CagriSema (Cagrilintide/Semaglutide)

CagriSema is an investigational injectable medication taken once per week that is being researched to help adults with obesity or overweight lose weight, including those living with type 2 diabetes. It combines cagrilintide, which mimics the body’s natural appetite-controlling hormone amylin, and semaglutide, a GLP-1 agonist. By working together, these ingredients may help a person feel full sooner, slow the emptying of the stomach, and improve blood sugar levels. No regulatory authority has approved CagriSema yet, so the information here may be updated once an official approval and product label are issued.

Directions

Since CagriSema is still in development, there is no approved dosing schedule, and it should be used only within an authorized clinical trial or exactly as a healthcare provider prescribes. During phase 3 trials, it was administered as a once-weekly injection just under the skin, most often in the abdomen, thigh, or upper arm. The dose starts small and is increased slowly over several weeks so the body can adjust and manage side effects such as nausea.

If a dose is forgotten, it can be taken as soon as possible within a defined number of days. If that window has passed, it should be skipped rather than doubled. CagriSema is meant to be combined with a calorie-reduced diet and increased physical activity.

Ingredients

This medication’s active ingredients are cagrilintide and semaglutide.

Cautions

Before you begin this medication, it can be useful to review the following with a healthcare provider:

• Any health conditions you currently have
• Any allergies you have
• A complete list of the medicines you are taking

CagriSema is an investigational treatment that should be used only under a clinician’s supervision, as complete data on its long-term safety are not yet available.

Semaglutide has been tied to thyroid tumors, including medullary thyroid carcinoma, in animal research. It is unknown whether the same effect occurs in people. Mention any neck lump or swelling, hoarseness, or trouble swallowing to your healthcare provider.

Gastrointestinal effects such as nausea, vomiting, and diarrhea may arise, particularly at the start of treatment or after a dose increase. Severe or continuing vomiting or diarrhea can lead to dehydration, which may harm the kidneys.

Medicines in the GLP-1 receptor agonist class, including semaglutide, have been associated with pancreatitis and gallbladder problems. Seek medical attention for severe, ongoing abdominal pain that can radiate to the back, fever, or a yellow tint to the skin or eyes.

In people with type 2 diabetes who also use insulin or insulin-stimulating drugs, such as sulfonylureas, the risk of low blood sugar, also called hypoglycemia, may be increased, so the doses of those medicines may need to be lowered.

Anyone with a history of diabetic eye disease, also called diabetic retinopathy, may need their eyes monitored by a healthcare provider, as rapid blood sugar changes can affect this condition.

Because CagriSema delays stomach emptying, it may alter how food and other oral medications are absorbed. Inform your healthcare providers, including any surgeon or anesthesiologist, that you take it before any planned surgery or procedure.

As semaglutide lingers in the body for a long period, it should be stopped well ahead of a planned pregnancy.

Contraindications

An approved drug label with formal contraindications does not yet exist for CagriSema. Based on its ingredients and the criteria used to enroll participants in clinical studies, it should be avoided in any of these circumstances:

• A previous serious allergic, or hypersensitivity, reaction to cagrilintide, semaglutide, or any component of the product.
• A personal or family history of medullary thyroid carcinoma, or MTC, or Multiple Endocrine Neoplasia syndrome type 2, or MEN 2.
• During pregnancy or breastfeeding, as CagriSema has not been tested in these populations.

Side Effects

In clinical trials, the most frequently reported side effects of CagriSema were gastrointestinal. They were typically mild to moderate and most often occurred when therapy began or the dose was raised. They include:

• Nausea
• Vomiting
• Diarrhea
• Constipation
• Abdominal, or stomach, pain
• Loss of appetite

Other, more serious reactions can happen. Seek medical help for signs of a serious allergic reaction, including trouble breathing, a severe rash, or swelling of the face, lips, tongue, or throat. Tell a healthcare provider about severe or persistent stomach pain that may extend to the back, any gallbladder-related symptoms, or indicators of low blood sugar such as trembling, sweating, confusion, or a racing pulse. You should also get medical advice for heavy or lasting vomiting or diarrhea, or for a new lump or swelling in the neck, hoarseness, or difficulty swallowing.

References

1. Garvey WT, Blüher M, Osorto Contreras CK, et al. Coadministered Cagrilintide and Semaglutide in Adults with Overweight or Obesity. N Engl J Med. 2025;393(7):635-647.

2. Davies MJ, Bajaj HS, Broholm C, et al. Cagrilintide-Semaglutide in Adults with Overweight or Obesity and Type 2 Diabetes. N Engl J Med. 2025;393(7):648-659.

Medically Reviewed by Dr. Gerardo Sison

Dr. Sison graduated with honors from the University of Florida and has experience in community pharmacy, hospitals, clinics, and medication therapy management services. All information shared here at CanPharm has been medically reviewed and fact-checked for accuracy based on current guidelines, professional consensus, and the latest available research.