Cagrilintide 20mg — Extended-protocol format, long-acting amylin analog

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The 10mg is in stock, shipped on the next dispatch, at 65,00 €I take the 10mg

Cagrilintide 20mg is the extended-protocol format for long cohorts and CagriSema combinations over prolonged duration. The molecule is strictly identical to the 5mg or 10mg versions: only the total lyophilized peptide quantity per vial changes. 20mg enables the full 0.3-4.5mg weekly escalation (9mg consumed over 10 weeks) followed by a 2.4mg maintenance phase over an additional 4 to 5 weeks — 14 to 15 weeks of single-subject follow-up. Alternatively: supply 2 subjects in parallel through the full escalation phase. Cost per mg reduced by about 35% versus 10mg. Long-acting synthetic analog of human amylin developed by Novo Nordisk. Our Cagrilintide 20mg batch is solid-phase synthesized, HPLC purity of at least 98%, lyophilized under inert atmosphere. Stock in France, discreet shipping the next day, 3 to 7 business days in the EU. Reference choice to reproduce REDEFINE designs or CagriSema combinations documented in phase 2 over extended duration.

Science

01
Mechanism of action

Cagrilintide is a long-acting synthetic analog of human amylin, designed by Novo Nordisk to overcome the pharmacokinetic limitations of pramlintide (short half-life, multi-daily administration). The molecule is modified by acylation with a C18 fatty acid chain on the Lys22 residue, which maximizes serum albumin binding and extends plasma half-life to approximately 7 days in humans, compatible with weekly administration.

At the receptor level, Cagrilintide simultaneously activates the calcitonin receptor (CTR) and the amylin receptor complexes (AMY1, AMY2, AMY3) formed by association of CTR with receptor activity-modifying proteins (RAMPs). This signaling, distinct from that of GLP-1, produces an anorexigenic effect through complementary neuronal pathways: activation of catecholaminergic neurons in the solitary tract (NTS), modulation of satiety circuits in the hypothalamus, and GLP-1-independent slowing of gastric emptying.

In preclinical DIO (Diet-Induced Obesity) models, animals treated with Cagrilintide alone have shown a 11 to 13% weight reduction over 4 weeks, with preservation of lean mass. The most striking effect documented in the literature remains the synergy observed in co-administration with Semaglutide (CagriSema): full addition of anorexigenic effects, weight reduction exceeding 20% in clinical phase 2 at 32 weeks (Frias et al., Lancet 2023). This synergy has opened an entire field of exploration on amylin + GLP-1 combination that neither molecule alone can achieve.

Cagrilintide also modulates bone markers and calcium metabolism via the calcitonin pathway, which is the subject of parallel studies on bone mineral density and post-menopausal fractures. These avenues remain exploratory but broaden the research scope beyond pure energy metabolism.

Cagrilintide is a synthetic analogue of human amylin (hIAPP, Islet Amyloid Polypeptide, 37 aa, 3904 Da), a peptide hormone co-secreted with insulin by pancreatic β-cells whose sequence is closely conserved with calcitonin. Native human amylin shows amyloidogenic propensity (Aβ-like fibril formation in diabetic pancreatic islets) requiring stabilising modifications: cagrilintide incorporates (1) Pro25, Pro28, Pro29 substitutions (inherited from pramlintide) blocking β-sheet propensity and fibrillisation, (2) an Arg18 substitution improving solubility, and (3) a C20 diacid acylation (eicosanedioic acid) on Lys8 via γ-Glu/OEG linker, conferring reversible plasma albumin binding responsible for its exceptional half-life (~180 hours, compatible with weekly administration). Pharmacologically, cagrilintide activates hybrid receptors AMY1R, AMY2R, AMY3R (calcitonin-receptor + RAMP1/2/3 complexes), the amylin/CGRP receptor family, and more weakly the calcitonin receptor CTR. Signalling pathways include adenylate cyclase activation (cAMP), glucagon suppression, slowed gastric emptying, and central action on arcuate hypothalamic nucleus (POMC/CART neurons) for satiety.

