How CagriSema works
CagriSema combines two drugs in a single once-a-week injection: cagrilintide and semaglutide.
The drugs each mimic different hormones, GLP-1 and amylin, which is why the combination produces more weight loss than semaglutide alone.
Semaglutide is the same drug used in Wegovy and Ozempic.
It mimics GLP-1, a hormone our gut releases after we eat.
Semaglutide slows the rate at which our stomach empties, reduces glucagon levels, enhances insulin release, and communicates with the appetite centres in the brain.
Cagrilintide is a long-acting form of amylin, a hormone our pancreas releases alongside insulin. It works on a different brainstem pathway from GLP-1 and prolongs the feeling of fullness after eating.
By targeting two appetite pathways at once, CagriSema can reduce hunger signals more effectively than either drug alone.
In REDEFINE 1, semaglutide on its own produced 16.1% weight loss, cagrilintide on its own produced 11.8%, and the two combined produced 22.7%.1
Dose schedule used in the trials
The trials used a 16-week build-up to the full dose, increasing from 0.25 mg to 2.4 mg every 4 weeks, the same schedule used for Wegovy.1 Both drugs are injected together in one prefilled pen.
This schedule is for context only, not a patient instruction.
The dose any individual would actually be prescribed depends on their clinician’s judgement and the final licensed schedule, which won’t be confirmed until after regulatory approval.
The phase 3 trial results
CagriSema’s Phase 3 evidence comes from the REDEFINE programme: four large trials run by Novo Nordisk in different populations.
Two have been published in the New England Journal of Medicine. One is ongoing. One was announced via press release but hasn’t yet been peer-reviewed.
How to read the numbers
Two figures appear for each result: an ‘on-treatment’ figure (how much weight people lost while still taking the drug) and a ‘treatment-policy’ figure (how much weight people lost overall, including those who stopped).
Real-world results sit somewhere between the two, usually closer to the treatment-policy number.
REDEFINE 1: adults living with obesity
REDEFINE 1 enrolled 3,417 adults with overweight or obesity, randomly assigned to CagriSema, semaglutide alone, cagrilintide alone, or placebo for 68 weeks.1
On the on-treatment figure, CagriSema produced an average weight loss of 22.7%, compared with 16.1% for semaglutide, 11.8% for cagrilintide, and 2.3% for placebo.
On the treatment-policy figure, CagriSema produced 20.4%, against 14.9% for semaglutide and 3.0% for placebo.1
Of those taking CagriSema, 40.4% lost at least 25% of their body weight, compared with 16.2% on semaglutide and 0.9% on placebo.1
No previous Novo Nordisk obesity trial has reported figures this high.
REDEFINE 2: adults living with obesity and type 2 diabetes
REDEFINE 2 enrolled 1,206 adults with type 2 diabetes, randomly assigned to CagriSema or placebo for 68 weeks.2
CagriSema produced 15.7% weight loss on the on-treatment figure and 13.7% on the treatment-policy figure, compared with about 3% for placebo.
HbA1c, a measure of average blood glucose over the previous three months, fell by 1.8 percentage points on CagriSema. Of those taking CagriSema, 89.7% achieved at least 5% weight loss.2
The lower weight loss in REDEFINE 2 isn’t unusual. People living with type 2 diabetes consistently lose less weight on GLP-1 drugs than people without diabetes.
REDEFINE 4: directly compared with Mounjaro
Novo Nordisk announced in February 2026 that REDEFINE 4 didn’t meet its main goal of showing CagriSema was at least as effective as Mounjaro.
CagriSema produced an average weight loss of 23.0% versus 25.5% for Mounjaro at its 15 mg dose over 84 weeks.3 The full results haven’t yet been peer-reviewed.
REDEFINE 4 enrolled 809 adults and was open-label, meaning participants and clinicians knew which drug each person was on.
Both drugs reached their licensed maximum doses. On the treatment-policy figure, the comparison was 20.2% versus 23.6%.3
This was the first published comparison of CagriSema and Mounjaro. A peer-reviewed publication will offer a fuller picture, but the main numbers are unlikely to change materially.
REDEFINE 3: heart health outcomes
REDEFINE 3 is a long-term trial in around 7,000 adults with established heart disease.
It treats participants for 156 weeks and is testing whether CagriSema reduces the risk of heart attacks, strokes, and similar events.
