Cagrilintide dosage chart by week

In the chart, the first row is the amount from the large trial and the third is from an earlier dose-finding study, so those two have a study behind them. The middle row is the step-up pattern on vendor pages, which fills in the weeks between. Background on what cagrilintide is lives on the cagrilintide page.

Cagrilintide comes as a freeze-dried powder for injection under the skin. You mix it with bacteriostatic water, which is sterile water with a preservative so one vial can be drawn from more than once. The tables cover 10 mg and 5 mg vials. They show the units to draw on a U-100 syringe, which holds 100 units in 1 mL, for each step on the vendor schedule at 1, 2 and 3 mL of water.

The 4.5 mg amount from the earlier study is 45 units from a 10 mg vial mixed with 1 mL and 90 units with 2 mL. Rows over 100 units take two draws, so less water is the easier choice for the higher steps.

For any other vial, water or amount, the reconstitution calculator does the same math.

Once a week. The trial dosed once a week, and so do the vendor pages. Nothing we found sets a time of day.

Sixteen weeks up, then 52 weeks held. The trial stepped up to 2.4 mg over 16 weeks and held it for 52 more. If the vendor steps run four weeks each, the step-up adds to 13.8 mg (1 mg, 2 mg, 4 mg and 6.8 mg across the four-week blocks, with 2.4 mg from week 17).

For planning, a first year of 16 weeks of steps plus 36 weeks at 2.4 mg is about 100 mg dosed, and a year held at 2.4 mg is 124.8 mg. Because a mixed vial lasts 28 days, a first year takes about 13 ten-milligram vials (4 for the step-up and 9 for the 36 weeks at 2.4 mg), so compare vendors on price per milligram against 130 mg, not the price of one vial.

A mixed vial goes on a 28-day clock in the fridge the day water goes in, however much of it gets used. At 2.4 mg a week a 10 mg vial gives 4 whole doses with 0.4 mg left, so it fits the clock almost exactly, and a 5 mg vial gives 2. The early steps are the problem, because four weeks at 0.25 mg uses 1 mg and four weeks at 1 mg uses 4 mg, so most of a 10 mg vial expires unused in the early steps. At 4.5 mg a week, a 10 mg vial gives 2 whole doses.

The large trial also tested cagrilintide 2.4 mg with semaglutide 2.4 mg, once a week, as one combined product from the company (a fixed-dose combination, according to the company's trial announcement). Over 68 weeks, counting everyone who started, the pair lost an average of 20.4% of body weight, against 11.5% for cagrilintide alone, 14.9% for semaglutide alone and 3.0% for placebo. Vendors sell the two separately, so running them together means two vials and two injections, and we found no study of that setup. Amounts for semaglutide are on its dosage page, and background and pricing are on the semaglutide page.

These are reported experiences, not findings from a study of research vials.

Nausea that gets in the way of eating. Stomach upset was the most common problem in both company studies, and people say it peaks after a step up. People in forums report holding at the current step longer or going back down, and no study sets that.

Redness where you injected. The earlier study listed injection-site reactions among its common problems. People rotate the spot each week.

Cloudy or discolored liquid. People describe throwing out a mixed vial that has turned cloudy or changed color, and no study sets a rule for it.