CagriSema

What it is

CagriSema is Novo Nordisk's weekly injection that combines two peptides: cagrilintide, a long-acting analogue of the hormone amylin, and semaglutide, the GLP-1 receptor agonist in Ozempic and Wegovy. The phase 3 product delivers 2.4 mg of each in one shot.

It is a medicine in development, not a research peptide in the usual sense. Novo positions it as the next step after Wegovy and describes it as the first once-weekly GLP-1 and amylin combination filed for approval.

How it works

The two halves act on different appetite systems.

• Semaglutide mimics GLP-1, a gut hormone released after meals. It slows stomach emptying, raises insulin when glucose is high, and acts on appetite centres in the brain. See the semaglutide page for the full picture.
• Cagrilintide mimics amylin, a hormone the pancreas releases alongside insulin. Amylin also slows gastric emptying and signals fullness, but through its own receptors in the hindbrain. The native hormone lasts minutes; cagrilintide was engineered to last long enough for weekly dosing.

The idea is additive: two satiety signals arriving by different routes should reduce intake more than either one alone.

What the research found

All of the meaningful data is from human trials run by Novo Nordisk.

REDEFINE 1 (NEJM, 2025). 3,417 adults with obesity or overweight and no diabetes, 68 weeks. Counting everyone randomised regardless of whether they kept taking the drug, mean weight loss was 20.4% on CagriSema versus 3.0% on placebo. Among those who stayed on treatment, it was 22.7% versus 2.3%. On that on-treatment basis, 40.4% of the CagriSema group lost at least 25% of their body weight.

REDEFINE 2 (NEJM, 2025). 1,206 adults with type 2 diabetes plus obesity or overweight, 68 weeks. On-treatment weight loss was 15.7% versus 3.1% on placebo. As with every GLP-1 drug, people with diabetes lost less weight than those without.

REDEFINE 4 (topline, February 2026). The first head-to-head against tirzepatide 15 mg, open label, 809 adults, 84 weeks. CagriSema produced 23.0% weight loss versus 25.5% for tirzepatide on the on-treatment basis, and 20.2% versus 23.6% counting everyone. The trial did not meet its primary endpoint of showing CagriSema was non-inferior to tirzepatide.

Novo has also run a separate type 2 diabetes programme, REIMAGINE, and said a higher-dose trial would start in the second half of 2026.

The context matters. REDEFINE 1 is one of the larger effects recorded in a phase 3 obesity trial, but tirzepatide is already on the market and beat it directly, and retatrutide has since reported larger numbers in its own trials.

Side effects reported in studies

The pattern is the familiar GLP-1 one, slightly amplified. In REDEFINE 1, 79.6% of participants on CagriSema reported a gastrointestinal adverse event versus 39.9% on placebo: nausea 55% versus 12.6%, constipation 30.7% versus 11.6%, vomiting 26.1% versus 4.1%. Novo reported most GI events as mild to moderate and fading over time.

Discontinuation because of adverse events was around 6% on CagriSema versus under 4% on placebo in REDEFINE 1, and 8.4% versus 3% in REDEFINE 2. Warnings that apply to semaglutide (pancreatitis, gallbladder disease, the rodent thyroid C-cell tumour signal) would be expected to carry over to any approved label. See side effect management.

CagriSema vs other weekly incretin drugs

Cross-trial comparisons are rough: populations, durations and analysis methods differ. Only REDEFINE 4 compared two of these drugs directly.

Status in the Philippines

CagriSema is not approved in any country and is not registered with FDA Philippines, so no pharmacy can legally sell it. Anything offered locally under the name is either a research-market product of unknown make-up or a home mix of separately bought cagrilintide and semaglutide, neither of which matches what was tested in REDEFINE.

Enforcement against unregistered GLP-1 sellers has been active in 2026: the NBI arrested two people in Tondo in May for selling unregistered tirzepatide online, and the Philippine College of Physicians has warned against compounded and non-registered products. The registered alternatives here are Wegovy and Mounjaro; prescribing belongs with a licensed Philippine physician. For current pen prices see cost reality in the Philippines.

Storage

There is no approved label yet, so no official storage instruction exists. The peptides it contains are handled like other GLP-1 peptides in research: kept at 2 to 8°C, never frozen, and protected from heat. In Manila that means a fridge with a plan for brownouts and an insulated pouch with ice packs for transport.