Clinical data

02Clinical studies

The scientific database on Cagrilintide rapidly took shape between 2020 and 2024 around four reference trials published or presented at major congresses (ADA, EASD, ObesityWeek).

The pivotal phase 2 study by Lau et al., published in The Lancet in 2021 (DOI: 10.1016/S0140-6736(21)00845-X), evaluated Cagrilintide as monotherapy in 706 overweight or obese adults, randomized between placebo, liraglutide 3.0mg and Cagrilintide at escalating doses (0.3, 0.6, 1.2, 2.4, 4.5 mg weekly). At 26 weeks, weight reduction reached 10.8% in the Cagrilintide 4.5mg group, 8.0% at 2.4mg, versus 9.0% for liraglutide 3.0mg and 3.0% for placebo. The tolerance profile proved more favorable than that of liraglutide with fewer transient gastrointestinal effects.

The CagriSema combination study (Frias et al., Lancet 2023, DOI: 10.1016/S0140-6736(23)01163-7) evaluated 92 adults with type 2 diabetes, randomized between Semaglutide 2.4mg, Cagrilintide 2.4mg and the CagriSema 2.4mg/2.4mg combination. At 32 weeks, weight reduction reached 15.6% in the CagriSema group, versus 5.1% for Cagrilintide alone and 5.1% for Semaglutide alone. HbA1c dropped by 2.2% absolute in the combination group. This additive synergy was the trigger for the phase 3 REDEFINE program.

The REDEFINE program (phase 3, initiated late 2023) includes five active trials, including REDEFINE-1 (obesity without diabetes) and REDEFINE-2 (type 2 diabetes). Initial partial readouts presented at ADA 2024 confirm a weight reduction exceeding 20% at 68 weeks for CagriSema, a value unmatched to date in the incretin class outside Retatrutide. Complete results are expected for 2025-2026.

In preclinical research, work by Jensen et al. (Cell Reports Medicine 2022) on C57BL/6J mouse models subjected to a high-fat diet documented a 40% reduction in spontaneous caloric intake under Cagrilintide at 100 µg/kg weekly, with a 23% weight reduction over 8 weeks. c-Fos brain imaging confirmed preferential activation of the solitary tract nuclei and area postrema, corroborating the central amylin mechanism.

On the safety front, cumulative phase 2 and early phase 3 data indicate a gentler gastrointestinal profile than GLP-1 agonists, with no notable signal on cardiovascular, renal or hepatic parameters. The most frequent effects remain transient nausea (dose-dependent) and injection-site reactions. No measurable neoplasia has been reported in extension follow-up beyond 52 weeks.

Cagrilintide preclinical models focus on weight reduction and glycaemic control. In DIO (Diet-Induced Obesity) Sprague-Dawley rat model: SC administration 1-5 nmol/kg weekly over 4-8 weeks, dose-dependent weight loss 8-20% vs control, significant reduction in daily food intake (Lau et al., J Med Chem 2015 — reference paper for preclinical cagrilintide). In ZDF (Zucker Diabetic Fatty) rat model: improved fasting glycaemia, decreased rodent HbA1c, postprandial glucagon suppression. In non-human primate (cynomolgus) model: pharmacokinetics confirming extended ~7-day half-life, SC bioavailability > 80%. The cagrilintide + semaglutide combination (CagriSema co-formulation) produces documented additive effects on body weight and glycaemic profile in DIO rats and primates, justifying current clinical development at Novo Nordisk (REDEFINE and REIMAGINE trials). Additivity mechanisms involve convergence of GLP-1R (semaglutide) and AMY-R/CTR (cagrilintide) pathways on hypothalamic appetite regulation nuclei.

No references yet for this peptide — search PubMed for associated scientific literature.

The listed studies are provided for documentation and research purposes only. They do not constitute a therapeutic indication nor a recommendation for human use. This product is strictly for laboratory use only (RUO).

Lab workflow

03
Research protocols

The Cagrilintide 20mg vial is reconstituted with 2 ml of 0.22 µm sterile-filtered bacteriostatic water, giving a final concentration of 10 mg/ml. This concentration optimizes readability across the full dose range (0.3mg = 0.03 ml, 2.4mg = 0.24 ml, 4.5mg = 0.45 ml). Precision 1 ml U100 graduated syringe (29G or 30G) required for micro-volume reading.

