CagriSema Blend (Cagrilintide 5 mg + Semaglutide 5 mg)

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What Is CagriSema?

CagriSema is Novo Nordisk’s developmental name for the fixed-ratio combination of two long-acting peptides in a single subcutaneous formulation: cagrilintide (the long-acting amylin analog, developmental code AM833) and semaglutide (the long-acting GLP-1 receptor agonist marketed as Ozempic and Wegovy as a stand-alone agent). The combination is the lead Phase 3 obesity programme in Novo Nordisk’s pipeline and reported the REDEFINE-1 trial results in 2024–2025: approximately 20–23% body-weight reduction over 68 weeks at the 2.4 mg + 2.4 mg weekly dose — effect sizes that place CagriSema in the same range as the triple-receptor-agonist retatrutide while taking a completely different pharmacological route.

The strategic rationale for CagriSema rests on the complementary, non-overlapping mechanisms of its two component peptides. GLP-1 receptor agonists (semaglutide) act predominantly on hypothalamic arcuate-nucleus POMC neurons (central appetite regulation) and pancreatic beta-cells (glucose-dependent insulin secretion). Amylin/calcitonin receptor agonists (cagrilintide) act predominantly on brainstem area-postrema neurons (per-meal satiety reinforcement) and pancreatic alpha-cells (glucagon suppression). The two mechanisms are mechanistically additive rather than redundant, which is why the combination produces body-weight effects substantially greater than either component alone — demonstrated in the Phase 2 head-to-head data where CagriSema outperformed both cagrilintide monotherapy and semaglutide monotherapy.

This research-grade CagriSema co-formulation contains 5 mg cagrilintide + 5 mg semaglutide per vial in a 1:1 mass ratio matching the fixed-dose ratio used in the Phase 3 clinical programme. Both components are pre-mixed in the same lyophilized vial; reconstitution with bacteriostatic water yields a working solution containing both peptides simultaneously. This approach eliminates the need to combine separate vials at the bench. CagriSema is not approved by the FDA, EMA, MHRA, or any other major regulator for human therapeutic use as of current literature; regulatory submission and review are ongoing. The research-grade CagriSema sold here is supplied uitsluitend voor laboratoriumonderzoek and is not intended for human or veterinary administration. For deeper detail on each component, see our individual Cagrilintide en Semaglutide product pages.

Mechanism of Action — Complementary Dual-Receptor Pharmacology

What makes CagriSema mechanistically distinctive among current metabolic-research compounds is that the two component peptides activate entirely different receptor families with non-overlapping central and peripheral mechanisms — achieving multi-axis pharmacology through combination rather than through engineering a single multi-agonist molecule like tirzepatide or retatrutide:

• GLP-1 receptor arm (semaglutide) — central appetite regulation and glycaemic control — Semaglutide activates the GLP-1 receptor on hypothalamic arcuate-nucleus POMC neurons (suppressing food intake via the central appetite system), pancreatic beta-cells (glucose-dependent insulin secretion), pancreatic alpha-cells (glucagon suppression), and gastric vagal afferents (delayed gastric emptying). This arm provides the canonical incretin pharmacology that semaglutide and other GLP-1 agonists are known for in published research and approved clinical use.
• Amylin / calcitonin receptor arm (cagrilintide) — brainstem satiety and per-meal feedback — Cagrilintide activates the amylin receptor heterodimers (AMY1, AMY2, AMY3 — calcitonin receptor + RAMP1/2/3) located densely in the brainstem area postrema, a CNS region that lacks a blood-brain barrier. This produces per-meal satiety reinforcement on a different temporal pattern than GLP-1’s tonic central appetite suppression. The amylin arm also delays gastric emptying via a partly distinct vagal pathway and suppresses postprandial glucagon at pancreatic alpha-cells.
• Additive vs synergistic effect on body-weight phenotype — The Phase 2 head-to-head data are the cleanest evidence of additive (and possibly synergistic) pharmacology: cagrilintide monotherapy at 2.4 mg weekly produced ~10% body-weight reduction; semaglutide monotherapy at 2.4 mg weekly produced ~15%; the CagriSema combination at 2.4 + 2.4 mg produced ~20–23%. The net effect approaches or exceeds the sum of the individual effects, consistent with the mechanistic prediction that two non-overlapping satiety pathways activated simultaneously produce a stronger anorectic signal than either alone.