The published results are expected in 2027 or 2028, so REDEFINE 3 won’t influence the initial UK regulatory decision.
REDEFINE 11: a higher-dose follow-up
Novo Nordisk has a higher-dose CagriSema trial (REDEFINE 11) running in parallel, expected to report in the first half of 2027.
| Trial |
Population (n) |
Duration |
Main result |
| REDEFINE 11 |
Obesity, no type 2 diabetes (3,417) |
68 weeks |
22.7% weight loss vs 2.3% placebo |
| REDEFINE 22 |
Obesity with type 2 diabetes (1,206) |
68 weeks |
15.7% weight loss, HbA1c down 1.8 points |
| REDEFINE 43 |
Obesity, vs Mounjaro (809) |
84 weeks |
23.0% CagriSema vs 25.5% Mounjaro; main goal not met |
| REDEFINE 3 |
Heart disease (~7,000) |
156 weeks |
Heart-event outcomes; results expected 2027 to 2028 |
| REDEFINE 11 |
Higher dose, obesity |
Ongoing |
Results expected H1 2027 |
How CagriSema compares to Mounjaro and Wegovy
CagriSema produced more weight loss than Wegovy in the same trial, but less than Mounjaro in the only trial that directly compared the two.3
In REDEFINE 1, CagriSema produced 22.7% weight loss compared with 16.1% for semaglutide alone (the drug in Wegovy) over 68 weeks.1
In a like-for-like setup, CagriSema produced more weight loss than Wegovy by about 6 percentage points.
That comparison was against Wegovy at its standard dose of 2.4 mg.
The MHRA approved a higher dose of 7.2 mg Wegovy in January 2026, with 20.7% weight loss at 72 weeks in the STEP UP trial. CagriSema and Wegovy 7.2 mg haven’t been directly compared.
In REDEFINE 4, CagriSema produced 23.0% weight loss compared with 25.5% for Mounjaro at its 15 mg dose over 84 weeks.3
The trial was designed to show CagriSema was at least as effective as Mounjaro, and that goal wasn’t met.
| Drug |
How it works |
Headline weight loss |
UK status |
| CagriSema |
GLP-1 + amylin (two drugs) |
22.7% at 68 weeks (REDEFINE 1)1 |
Not approved |
| Mounjaro (tirzepatide) |
GLP-1 + GIP (one molecule) |
25.5% at 84 weeks (REDEFINE 4)3 |
MHRA-approved; NICE TA10266 |
| Wegovy (semaglutide) |
GLP-1 only |
14.9% (2.4 mg) / 20.7% (7.2 mg)1 |
MHRA-approved; NICE TA8757 |
Side effects and tolerability
CagriSema’s side-effect profile in REDEFINE 1 was similar in pattern to Wegovy and Mounjaro.
Side effects were mostly gastrointestinal (GI), and most occurred during the early weeks while the dose was being increased.
In the trial that excluded adults living with type 2 diabetes, 79.6% of CagriSema participants reported at least one GI side effect, compared with 39.9% on placebo.1
Nausea was the most common adverse event, affecting about 55% of CagriSema participants versus 12.6% on placebo.
Constipation affected 30.7% of those on CagriSema, compared with 11.6% on placebo, and vomiting affected 26.1% versus 4.1%.1 Most events were mild to moderate and resolved as participants continued treatment.
How many people stopped because of side effects
In REDEFINE 1, 5.9% of participants stopped CagriSema because of side effects, compared with 8.4% in REDEFINE 2 (the type 2 diabetes trial).1,2
These rates are broadly in line with what’s been reported for Wegovy and Mounjaro at their licensed maintenance doses.
The 57% maintenance-dose figure
Only 57% of the CagriSema group in REDEFINE 1 actually reached the planned 2.4/2.4 mg maintenance dose by the end of the build-up period.1 The rest stayed on lower doses, usually because of side effects.
Interestingly, this suggests that the 22.7% weight loss was achieved despite many participants not reaching the highest dose.
It also flags that, in a real-world environment, a meaningful share of patients may not tolerate the full dose.
If CagriSema reaches UK pharmacies, clinicians will probably need to set realistic expectations with patients about reaching the maintenance dose during the early weeks of treatment.
Who shouldn’t take CagriSema
CagriSema hasn’t been licensed yet, so contraindications won’t be confirmed until the label is published.