Typical titration schedule in exploratory research on 20mg (modeled on full Lau 2021): 0.3mg weekly for 2 weeks, 0.6mg for 2 weeks, 1.2mg for 2 weeks, 2.4mg for 4 weeks, 4.5mg for 4 weeks (total escalation 9mg consumed), then 2.4mg maintenance weekly for the remaining 4 to 5 weeks of the vial. This 14 to 15-week window faithfully reproduces pivotal observations and allows a documentable maintenance phase on the same peptide batch.

For a CagriSema combination, fix the Cagrilintide dose at 2.4mg in stabilization and introduce Semaglutide in parallel escalation at the end of the Cagrilintide cycle. This co-administration allows reproduction of REDEFINE-1 experimental parameters on a single subject.

Administration frequency: once weekly, same day, subcutaneous route in animal research or as in vitro application depending on experimental design. Classic rotation sites: peri-umbilical abdomen, lateral thigh, posterior triceps.

Stability window after reconstitution: up to 28 days at 2-8 °C if the vial is reconstituted under sterile conditions and the bacteriostatic water contains a preservative (benzyl alcohol 0.9%). Never freeze after reconstitution at the risk of partial denaturation of the peptide backbone. For a cycle exceeding 28 days, aliquot before final reconstitution.

Recommended in vitro measurements on an extended 20mg protocol: weekly weight, quarterly HbA1c, fasting glucose and insulin, HOMA-IR, full lipid panel, blood pressure, heart rate, bone densitometry at entry and exit. For central designs: food-stimulus fMRI, validated satiety scales. LC-MS/MS for intact peptide plasma assay.

Reconstitution for this format (20 mg)Standard volumes used in laboratory settings

Water added	Concentration	Reading marker
2 ml	10 mg/ml	10 UI = 1 mg
3 ml	6,67 mg/ml	40 UI = 2,67 mg

The volume of water does not change the product, only its concentration. Introduce the water slowly along the vial wall, never directly onto the lyophilisate, then swirl without shaking. Markers given on a 1 ml syringe graduated in 100 units.

Asepsis

Disinfect surfaces and stoppers (70% alcohol).

Solvent

Draw the required volume of bacteriostatic water.

Introduction

Inject gently against the vial wall (avoid direct jet on powder).

Solubilization

Roll the vial gently. Do not shake vigorously (degradation risk).

Solution storageOnce reconstituted: 2-8°C (refrigerator).

WarningTheoretical tool for chemical handling. Does not constitute medical advice.

I open the dilution calculator

What is normal on arrivalThe observations that worry customers, and are not defects

The amount of powder looks tiny. A lyophilisate takes up a few millimetres at the bottom of the vial, sometimes just a translucent film. The stated weight is there.
The powder is compact, stuck to the wall or to the stopper. Transport moves the freeze-dried cake around. It changes nothing to reconstitution.
The vial carries no individual label. That is our standard packaging, not a downgraded vial.
After reconstitution, deposits or filaments appear. This is common, especially with small molecules. Let it settle and roll the vial between your palms, never shake it.
The parcel is plain. Nothing on the outside indicates the contents or the brand name.

What is not normal: a cracked vial, an uncrimped cap or a stopper that moves, powder that has liquefied or changed colour. In those specific cases, write to us with a photo and we take the vial back.

