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Compound Evidence InstituteEvidence synthesis · established 2023Graded assessments of compounds, trials, methods and supply
Document set current to 30 July 2026
Compound monograph · §2

Cagrilintide — pharmacology

Molecular targets, mechanism of action, pharmacokinetics and interactions as characterised in humans.

Document identifier
CEI-MN-005/2
Series
Compound monograph
Version
4.3
Published
06 Nov 2023
Last reviewed
06 Feb 2025
Next review
06 Feb 2027
Identifier
10.71829/cei.mono.5
Certainty
Moderate
Cycle
2023 Q4

§2Pharmacology

§2.1Molecular targets

Table 2. Molecular targets recorded for Cagrilintide, with the character of the interaction and the potency where the Institute holds it.

TargetInteractionNote
Amylin receptors (AMY1–AMY3, calcitonin receptor with RAMP co-expression)AgonistNon-selective across the amylin receptor family
Calcitonin receptor (CTR)AgonistContributes to the pharmacology; relevance to the weight effect is debated

§2.2Mechanism of action

Amylin is co-secreted with insulin and acts at the area postrema to promote meal-related satiation, and separately reduces gastric emptying and glucagon secretion. Cagrilintide reproduces this signalling with a pharmacokinetic profile permitting weekly administration. The mechanism is complementary rather than redundant to GLP-1 receptor agonism, which is the rationale for the fixed-combination programme with semaglutide.[1,2]

§2.3Pharmacokinetics

Terminal half-life
≈7–8 days
Time to maximum concentration
approximately 24–72 h
Volume of distribution
not published
Plasma protein binding
high
Clearance
not published
Bioavailability
not published

Assumed proteolytic with beta-oxidation of the lipid chain. Human mass-balance data have not been published.

Reconstructed plasma concentration–time profilePlasma concentration plotted against time after dosing, reconstructed from published pharmacokinetic parameters.0.00.51.01.50200400600800Time after first dose (hours)Relative concentrationt max ≈ 560 ht½ ≈ 192 h
Modelled profileSimulated observationsDose administration
Figure 2. Illustrative. Plasma concentration–time profile reconstructed by the Institute from the published half-life and time-to-maximum-concentration parameters using a one-compartment model with first-order absorption. The curve is not digitised from a published figure and its vertical scale is relative. It is published to convey the shape of the profile and the approach to steady state, not to supply a concentration at any time point.

§2.4Interactions

  • Insulin — hypoglycaemia risk
  • Concomitant medicines with narrow absorption windows may be affected by delayed gastric emptying

References cited on this page

References are numbered in order of first citation in this document. Each superscript in the text links to its entry below.

  1. Lau DCW, Erichsen L, Francisco AM, Satylganova A, le Roux CW, McGowan B, Pedersen SD, Pietiläinen KH, Rubino DM, Batterham RL. Once-weekly cagrilintide for weight management in people with overweight and obesity: a multicentre, randomised, double-blind, placebo-controlled and active-controlled, dose-finding phase 2 trial. The Lancet 2021;398(10317):2160–2172. doi:10.1016/S0140-6736(21)01751-7 · PMID 34798060
  2. Frías JP, Deenadayalan S, Erichsen L, Knop FK, Lingvay I, Macura S, Mathieu C, Pedersen SD, Davies M. Efficacy and safety of co-administered once-weekly cagrilintide 2·4 mg with once-weekly semaglutide 2·4 mg in type 2 diabetes: a multicentre, randomised, double-blind, active-controlled, phase 2 trial. The Lancet 2023;402(10403):720–730. doi:10.1016/S0140-6736(23)01163-7 · PMID 37364591

Identifiers are reproduced only where the Institute holds them. Where a digital object identifier or PubMed identifier is not shown, the Institute has recorded the journal and year and has not constructed an identifier.

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