Semaglutide vs Cagrilintide
There is no winner on this page. What is set side by side is the published record behind each one, which is the part the two are rarely compared on.
Both in Metabolic and GLP-1
The number quoted for cagrilintide is semaglutide's. 2.4 mg a week is semaglutide's share of the fixed pen the two are sold in together, and it became cagrilintide's maintenance target by being printed beside its name. The headline percentage travels the same way: 20.4 percent of body weight over 68 weeks belongs to the pen holding both drugs, while the single agent arm of the same trial, the same 68 weeks, came out at 11.8. The only dose finding trial cagrilintide alone has had found 4.5 mg did better than 2.4.
| Field | Semaglutide | Cagrilintide |
|---|---|---|
| What a trial gave | Large randomised placebo controlled trialsThe strongest evidence base of anything on this site | 0.3 to 4.5 mg a week, including 2.4 mgLau 2021 in 706 adults, plus single agent arms of 302 and 152 in two phase 3 trials |
| What circulates | Prescription doses, often from grey market vials | 2.4 mg a week from a 0.25 mg start, or up to 4.5 mg |
| The gap | Lands on a studied dose | Lands on a studied dose |
| How long it lasts | About seven days in people, which is why it is a weekly shot. The natural gut hormone it is copied from lasts about two minutes. | Novo gives it as approximately 180 hours, in the company's own words, supporting once weekly dosing. That is about seven and a half days, which is why the schedule is one injection a week. |
| Route studied | Weekly injection of pharmaceutical product, in large trials. Also approved as a pill. | Injected under the skin, once a week, in trials running 26 to 68 weeks. The first in human trial gave it daily instead, up to 800 micrograms a day over eight weeks in 96 people. |
| Route used | Weekly injection at home, often mixed by the person from a powder vial. | Injected under the skin, once a week, from vials labelled research chemical. |
| Vial sizes | 5, 10, 20, 30 mg | 10 mg |
The distance, stated
Lands on a studied dose
Semaglutide
The risk moved off the molecule and into the vial. Three tested vials were far less pure than claimed and simultaneously over label, so careful dosing meant overdosing.
Lands on a studied dose
Cagrilintide
2.4 mg is a dose the single agent really was given, and it is also semaglutide's share of the fixed pen, which is where the convention came from. The one dose finding trial in the single agent found 4.5 mg did better, minus 10.8 against minus 9.7 percent. The monotherapy trials that would settle it started in November 2025 and I could not find their dose in either registration.
What people get wrong
Semaglutide
People assume the huge trial results and the number on the label both apply to the vial that arrived in the mail. No trial has ever used research grade or compounded material, and the one published test of grey market vials found the street belief backwards: the product was not weak and underdosed, it was dirty and stronger than the label said, which is how somebody dosing by that label overdoses.
Cagrilintide
The costly mistake is paying for one drug on another drug's numbers. The percentage usually printed beside the cagrilintide name is 20.4 percent of body weight over 68 weeks, and that belongs to the pen holding both drugs. The single agent arm of the same trial, the same 68 weeks, the same kind of people, came out at 11.8 percent. About half, and semaglutide is doing most of the work. The dose has the same problem. 2.4 mg a week is semaglutide's share of the fixed pen, so the maintenance target people copy for cagrilintide alone was set by the other half of a product cagrilintide alone is not in, and the only dose finding trial the single agent has had found 4.5 mg did better than 2.4.
Every figure above is carried across from each compound’s entry, which is where the citations live.
All 65 compounds on one page at what circulates vs what was studied, or pick another two to compare.