Both peptides are acylated with fatty-diacid chains that bind reversibly to circulating serum albumin (cagrilintide uses a C20 chain via γ-Glu-OEG-OEG; semaglutide uses C18 via γ-Glu-AEEA-AEEA). The half-lives are well matched at ~159 hours (cagrilintide) and ~165 hours (semaglutide) — both supporting once-weekly subcutaneous dosing without divergent pharmacokinetics. This pharmacokinetic alignment is one of the design features that makes co-formulation in a single vial practical: the two components can be reconstituted, stored, and dosed together without compromising either’s exposure profile.

Published Research Applications

CagriSema co-formulation research peptides are used in laboratory contexts that investigate:

• Combination obesity pharmacology — the lead programme: preclinical DIO rodent models, body-composition (DEXA/MRI), food-intake assays, energy-expenditure characterisation; head-to-head against monotherapy arms (cagrilintide alone, semaglutide alone) to dissect the additive vs synergistic question (Enebo et al., Lancet 2021; REDEFINE-1 / REDEFINE-2 Phase 3 results)
• Type 2 diabetes preclinical research — glycaemic control, HbA1c surrogates, postprandial glucose dynamics in db/db and high-fat-diet rodent models
• Comparative multi-agonist research — head-to-head with single-molecule multi-agonists including Tirzepatide (dual GLP-1/GIP), Retatrutide (triple GLP-1/GIP/glucagon), Mazdutide (dual GLP-1/glucagon), and Survodutide (dual GLP-1/glucagon); the central question is whether combination-of-two-molecules pharmacology has any advantage over single-multi-agonist molecules
• Amylin / GLP-1 axis interaction research — non-overlapping mechanism characterisation, brainstem-vs-hypothalamic central appetite circuit dissection, simultaneous receptor occupancy assays
• Gastric emptying and postprandial physiology — gastric emptying time under combined vs individual treatment, postprandial glucose dynamics, gut-hormone-axis integration
• Energy expenditure research — resting energy expenditure, respiratory exchange ratio; the CagriSema combination produces a distinct profile from glucagon-receptor-containing multi-agonists (mazdutide, retatrutide) because neither component activates the glucagon receptor
• Combination-pharmacology design research — CagriSema as a case study in fixed-ratio multi-peptide formulation, comparison of co-formulation pharmacokinetics vs sequential or co-administered separate vials.

For broader context, see our individual Cagrilintide en Semaglutide product pages for component-level pharmacology, Retatrutide as the principal single-molecule triple-agonist alternative, and Tirzepatide as the dual GLP-1/GIP comparator. Browse the full onderzoekspeptiden catalogus voor gerelateerde verbindingen.

Available Configurations

MedsBase stocks the CagriSema blend in a single co-formulation: 5 mg cagrilintide + 5 mg semaglutide per vial at the clinical 1:1 mass ratio. The vial is available in 10-vial or 20-vial pack formats with full reconstitution guidance:

Both components are supplied at ≥99% HPLC purity (each verified individually) and pre-mixed in the same lyophilized vial. The 5 mg + 5 mg per vial composition supports approximately 2 weeks of clinical-equivalent dosing (2.4 mg + 2.4 mg weekly) per vial — a 10-vial pack covers approximately 20 weeks of research at the Phase 3 maintenance dose. Compared with buying 10 vials of stand-alone Cagrilintide (5 mg) plus 10 vials of stand-alone Semaglutide (5 mg) separately, the co-formulated blend offers a modest cost saving and the practical convenience of single-vial reconstitution.

How It Compares — CagriSema vs Retatrutide

CagriSema and Retatrutide are the two leading multi-mechanism approaches to maximum-magnitude body-weight effect in current metabolic-peptide research. They take fundamentally different design approaches: CagriSema combines two single-receptor agonists in a fixed-dose blend, while retatrutide engineers triple-receptor pharmacology into a single molecule. The two reach comparable Phase 2/3 body-weight effect sizes through these distinct routes — the comparison is one of the most-cited in current obesity-pharmacology research.

The pharmacological choice between CagriSema and retatrutide depends on the research question. For research interested in maximum body-weight effect with the cleanest receptor-selectivity profile (no off-target GIP or glucagon signalling), CagriSema is the preferred reference. For research interested in the additional mechanism breadth that glucagon-receptor activation provides (energy expenditure, hepatic lipid mobilisation), retatrutide is the canonical comparator. The combination-vs-single-molecule design question is itself an active area of pharmaceutical research — both approaches have reached late-stage development, and Phase 3 head-to-head trials are likely to inform the long-term winner.

