 2026
  14. 14Reddit thread in r/Retatrutide (user reports, unverified)Reddit, via the Arctic Shift archive · 2025reddit.comAccessed 11 Oct 2026

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