Cagrilintide Dosing and Reconstitution Explained

Last updated: July 2026

Cagrilintide is an investigational long-acting amylin analogue with no FDA-approved product, so “dosing and reconstitution” here means one thing: the arithmetic that turns a lyophilised vial plus a weekly target dose into exact syringe units. The formula never changes — reconstitute the powder with bacteriostatic water to a known mg/mL concentration, divide your weekly dose by that concentration to get millilitres, then multiply by 100 to read units on a U-100 syringe.

Have a vial and a weekly dose? Turn any cagrilintide dose into exact mL and U-100 units in seconds.

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TL;DR — key takeaways

Investigational only. Cagrilintide is a research amylin analogue. It is not an approved medicine and has no validated retail dose — every number below is arithmetic, not a recommendation.
It is not a GLP-1. Cagrilintide is an amylin-receptor agonist, a different hormone system from semaglutide or tirzepatide. That is why the two classes are studied together rather than swapped.
Trial dose ladder. The phase 2 weight-management study stepped weekly doses 0.3 → 0.6 → 1.2 → 2.4 → 4.5 mg, escalating roughly monthly to limit nausea.
Water sets the units. The same 2.4 mg dose is 48 units from a 5 mg/mL vial but 24 units from a 10 mg/mL vial — more bacteriostatic water means more units for the identical dose.

What cagrilintide actually is

Amylin is a hormone co-secreted with insulin from pancreatic beta cells. It slows gastric emptying, blunts glucagon, and signals fullness — the same appetite levers GLP-1 pulls, but through a separate receptor system. Native amylin lasts only minutes in the blood. Cagrilintide (code AM833) adds a fatty-acid chain that binds serum albumin, stretching its half-life to roughly seven to eight days so one weekly injection holds a steady level.

The only FDA-approved amylin analogue is pramlintide (Symlin), a short-acting mealtime injection dosed several times a day — the opposite of cagrilintide’s weekly design. Cagrilintide itself remains investigational: it is furthest along paired with semaglutide as “CagriSema,” which has run through phase 3 obesity trials, but neither is an approved product you can be prescribed today. Treat any figure from a research-chemical vendor as unvalidated.

The dose ladder studied in trials

In the phase 2 dose-finding study participants climbed one rung roughly every four weeks, like a GLP-1 titration, because the appetite effect that drives weight loss also causes early nausea. The 4.5 mg top dose gave the largest weight loss but is the ceiling that was tested, not a target.

Step	Weekly dose	Typical hold
1 (start)	0.3 mg	~4 weeks
2	0.6 mg	~4 weeks
3	1.2 mg	~4 weeks
4	2.4 mg	~4 weeks
5 (max tested)	4.5 mg	maintenance

The 2.4 mg rung is the dose used inside CagriSema. These numbers are not interchangeable with any GLP-1: 2.4 mg of cagrilintide and 2.4 mg of semaglutide are different molecules that happen to share a number.

The one formula behind every draw

Reconstitution just dissolves a known mass of powder in a known volume of liquid, fixing the concentration:

concentration (mg/mL) = vial amount (mg) ÷ water added (mL)

Once you have that concentration, converting any weekly dose to units takes two steps — find the volume, then read it in units:

volume (mL) = dose ÷ concentration • units = volume × 100

A U-100 insulin syringe holds 100 units per 1 mL, so 0.1 mL is 10 units. Keep any single draw under 100 units (1 mL) — if the maths asks for more, the vial is too dilute; use less water or a stronger vial.

The titration staircase, visualised

Each rung is held about four weeks, so the weekly dose climbs as a staircase rather than a ramp.

Reconstitution reference: 10 mg vial

A 10 mg vial is a common research size. The table shows the concentration you land on for different volumes of bacteriostatic water, and what the 2.4 mg dose would read on a U-100 syringe at each.

Water added	Concentration	2.4 mg = volume	2.4 mg = units
1 mL	10 mg/mL	0.24 mL	24 units
2 mL	5 mg/mL	0.48 mL	48 units
3 mL	3.33 mg/mL	0.72 mL	72 units
4 mL	2.5 mg/mL	0.96 mL	96 units

At 4 mL the 2.4 mg dose already fills 96 of the 100 units on the barrel — add any more water and it spills past a single syringe. That is why a 10 mg vial is often reconstituted with just 1–2 mL.