Opslag en Reconstituering

Voor reconstituering: store lyophilized vials refrigerated at 2–8 °C in original packaging for short-term working stock. For unopened long-term storage, freeze at −20 °C. The lyophilized CagriSema co-formulation is stable under refrigeration for up to 24 months and at −20 °C for up to 36 months. Both component peptides have closely-matched stability profiles, so storage is governed by whichever peptide degrades first under given conditions — in practice, the two components are remarkably similar. Avoid freeze-thaw cycles on the lyophilized powder.

Reconstitueringsprocedure: inject bacteriostatic water down the side wall of the vial (not directly onto the lyophilized cake). Because the vial contains 10 mg total peptide mass (5 mg cagri + 5 mg sema), a 2.0 mL reconstitution yields a 5 mg/mL total-peptide working concentration — equivalent to 2.5 mg/mL of each individual component. Approximately 0.96 mL delivers a 2.4 mg + 2.4 mg clinical-equivalent research dose. Swirl gently — do niet shake — and allow 5–10 minutes for full dissolution (both peptides are acylated and dissolve more slowly than smaller unmodified peptides). A correctly reconstituted solution should be clear and colourless with no visible particles.

Na reconstitutie: store refrigerated at 2–8 °C and use within 30 days for optimal stability of both components. Do not freeze the reconstituted solution — freeze-thaw cycles degrade peptide integrity and could disproportionately affect either component. Discard any vial showing cloudiness, precipitate, or discolouration.

Veelgestelde vragen

What is CagriSema used for in research?

CagriSema is used in laboratory research investigating the additive pharmacology of GLP-1 and amylin receptor activation, combination obesity pharmacology, type 2 diabetes preclinical models, comparative head-to-head studies against single-molecule multi-agonists (tirzepatide, retatrutide, mazdutide, survodutide), and combination-pharmacology design questions. It is the lead Phase 3 combination-pharmacology compound in current metabolic-peptide research from Novo Nordisk. The research-grade CagriSema sold here is niet FDA-approved and is supplied strictly for laboratory research use only.

What is in a CagriSema vial?

Each vial contains 5 mg of cagrilintide and 5 mg of semaglutide, co-formulated and lyophilized together as a single powder. The 1:1 mass ratio matches the fixed-dose ratio used in the Phase 3 clinical CagriSema programme (2.4 mg + 2.4 mg weekly). Both peptides reconstitute simultaneously when bacteriostatic water is added.

How is CagriSema different from Cagrilintide alone or Semaglutide alone?

CagriSema combines both peptides in one vial. Cagrilintide alone activates only the amylin/calcitonin receptor family and produces approximately 10% body-weight reduction in Phase 2 monotherapy research. Semaglutide alone activates only the GLP-1 receptor and produces approximately 15% body-weight reduction in Phase 3 monotherapy (STEP trials). The CagriSema combination produces approximately 20–23% — greater than either component alone, because the two mechanisms are non-overlapping (different receptors, different CNS sites, complementary peripheral effects).

How is CagriSema different from Retatrutide?

Both are leading multi-mechanism approaches to body-weight effect, but they take fundamentally different design routes. CagriSema combines two separate single-receptor agonists (cagrilintide + semaglutide) in one vial — combination pharmacology. Retatrutide engineers triple-receptor pharmacology (GLP-1 + GIP + glucagon) into a single molecule. Both reach approximately 20–24% body-weight effect at maintenance dose in Phase 2/3 research, but through different receptor sets — CagriSema uses GLP-1 + amylin, retatrutide uses GLP-1 + GIP + glucagon.

Why combine the two peptides in a single vial?

Co-formulation has three practical advantages: (1) the half-lives of cagrilintide (~159 h) and semaglutide (~165 h) are well-matched, so a single weekly injection delivers both peptides on the same pharmacokinetic schedule; (2) reconstitution is simpler — one vial, one diluent volume, one withdrawal; (3) fixed-dose-ratio research is straightforward because the dose ratio is set at manufacture and cannot drift between separate vial draws. The principal trade-off is that the dose ratio is fixed at 1:1 mass — for research requiring different ratios, separate vials of cagrilintide en semaglutide may be preferred.

What is the typical CagriSema research dose?

Published Phase 3 clinical research uses 2.4 mg cagrilintide + 2.4 mg semaglutide weekly as the maintenance dose, with a multi-month titration schedule starting at 0.25 mg + 0.25 mg. A vial reconstituted with 2.0 mL bacteriostatic water yields 2.5 mg/mL of each component (5 mg/mL total peptide mass) — approximately 0.96 mL equals a clinical-equivalent 2.4 mg + 2.4 mg research dose.