Based on the wider GLP-1 class, the medication is likely to be unsuitable for people with a personal or family history of medullary thyroid cancer or MEN 2 (multiple endocrine neoplasia type 2).
It may also need caution in people with a history of pancreatitis or gallbladder disease.
Anyone with these conditions should discuss the risks with their clinician before considering CagriSema or any GLP-1 medication.
UK availability and likely timeline
CagriSema isn’t approved or available anywhere in the world as of May 2026.
Novo Nordisk has applied to the U.S. FDA, with a review decision expected in late 2026.5
No public confirmation has been made of an MHRA submission in the UK or an EMA submission in Europe.
That doesn’t mean applications haven’t been made, but they haven’t been announced.
What Wegovy and Mounjaro show us
Wegovy was MHRA-approved before its National Institute for Health and Care Excellence (NICE) technology appraisal.
NICE is the body that decides which medicines the NHS will fund.
NICE published TA875 in 2023, recommending Wegovy for the management of overweight and obesity in eligible adults.7
NHS commissioning followed later, through specialist weight-management services. Mounjaro followed a similar path.
NICE TA1026 was published in December 2024, with NHS rollout for obesity beginning in June 2025.6
NHS eligibility is strict, requiring a body mass index (BMI) of 40 or higher, plus four of five specified weight-related health conditions, alongside a specialist support programme.
If CagriSema follows the same route, a UK private-pharmacy launch in late 2026 or 2027 is plausible, assuming Novo Nordisk submits an application to the MHRA in the coming months.
NHS access would follow a NICE technology appraisal, which historically arrives 13 to 18 months after MHRA approval for this kind of medication.
Likely UK pricing
Novo Nordisk hasn’t announced UK pricing. As a benchmark, private monthly costs for Wegovy and Mounjaro in the UK currently range from £150 to £375+, depending on dose and provider.
CagriSema will likely launch at a similar level or slightly higher.
For a more detailed timeline, see our dedicated article on when CagriSema will become available in the UK.
Who CagriSema might suit
This section is speculative. CagriSema isn’t yet licensed, so any guidance about who it might suit is based on how Wegovy and Mounjaro are currently used in the UK.
If CagriSema reaches the UK, the most likely route would mirror Wegovy and Mounjaro.
NHS access would come via NICE-recommended pathways for adults with severe obesity and weight-related health conditions.
Private pharmacy access would be available to adults with a BMI of 30 or higher, or 27 or higher with weight-related health conditions.
NHS eligibility would likely be tighter than via private pharmacies, as is currently the case for Mounjaro.6
CagriSema may particularly appeal to people who haven’t tolerated Mounjaro well, or who haven’t reached their goal weight on Wegovy alone.
The trials suggest that the dual-drug combination can produce more weight loss than Wegovy alone, so for people who aren’t making the progress they want to on Wegovy, switching to CagriSema could be a good option.
For people with type 2 diabetes, REDEFINE 2 showed CagriSema produced 15.7% weight loss alongside an HbA1c reduction of 1.8 percentage points.2
The current first-line GLP-1 drug for people with both type 2 diabetes and obesity in the UK is Mounjaro, but CagriSema may become an alternative once licensed.
People who currently can’t tolerate Mounjaro’s side effects may not tolerate CagriSema either, given the similar GI profile.
Anyone considering switching medications should discuss it with their prescribing clinician.
What happens when you stop the medication
Weight loss on GLP-1 drugs is sustained while the medication is being taken.
When people stop, most regain a significant proportion of the weight lost.
Wegovy data from the STEP 1 extension showed that roughly two-thirds of the lost weight returned within a year of stopping, and Mounjaro showed a similar pattern in SURMOUNT-4.
In both trials, participants stopped the medication abruptly without any tapering and didn’t receive structured habit-change support to help them maintain their weight loss off the drug.
Emerging research suggests that if patients come off the drugs slowly and have behaviour change support, they’re more likely to maintain their weight loss.
CagriSema hasn’t been studied beyond the trial duration, so the pattern of regain after stopping isn’t yet known.
Frequently asked questions
Is CagriSema better than Mounjaro?