Worked examples

Example 1 — 10 mg vial, 2 mL water, starting dose

10 mg ÷ 2 mL = 5 mg/mL. For the 0.3 mg start: 0.3 ÷ 5 = 0.06 mL × 100 = 6 units.

Example 2 — same vial, CagriSema-matched dose

Same 5 mg/mL vial, target 2.4 mg: 2.4 ÷ 5 = 0.48 mL × 100 = 48 units.

Example 3 — the top tested dose

Same 5 mg/mL vial, 4.5 mg: 4.5 ÷ 5 = 0.9 mL × 100 = 90 units — close to the 100-unit ceiling.

Example 4 — denser vial, same 4.5 mg

10 mg ÷ 1 mL = 10 mg/mL. Now 4.5 ÷ 10 = 0.45 mL × 100 = 45 units — half the units of Example 3 for the identical dose.

Example 5 — 5 mg vial, mid-ladder dose

5 mg ÷ 1 mL = 5 mg/mL. For a 1.2 mg dose: 1.2 ÷ 5 = 0.24 mL × 100 = 24 units.

Example 6 — the over-1 mL trap

10 mg ÷ 5 mL = 2 mg/mL. A 4.5 mg dose = 4.5 ÷ 2 = 2.25 mL = 225 units — more than two syringes. Use less water so it fits one draw.

Example 7 — how long a 10 mg vial lasts

At a 2.4 mg weekly dose, a 10 mg vial holds 10 ÷ 2.4 = 4 doses (about a month); at the 0.3 mg start it holds 33. Vial size fixes the dose count, whatever the concentration.

Dose-to-units chart

Each trial-ladder dose shown as units on a U-100 syringe at two typical reconstitutions of a 10 mg vial. Always confirm against your own vial label and the volume you actually added.

Weekly dose	At 5 mg/mL (2 mL water)	At 10 mg/mL (1 mL water)
0.3 mg (start)	6 units	3 units
0.6 mg	12 units	6 units
1.2 mg	24 units	12 units
2.4 mg	48 units	24 units
4.5 mg (max tested)	90 units	45 units

The whole ladder fits inside one syringe at both strengths — the stronger 10 mg/mL vial simply halves the units at every rung.

How this is calculated

Every figure here comes from the same two facts: a U-100 syringe holds 100 units per millilitre, and concentration equals dose divided by volume. There is no cagrilintide-specific constant — the arithmetic is identical for any lyophilised peptide, which is why the reconstitution calculator handles cagrilintide, BPC-157, or a GLP-1 with one engine. None of it is medical advice or a claim that cagrilintide is safe or effective outside a trial; it is only the maths for converting a dose into units.

Safety and honesty notes

Cagrilintide is investigational. It is not approved by the FDA for sale or self-administration, its safety and efficacy are still being established, and the most common trial effects are gastrointestinal — nausea, vomiting, reduced appetite — which is why the studied schedule escalates slowly. Reconstitute only with sterile bacteriostatic water, keep the vial refrigerated, and treat vendor dose charts as unvalidated. Whether to use it at all is a decision for a qualified clinician, not a calculator.

Frequently asked questions

Is cagrilintide a GLP-1 like semaglutide?

No. Cagrilintide is an amylin-receptor agonist, a different hormone pathway. It is studied alongside GLP-1 drugs — the CagriSema combination pairs it with semaglutide — precisely because the two act on separate receptors, not because they are the same class.

Is there an official cagrilintide dose?

Not for general use. Cagrilintide is investigational, so there is no approved label dose. Clinical trials used a stepped ladder from 0.3 mg up to 4.5 mg weekly, with 2.4 mg used inside CagriSema. Those are trial parameters, not a prescription.

Why is the same dose a different number of units in two vials?

Because units track the concentration, not the drug. A 2.4 mg dose is 48 units from a 5 mg/mL vial but 24 units from a 10 mg/mL vial. More water means a weaker solution and more units for the identical milligram dose.

What if my calculated draw is over 100 units?

Your vial is too dilute for that dose in one shot. Reconstitute the next vial with less bacteriostatic water, or use a stronger vial, so the same dose fits within a single 1 mL U-100 syringe.

Sources

This guide is for general educational purposes only and does not constitute medical advice. Always follow your prescriber’s specific instructions and consult a qualified clinician before changing any protocol.