Cagrilintide 10 mg vial dosage

What Cagrilintide is

Class:

Long-acting amylin receptor agonist

Also called:

CagriSema (combined with semaglutide)

Used for:

Investigational amylin analogue studied alone and, more prominently, combined with semaglutide as the fixed-dose combination CagriSema, for chronic weight management. Not approved for any indication in the US; the combination is under FDA review following the sponsor's New Drug Application.

Human evidence:

Moderate human evidence. Multiple randomised, double-blind, placebo-controlled Phase 3 trials of cagrilintide, alone and combined with semaglutide as CagriSema, have been run in humans, confirmed this session on the ClinicalTrials.gov registry (REDEFINE 1, primary endpoint percent body weight change at week 68). REDEFINE 1, with 3,417 participants randomised, was published in the New England Journal of Medicine in 2025: mean weight loss of 20.4% on CagriSema against 3.0% on placebo at 68 weeks, counting everyone as randomised; the sponsor's press release adds 22.7% among those who stayed on treatment. No results are posted to the public registry as of this writing, the trials were funded by the sponsor, and none of the data has been reviewed by FDA.

US status:

Research use only. Not FDA-approved for any indication in the US. FDA states plainly that cagrilintide cannot be used in compounding under federal law, because it is not a component of an FDA-approved drug and has not been found safe and effective for any condition. Novo Nordisk announced submission of a New Drug Application for the fixed-dose combination CagriSema (cagrilintide 2.4 mg plus semaglutide 2.4 mg) in December 2025; the sponsor has reported FDA review as ongoing, with a decision it expects in late 2026 - a company-reported timeline, since FDA does not itself publish pending-review dates.

The full picture, with every study: Cagrilintide guide.

How to mix a 10 mg Cagrilintide vial

For this vial: 1 mL of bacteriostatic water makes 10 mg/mL, so 2.5 mg is 25 units (0.25 mL) on a U-100 insulin syringe. Pick a different volume from the units table if you want bigger or smaller draws; the number of doses stays the same.

1. Wipe the rubber stoppers of both the peptide vial and the bacteriostatic water vial with an alcohol swab and let the alcohol dry. ^[3][4]
2. With a new sterile needle and syringe, draw up the amount of bacteriostatic water you have chosen for the dilution. ^[3][4][5]
3. Inject the water into the peptide vial by aiming the stream against the inside glass wall, which helps prevent foaming. ^[6]
4. Swirl or roll the vial gently until the powder has fully dissolved; do not shake it. Do not inject the solution if it is cloudy or has particles in it. ^[3][4][6]
5. Label the vial with the date and time it was mixed, the amount of water added and how long it can be used after mixing. ^[3]
6. Store the mixed vial in the refrigerator at 2-8°C (36-46°F) and do not freeze it. ^[6]

Step by step with pictures: how to reconstitute peptides. About the water itself: bacteriostatic water.

Storing Cagrilintide vials

• Freeze-dried (lyophilized) peptide keeps far longer than peptide in solution; peptide suppliers advise storing the powder at -20°C away from bright light. ^[7]
• Protect peptide vials from heat and light. ^[7][8]
• Avoid repeated freeze-thaw cycles; a prescription peptide label also says not to freeze a vial once it has been mixed. ^[6][7]
• Once a multi-dose vial, such as bacteriostatic water, has been opened (needle-punctured), date it and discard it within 28 days unless its manufacturer states another date. ^[9][10]

More detail: peptide storage and shelf life.

Injecting safely

• Clean the injection site with an alcohol swab and let the skin dry completely before injecting. ^[11][12]
• Pinch up a fold of skin and fat (not muscle) and insert the needle at a 45- to 90-degree angle: 90 degrees where there is enough fatty tissue, 45 degrees where there is little. ^[11][12][13]
• Pulling back on the plunger (aspiration) is not necessary for a subcutaneous injection, because the chance of the needle being in a blood vessel is small. ^[11]
• Inject slowly, at roughly 10 seconds per mL. ^[11]
• Common sites are the belly, the thigh and the upper arm; rotate sites, keeping each injection at least 1 inch (2.5 cm) from the last. ^[6][11][12]

Hygiene and warning signs

• Use a new sterile needle and syringe for every injection and every time you enter a vial; never reuse them. ^[5][9][12]
• Never share needles, syringes or pens with anyone, even if the needle is changed; unsafe injection practices spread hepatitis B, hepatitis C and HIV. ^[5][8][9]
• Put used needles and syringes in a sharps disposal container straight away (FDA-cleared if possible), never loose in the trash, recycling or toilet, and dispose of the container following your community's guidelines. ^[14][15]
• Contact a health care provider if the injection site shows signs of infection, such as redness, swelling, red streaks or a fever. ^[12]

Where to inject: subcutaneous injection sites.

How Cagrilintide works

• Amylin is a hormone released by the pancreas that induces satiety. Cagrilintide is a long-acting analogue of it, designed for once-weekly injection. ^[16]
• Natural amylin readily clumps into amyloid fibrils, and the existing amylin drug pramlintide needs three injections a day. Cagrilintide was developed as a stable, lipidated (fatty-acid-attached) analogue to get around both problems. ^[17]
• In receptor studies it acts as a non-selective agonist: it activates amylin receptors (the calcitonin receptor paired with an accessory RAMP protein) and the calcitonin receptor on its own. Targeting amylin receptors may add to the effect of GLP-1 drugs such as semaglutide. ^[18]

What the Cagrilintide research found

Human evidence: moderate human evidence. Each result says what was studied.