Handling

04Storage & handling

Upon receipt, the lyophilized Cagrilintide vial is stable for up to 24 months at -20 °C, hermetically sealed, protected from direct light exposure. Temporary storage at 2-8 °C for a maximum of 30 days is tolerated with no documented loss of HPLC purity. Avoid repeated freeze-thaw cycles: each cycle marginally degrades tertiary structure and may reduce measurable biological activity. For reconstitution, use exclusively 0.22 µm sterile-filtered bacteriostatic water (benzyl alcohol 0.9% as preservative). Slowly deposit the solvent against the inner wall of the vial to avoid foaming that would damage the peptide chain. Swirl the vial gently — never vortex or shake abruptly. After reconstitution, store refrigerated (2-8 °C) protected from light, and ideally use within 28 days. If a protocol requires extended preservation (rare), aliquot into single-use fractions and freeze at -80 °C: this practice preserves integrity better than extended storage at 4 °C. Cagrilintide lyophilised stability is good at -20°C under desiccation: > 24 months with no measurable RP-HPLC purity loss. The critical stability point of cagrilintide lies in its residual fibrillisation propensity (inherited from native amylin, attenuated but not fully suppressed by Pro substitutions): in aqueous solution at neutral pH and room temperature, β-sheet oligomers may form over 72h+, detectable by ThT (thioflavin T) fluorescence and SEC-HPLC. Operational recommendations: reconstitute just before use or store < 14 days at 2-8°C, avoid mechanical agitation (prolonged vortex), use vials with low glass surface/volume ratio (limits interfacial nucleation), optimal pH 6.0-7.0. UV light and temperatures > 25°C significantly accelerate fibrillisation. LC-MS dosing with SEC-HPLC detection is recommended before any critical pharmacological study to quantify the active monomeric fraction.

01What is the difference between Cagrilintide 20mg and other dosages?

The molecule is strictly identical. 20mg is sized for a full Lau 2021 cycle over 14 to 15 weeks single-subject, or to supply a 2-subject mini-cohort through the escalation phase. Cost per mg reduced by about 35% versus 10mg. Reference format to reproduce REDEFINE-1 or an extended CagriSema combination. For a pilot, favor the 5mg.

02What reconstitution protocol for the 20mg?

Reconstitute the 20mg vial with 2 ml of sterile bacteriostatic water (final concentration 10 mg/ml). Readable volumes across the full range (0.3mg = 0.03 ml, 2.4mg = 0.24 ml, 4.5mg = 0.45 ml). Stable for 28 days at 2-8 °C. Precision U100 29G or 30G syringe required for micro-volume.

03How does Cagrilintide act at the brain level?

Cagrilintide activates amylin and calcitonin receptors mainly in the solitary tract (NTS), area postrema and hypothalamus. It recruits satiety circuits distinct from those of GLP-1, which explains the additivity observed in CagriSema combination. c-Fos imaging in rodents confirms preferential NTS activation after peripheral administration.

04Can Cagrilintide be combined with Semaglutide?

Yes, and it is the most studied design to date (CagriSema). The 2.4mg Cagrilintide + 2.4mg Semaglutide combination documented in phase 2 produced a weight reduction of 15.6% at 32 weeks, superior to each molecule alone (5.1% each). The REDEFINE phase 3 program confirms reductions exceeding 20% at 68 weeks. This co-administration remains strictly exploratory in research.

05Which biological markers should be tracked under Cagrilintide?

Body weight, body composition (DEXA), carbohydrate workup (glucose, HbA1c, HOMA-IR), lipid panel, blood pressure, heart rate. For the calcitonin pathway: bone densitometry at entry and exit, bone remodeling markers (CTX, P1NP), calcemia. For central designs: validated satiety scales, food craving questionnaires. LC-MS/MS for intact peptide plasma assay.

06Is your Cagrilintide authentic and research-grade?

Yes. Solid-phase synthesis, HPLC purity of at least 98%, lyophilization under inert atmosphere.

07How long does shipping take?

Shipped the next day, Monday to Saturday, with tracking: 2 to 5 business days in France, 3 to 7 in the EU depending on the country. Neutral, discreet parcel; the lyophilised powder travels safely at room temperature.

08What tolerance profile is expected?

Gentler tolerance than GLP-1 agonists according to cumulative literature. Transient dose-dependent nausea, injection-site reactions. No major cardiovascular, renal or hepatic signal documented in phase 2 and early phase 3. Effects typically subside after 2 to 4 weeks of initiation.

09What distinguishes cagrilintide from pramlintide?

