Cagrilintide and CagriSema: The Amylin + GLP-1 Drugs Coming Next (Amycretin, Petrelintide, Eloralintide, MariTide)

The next wave of weight-loss drugs adds a second hormone, amylin, to the GLP-1 approach behind Wegovy and Zepbound. Novo Nordisk's CagriSema is the furthest along, and it's under FDA review. Several rivals are a step or two behind. None of them is approved yet. Here's what each one is, what the trials showed, and what that means if you're deciding on treatment today.

What is amylin, and why pair it with a GLP-1?

Amylin is a hormone your pancreas releases together with insulin after you eat. It slows how fast food leaves the stomach, holds down glucagon (a hormone that raises blood sugar), and acts on the brain to make you feel full sooner¹. A GLP-1 drug also curbs appetite and slows the stomach, but through a different receptor. The idea behind combining them is that two appetite signals working together may do more than one.

Amylin drugs aren't new. Pramlintide (Symlin), an amylin analog for diabetes, was approved in 2005 and is now listed as discontinued². What's new are long-acting versions given once a week, and combinations with semaglutide.

What did REDEFINE 1 and 2 show?

CagriSema is a once-weekly shot of cagrilintide 2.4 mg plus semaglutide 2.4 mg, the Wegovy maintenance dose. Two large phase 3 trials support Novo's application³⁴⁵:

In REDEFINE 2, 73.5% of people on CagriSema reached an A1c of 6.5% or lower, compared with 15.9% on placebo⁴. Stomach side effects were common: 79.6% on CagriSema versus 39.9% on placebo in REDEFINE 1, mostly mild to moderate and short-lived³.

For context, Wegovy 2.4 mg alone averaged 14.9% in STEP 1⁶, and Zepbound's top dose averaged 20.9% in SURMOUNT-1⁷. Those are separate trials, so they can only roughly be compared.

Did CagriSema beat Zepbound?

No. REDEFINE 4 tested CagriSema head to head against tirzepatide 15 mg, the top Zepbound dose, in 809 people over 84 weeks. Novo reported that the trial "did not achieve its primary endpoint of demonstrating non-inferiority on weight loss for CagriSema compared to tirzepatide"⁸.

The trial was open-label, meaning participants knew which drug they were taking⁸. Novo has said it plans trials of higher CagriSema doses.

When could CagriSema be approved?

Novo submitted CagriSema to the FDA for weight management in December 2025, based on REDEFINE 1 and 2⁵. In February 2026 it said an FDA decision was "anticipated by late 2026"⁸. As of October 2026 there is no FDA approval, and no cagrilintide product is listed in the FDA's drug approval database⁹. A filing isn't a guarantee: the FDA can approve, ask for more data or decline.

What are amycretin, petrelintide, eloralintide and MariTide?

Four other drugs in this space have published results. All are earlier in development than CagriSema and none is approved.

Sources: amycretin¹⁰, eloralintide¹¹, petrelintide¹², MariTide¹³.

A few notes on reading that table. The amycretin figure comes from a small early study at a single site, where many participants withdrew, so it says more about promise than about what a big trial will show¹⁰. Petrelintide's main result was measured at 28 weeks, and weight was still falling: by week 42 the reduction reached up to 10.7%¹². Its pitch is tolerability more than size. Nausea affected 20% of people on it versus 6% on placebo, and vomiting was rare¹². The eloralintide and petrelintide figures are efficacy estimands, which count people while they stayed on the drug, so they tend to run higher than an analysis of everyone assigned, as REDEFINE 4's two rows show. MariTide stands out for monthly dosing, and it isn't an amylin drug at all.

For other drugs in the pipeline, see retatrutide vs tirzepatide and the orforglipron pill, which has since been approved as Foundayo.

Can you get cagrilintide now?

Not as an approved drug. No FDA-approved medicine contains cagrilintide, so anything sold as cagrilintide today, including products labeled "for research use only," is an unapproved product of unknown strength and purity. Research-use labels mean it isn't meant for people. None of the telehealth programs we track lists cagrilintide. If you see it offered, treat that as a reason for caution, and don't follow a dosing protocol from a seller or forum.

What will it cost?

Novo hasn't published a U.S. price for CagriSema. For a sense of the range, brand semaglutide and tirzepatide currently cost $299 to $449 a month at maintenance through manufacturer self-pay programs. TrumpRx GLP-1 prices has the details. A combination drug could cost more than either.

What should you do if you're starting treatment now?

Waiting for a drug that isn't approved means going without one that is. The approved options already reach roughly 15% to 21% average weight loss in their main trials. Semaglutide vs tirzepatide compares the two leading drugs, and how a GLP-1 works explains the mechanism the new drugs build on. Not medical advice; see our medical disclaimer.