• Human studyIn a 26-week phase 2 randomised trial of 706 adults with overweight or obesity and no diabetes, weight fell on cagrilintide by 6.0% to 10.8% across weekly doses of 0.3 to 4.5 mg, against 3.0% on placebo. The 4.5 mg dose also beat daily liraglutide 3.0 mg (10.8% vs 9.0%). ^[16]
• Human studyIn REDEFINE 1, a 68-week phase 3 trial of 3,417 adults with overweight or obesity and no diabetes, cagrilintide 2.4 mg given with semaglutide 2.4 mg (CagriSema) reduced weight by 20.4% against 3.0% on placebo. ^[19]
• Human studyIn REDEFINE 2, a 68-week phase 3 trial of 1,206 adults with type 2 diabetes and a BMI of 27 or more, CagriSema reduced weight by 13.7% against 3.4% on placebo, and 73.5% reached an HbA1c of 6.5% or lower against 15.9%. ^[20]
• Human studyIn a 32-week phase 2 trial of 92 adults with type 2 diabetes, weight fell by 15.6% on CagriSema, 8.1% on cagrilintide alone and 5.1% on semaglutide alone. For HbA1c, CagriSema beat cagrilintide alone but was not significantly better than semaglutide alone. ^[21]

Cagrilintide side effects and risks

Cagrilintide has no FDA-reviewed label; these safety data come from published phase 2 and 3 trials funded by the developer, most of them testing it combined with semaglutide.

• Human studyIn the phase 2 trial of cagrilintide alone, gastrointestinal events (mainly nausea, constipation and diarrhoea) affected 41% to 63% across doses against 32% on placebo; nausea alone affected 20% to 47% against 18%. Injection-site reactions were among the most frequent adverse events. ^[16]
• Human studyIn that trial, 10% of participants stopped treatment permanently, at similar rates across groups, most often because of adverse events. ^[16]
• Human studyIn REDEFINE 1, gastrointestinal adverse events (nausea, vomiting, diarrhoea, constipation or abdominal pain) affected 79.6% on CagriSema against 39.9% on placebo, and were mainly transient and mild to moderate. ^[19]
• Human studyIn REDEFINE 2, in adults with type 2 diabetes, gastrointestinal adverse events affected 72.5% on CagriSema against 34.4% on placebo, mostly transient and mild or moderate. ^[20]
• Human studyIn the 32-week phase 2 diabetes trial, adverse events were reported by 80% on cagrilintide alone, 71% on semaglutide and 68% on CagriSema, mostly mild or moderate gastrointestinal events. No clinically significant or severe hypoglycaemia was reported. ^[21]

Other things to know

• No FDA-approved product exists for cagrilintide, alone or as CagriSema, so there is no FDA-reviewed safety label or confirmed adverse-reaction rate for either.
• FDA has taken enforcement action specifically naming cagrilintide: it cannot legally be compounded, and FDA has warned sellers marketing peptides including cagrilintide as "research use only" while selling them for human use.
• Amylin-receptor and GLP-1-receptor activity both slow gastric emptying and reduce appetite, so combining them (as CagriSema does) compounds the same class of gastrointestinal adverse effects seen with GLP-1 drugs alone. In the published REDEFINE 1 trial, gastrointestinal adverse events affected 79.6% on CagriSema against 39.9% on placebo, mainly transient and mild to moderate; none of these data has been reviewed by FDA.
• Sold outside the trial system as an unapproved research chemical, frequently marketed alongside semaglutide, tirzepatide and retatrutide by the same grey-market sellers FDA has warned about.

Reported side effects and what the studies measured: Cagrilintide side effects.

Where this vial size comes from

Cagrilintide is sold as a 10 mg vial by the page below, each checked on the date shown. I list them as evidence that this size exists, not as a recommendation to buy from them.

• Next Level PharmvendorLists it as: Size dropdown options: 2mg / 5mg / 10mg · checked 2026-09-28

The doses come from the sourced common protocol on the Cagrilintide dosing page, and every number on this page is arithmetic on those doses and this vial size.

Other Cagrilintide vial sizes

• 5 mg vial
• 10 mg

Where to buy Cagrilintide for research

Sold for research use only. Listed by Next Level Pharm and BioEdge Research Labs; compare them on my vendors page or see the listing on the Cagrilintide page.

Questions

How much water do I add to a 10 mg Cagrilintide vial?

There is no single correct amount: water changes how many units a dose is, not how many doses the vial holds. With 1 mL the vial is 10 mg/mL and 2.5 mg is 25 units (0.25 mL) on a U-100 insulin syringe. The units table gives 1, 2, 3 mL.

How many doses are in a 10 mg Cagrilintide vial?

40 doses at 250 mcg, 4 doses at 2.5 mg, 2 doses at 4.5 mg.

How long does a 10 mg Cagrilintide vial last?

At 2.5 mg a dose and once weekly, about 4 weeks. How long a mixed vial keeps is a separate limit; see storage below.

How many 10 mg vials do I need for a 4-week run?

1 vial at 250 mcg 1 time a week for 4 weeks; 2 vials at 4.5 mg 1 time a week for 4 weeks.

What does 1 unit equal in a 10 mg Cagrilintide vial?

100 mcg with 1 mL, 50 mcg with 2 mL, 33.33 mcg with 3 mL of bacteriostatic water, on a U-100 syringe.