Pramlintide (Symlin) is a short-half-life amylin analogue (~48 min) requiring 3 injections daily, FDA-authorised for T1D and T2D in the US. Cagrilintide has the same Pro25/28/29 substitutions (fibrillisation blocking) as pramlintide, but adds a C20 diacid acylation on Lys8 via γ-Glu/OEG linker extending half-life to ~180 hours through albumin binding. In research, this weekly kinetics enables simple 4-12-week chronic studies with a single weekly injection, versus multi-daily injection protocols for pramlintide.

10Can cagrilintide be combined with semaglutide in research?

Yes, co-administration of cagrilintide + semaglutide (sometimes called CagriSema in research) is documented in preclinical literature as producing additive effects on body weight and glycaemia in DIO rat and primate models. The two peptides act via complementary pathways (amylin/CGRP for cagrilintide, GLP-1R for semaglutide) converging on hypothalamic satiety circuits. In research practice, simultaneous or 6h-offset SC administration, independent dosing per standard DIO protocols.

11How to avoid cagrilintide fibrillisation in solution?

Despite Pro25/28/29 substitutions significantly reducing amyloidogenic propensity inherited from native amylin, cagrilintide can form β-sheet oligomers detectable by ThT fluorescence after several days in solution at neutral pH and room temperature. Recommendations: reconstitute just before use or limit storage to 14 days at 2-8°C (vs 28 days for classic peptides), optimal pH 6.0-7.0, amber vials with low surface/volume ratio, gentle agitation (no prolonged vortex), avoid light. SEC-HPLC testing before critical use quantifies the active monomeric fraction.

Benchmark

Similar peptides

Against Semaglutide (GLP-1 mono-agonist), Cagrilintide acts through a completely distinct pathway (amylin and calcitonin receptors). In monotherapy, its weight efficacy is slightly inferior (10-11% vs 15% in phase 2 at comparable dose), but its tolerance profile is gentler, its gastrointestinal effects less pronounced, and it modulates complementary neuronal circuits. The main interest of Cagrilintide is not to be better than Semaglutide solo, but to open the possibility of a synergistic combination.

Against Tirzepatide (dual GIP/GLP-1 agonist), Cagrilintide is clearly less powerful in monotherapy (10% vs 22%). The interest lies elsewhere: Cagrilintide engages no incretin receptor, making it an ideal orthogonal tool to dissect the contribution of the amylin pathway independently of the incretin axis. In combination with a GLP-1 or GIP/GLP-1 agonist, Cagrilintide brings an additive effect because it relies on distinct receptors.

Against Retatrutide (triple agonist), same logic: Cagrilintide is less powerful solo (10% vs 24%) but represents a complementary non-redundant pharmacological lever. Preclinical research programs are actively exploring triple-agonist + amylin combinations.

Strategic conclusion: choose Cagrilintide when the experimental design involves exploring the pure amylin pathway, or when the design incorporates co-administration with an incretin agonist to reproduce the CagriSema synergy documented in phase 2. Cagrilintide in monotherapy is a research tool more than a standalone therapeutic candidate.

Cagrilintide stands out among other amylin agonists by its extended half-life. Compared to pramlintide (Symlin, FDA-authorised amylin analogue for T1D/T2D US, 48 min half-life, 3x/day injectable), cagrilintide extends half-life to ~180h thanks to C20 acylation, allowing weekly administration compatible with chronic obesity model studies. Compared to pure GLP-1R agonists (semaglutide, liraglutide), cagrilintide targets a complementary pathway (amylin/CGRP) with distinct satiety and glucagon suppression mechanisms, justifying CagriSema combination development in clinical research. Compared to GLP-1/GIP co-agonists (tirzepatide) or GLP-1/GIP/GCGR (retatrutide), cagrilintide shares no pathway but may theoretically be additive with these co-agonists (study not yet reported). Compared to davalintide (AC2307, amylin/calcitonin chimera), cagrilintide has a more selective amylin-like profile while preserving residual calcitonin receptor activity (involved in central satiety effects).

Cagrilintide 20mg Perte de poids

Metabolism

01
Mechanism of action

02Clinical studies

03
Research protocols

Asepsis

Solvent

Introduction

Solubilization

04Storage & handling

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Asepsis

Solvent

Introduction

Solubilization

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