Wegovy and Mounjaro have been dominating the weight loss injection market, but there’s something new in development: CagriSema, Novo Nordisk’s combination weight loss treatment.
CagriSema combines semaglutide (the active ingredient in Wegovy) with cagrilintide in a single injection.
While it’s not yet available in the UK, early clinical trial results suggest this new weight loss injection could offer greater weight loss than current medications for adults with overweight or obesity.
Cagrilintide is a long-acting amylin analogue that’s being developed by Novo Nordisk. It’s designed to mimic the effects of amylin, a hormone that’s naturally produced by your pancreas alongside insulin when you eat.
In people without diabetes, amylin helps control blood sugar levels after meals and contributes to feelings of fullness. However, people with obesity often have disrupted amylin signalling, which can make it harder to feel satisfied after eating.
Cagrilintide works by:
While GLP-1 medications like semaglutide have been available for years, cagrilintide represents a newer approach to weight loss treatment. It’s currently only being studied as part of combination therapies like CagriSema, rather than as a standalone medication.
CagriSema works by combining two medications that target weight loss in different ways.
This is the same medication found in Wegovy and Ozempic. It mimics a hormone called GLP-1 that your body produces after eating. Semaglutide:
This mimics amylin, another hormone your body releases after meals. Cagrilintide:
By combining both medications, CagriSema helps target weight loss from multiple angles. This dual approach is why it may be more effective than using either drug alone.
This clinical study was a 68-week trial involving 3,417 adults with obesity or overweight and at least one weight-related health condition (such as high blood pressure or high cholesterol). The average starting weight was 106.9 kg. The trial measured weight loss in adults taking different treatments.
The trial compared CagriSema against semaglutide alone, cagrilintide alone, and placebo. Participants could adjust their dose throughout the study if needed. Only 57.3% of people taking CagriSema reached the highest dose.
Weight loss results (accounting for all participants):
To put that in perspective, someone weighing 100 kg could lose around 20.4 kg on CagriSema.
For people who stayed on treatment throughout the results were even more impressive. In a phase 3 clinical trial, CagriSema users achieved an average weight loss of 22.7%, compared with 16.1% with semaglutide alone.
40.4% of people taking CagriSema lost 25% or more of their body weight. In comparison, only 16.2% of semaglutide users and 6.0% of cagrilintide users achieved this level of weight loss.
These results are particularly notable because less than 60% of participants reached the maximum dose, suggesting CagriSema could be even more effective when fully optimised.
This 68-week trial involved 1,206 adults with obesity and type 2 diabetes. Unlike REDEFINE 1, this trial focused specifically on people managing both conditions and measured loss in adults with obesity who also had diabetes.
Weight loss results:
73.5% of people taking CagriSema achieved an HbA1c level of 6.5% or lower (indicating good diabetes control), compared with just 15.9% in the placebo group.
More people taking CagriSema achieved weight loss of 5%, 10%, 15%, and 20% or more compared to placebo.
Other ongoing trials:
Like all weight loss medicines, CagriSema can cause side effects. Because it contains semaglutide, many of the side effects are similar to what you’d experience with Wegovy or Ozempic.
Common side effects include:
Around 8 in 10 people taking CagriSema experienced mild-to-moderate gastrointestinal side effects. These gastrointestinal side effects are usually most noticeable when you first start treatment or when your dose is increased. For most people, they improve over time as their body adjusts to the medication.
In the REDEFINE 1 trial, around 6-7% of participants stopped taking CagriSema due to side effects, with nausea and vomiting being the most common reasons for discontinuation.
Because CagriSema is still in clinical trials, the full efficacy and safety profile haven’t been fully established yet. If and when it becomes available, it will come with detailed prescribing information and monitoring requirements.
CagriSema isn’t available yet, so there are no official prescribing criteria. However, based on the clinical trials, we can get an idea of who might be eligible to lose weight with this medication once it’s approved.
Trial participants had:
This is similar to the criteria used for other weight loss medications.
Based on what we know about semaglutide and similar medications, CagriSema likely won’t be suitable for:
If you’re currently taking other diabetes medications, particularly insulin or medications that can cause low blood sugar, you’ll need careful monitoring and possibly dose adjustments.
The final prescribing guidelines will be determined by regulatory authorities like the MHRA if and when CagriSema is approved for use in the UK.
CagriSema is given as a once-weekly injection, similar to Wegovy and Mounjaro. The exact dosing schedule used in clinical trials involved gradually increasing the dose over time to help minimise side effects.
The dose is increased slowly over several months, allowing your body to adjust to the medication. This gradual approach helps reduce gastrointestinal side effects like nausea and vomiting.
In the REDEFINE 1 trial, participants started on a lower dose and increased every few weeks until reaching the maintenance dose. The final maintenance dose contained semaglutide 2.4 mg and cagrilintide 2.4 mg for weight management, combining cagrilintide and semaglutide in adults with overweight.
If the medication is approved, the exact dosing protocol may differ slightly from what was used in trials. Your prescriber will give you specific instructions on how to use it and when to increase your dose.
| Medication | Type | Average Weight Loss | Dosing |
| CagriSema | Injection | 20.4% in 68 weeks | Once weekly |
| Mounjaro (Tirzepatide 15mg) | Injection | 20.9% in 72 weeks | Once weekly |
| Wegovy (Semaglutide 2.4mg) | Injection | 14.9% in 68 weeks | Once weekly |
Weight loss percentages are based on clinical trial data and may vary between individuals.
While CagriSema shows promising results in trials, it’s worth noting that Mounjaro (tirzepatide) has also demonstrated strong weight loss outcomes, with some studies showing up to 21% weight loss. The REDEFINE 4 trial is currently comparing CagriSema directly against tirzepatide, which should give us clearer insight into how these medications stack up against each other.
Until CagriSema is approved, Wegovy and Mounjaro remain the most effective weight management options currently available in the UK.
CagriSema is not yet available in the UK. It’s still in clinical trials and hasn’t been submitted for regulatory approval.
Before it can be prescribed, Novo Nordisk needs to complete their trial programme, submit the data to regulatory bodies like the MHRA, and receive approval. After that, NICE would need to assess whether it’s cost-effective for NHS use.
Based on typical timelines, CagriSema likely won’t be available until late 2026 at the earliest