Is CagriSema FDA approved?

No. CagriSema is not approved by the FDA, EMA, MHRA, or any other major regulator for human therapeutic use. The REDEFINE-1 (obesity) and REDEFINE-2 (T2DM) Phase 3 trials reported positive results in 2024–2025, but regulatory submission and review are ongoing. All CagriSema sold by research-use-only suppliers is for laboratory investigation and should not be administered to humans.

How should CagriSema be stored?

Lyophilized vials: refrigerated at 2–8 °C for short-term working stock, or −20 °C for long-term storage of unopened vials. Reconstituted solution: refrigerated at 2–8 °C, use within 30 days. Do not freeze reconstituted solution — freeze-thaw cycles degrade peptide integrity and could disproportionately affect either component. Protect from direct light at all times.

How do I reconstitute CagriSema?

Follow the reconstitution procedure above. Add bacteriostatic water down the side wall of the vial (not onto the lyophilized cake), swirl gently, and allow 5–10 minutes for full dissolution (both peptides are acylated and dissolve more slowly than smaller unmodified peptides). Do niet shake the vial. Both peptides reconstitute simultaneously from the same vial. A correctly reconstituted solution is clear and colourless with no visible particles. For a vial + 2.0 mL diluent, the working concentration is 2.5 mg/mL of each peptide.

What configurations does MedsBase stock?

MedsBase carries the CagriSema co-formulation in a single composition: 5 mg cagrilintide + 5 mg semaglutide per vial (1:1 mass ratio, lyophilized). The vial is available in 10-vial or 20-vial pack sizes. Each component is verified individually at ≥99% HPLC purity with a certificate of analysis available on request.

Can I buy CagriSema components separately instead?

Yes — MedsBase stocks both component peptides as stand-alone products: Cagrilintide in 5 mg and 10 mg vials, and Semaglutide in 2–50 mg vials. Separate vials are useful if research protocols require dose ratios other than the clinical 1:1 mass ratio, or if researchers want to dose cagrilintide and semaglutide independently. The co-formulated blend offers a small bundle saving and the convenience of single-vial reconstitution for protocols at the 1:1 clinical ratio.

Does CagriSema cause side effects in research?

The side-effect profile of CagriSema in Phase 3 research is dominated by gastrointestinal findings shared with both component peptides: nausea, transient appetite suppression, and delayed gastric emptying are dose-dependent and tend to attenuate over 4–8 weeks of continuous dosing. The combined regimen does not produce qualitatively different side effects from either component alone — the GI-axis tolerability is roughly comparable to semaglutide monotherapy at equivalent doses.

What is the half-life of CagriSema?

Both component peptides have closely-matched plasma half-lives: cagrilintide ~159 hours (~6.5 days) and semaglutide ~165 hours (~7 days). The matching is one of the design features that makes co-formulation in a single vial practical — both peptides clear from circulation on the same schedule, supporting once-weekly dosing without divergent pharmacokinetics. The albumin-binding mechanism (C20 / C18 fatty-acid acylation) is the basis for the extended half-life in both peptides.

How long does CagriSema take to show effects in preclinical research?

Acute pharmacodynamic effects on gastric emptying, per-meal satiety, and glucose tolerance are detectable within hours of the first dose. Body-weight effects in DIO rodent models typically become statistically significant after 1–2 weeks of weekly dosing and continue to accrue through 16–24 weeks. Maximum effect on body composition develops over 48–68 weeks, matching the REDEFINE-1 Phase 3 trajectory.

Can I order CagriSema for international shipping?

Yes. MedsBase ships CagriSema worldwide from our dedicated peptide shipping network. Peptide-only orders qualify for our standalone peptide shipping service. All orders ship in temperature-controlled packaging with full tracking and are covered by our Reshipment Assurance Policy.

Other Peptides for Metabolic, Body-Composition, and Multi-Mechanism Research

• Cagrilintide — Long-acting amylin analog — the amylin component of CagriSema, stand-alone vials
• Semaglutide — Long-acting GLP-1 agonist — the GLP-1 component of CagriSema, stand-alone vials
• Retatrutide — Triple GLP-1/GIP/glucagon agonist — single-molecule multi-agonist alternative
• Tirzepatide — Dual GLP-1/GIP agonist — alternative multi-mechanism approach
• Mazdutide — Dual GLP-1/glucagon co-agonist — oxyntomodulin-derived alternative

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