Not in the trial that directly compared the two so far. REDEFINE 4, announced in February 2026, found that CagriSema produced 23.0% weight loss versus 25.5% for Mounjaro at its 15 mg dose over 84 weeks.3
The trial’s main goal of showing that CagriSema was at least as effective as Mounjaro wasn’t met.
The full peer-reviewed paper is still pending. Until it’s published, the press release is the best source we have.
When can I get CagriSema in the UK?
There’s no firm timeline. As of May 2026, no MHRA submission has been publicly confirmed.
Novo Nordisk applied to the US FDA in December 2025, with a decision expected in late 2026.5
If Novo Nordisk applies to the MHRA in the coming months, a private UK launch could follow in late 2026 or 2027.
NHS access would arrive later, after a NICE technology appraisal.
How much weight do people lose on CagriSema?
In the Phase 3 REDEFINE 1 trial, adults without type 2 diabetes lost an average of 22.7% of their body weight over 68 weeks. Of those, 40.4% lost at least 25% of their body weight.1
Adults living with type 2 diabetes in REDEFINE 2 lost an average of 15.7% over the same period.2
Real-world results outside trials may be lower, particularly for people who don’t reach the maintenance dose.
Is CagriSema safe?
Phase 3 trials have shown a side-effect profile in line with other GLP-1 drugs.
The most common side effects are mild to moderate gastrointestinal effects, such as nausea, constipation, and vomiting.1,2 Around 6 to 8% of participants stopped because of side effects.
CagriSema’s long-term safety in people with heart disease is being studied in REDEFINE 3. The results of this trial aren’t expected until 2027 or 2028.
As with all medications, CagriSema’s safety in widespread use will only be fully known after launch.
Will the NHS prescribe CagriSema?
Not yet. CagriSema isn’t licensed in the UK, so it can’t be prescribed on the NHS.
If it follows the Wegovy and Mounjaro pattern, NHS access would only happen after MHRA approval and a NICE technology appraisal.6,7
Even then, NHS eligibility for new GLP-1 drugs has historically been strict.
Mounjaro is currently restricted to adults with a BMI of 40 or higher plus specified weight-related health conditions.6
Is CagriSema a tablet or an injection?
CagriSema is an injection given once a week, into the skin of the abdomen, thigh, or upper arm.
It’s a fixed-dose combination of cagrilintide and semaglutide in a single prefilled pen.1
Novo Nordisk hasn’t announced an oral form of CagriSema.
Oral semaglutide already exists as Rybelsus, but no combination tablet with cagrilintide is in development at this stage.
Can I get CagriSema if I have type 2 diabetes?
Once it’s licensed, possibly. REDEFINE 2 specifically tested CagriSema in adults with type 2 diabetes and found it produced 15.7% weight loss and an HbA1c reduction of 1.8 percentage points over 68 weeks.2
Until CagriSema reaches the UK, Mounjaro and Wegovy remain the licensed options for adults with both type 2 diabetes and obesity who want a GLP-1 drug for weight management.
How is CagriSema different from Wegovy?
Wegovy contains semaglutide on its own. CagriSema contains semaglutide plus cagrilintide, which mimics amylin and works on a separate appetite-control pathway.1
In REDEFINE 1, CagriSema produced 22.7% weight loss compared with 16.1% for semaglutide alone over 68 weeks.1 Both are once-a-week injections with a similar dose schedule.
Take home message
CagriSema is an investigational once-a-week injection from Novo Nordisk that combines cagrilintide and semaglutide.
It produced an average weight loss of 22.7% in its Phase 3 REDEFINE 1 trial, the highest reported for any Novo Nordisk obesity drug to date.1
The Phase 3 evidence shows CagriSema produces more weight loss than Wegovy at the standard 2.4 mg dose in the same trial.
The first trial that directly compared CagriSema with Mounjaro (REDEFINE 4) found Mounjaro produced more weight loss, and CagriSema didn’t meet its main goal of being at least as effective as Mounjaro.3
Side effects were mostly mild to moderate gastrointestinal events.
Only 57% of REDEFINE 1 participants reached the 2.4/2.4 mg maintenance dose, which suggests many people won’t be able to tolerate the higher doses of the drug.1
CagriSema isn’t yet approved or available anywhere. A U.S. approval decision is expected in late 2026, with a UK private-pharmacy launch plausible in late 2026 or 2027 if Novo Nordisk applies to the MHRA in the coming months.
Second Nature’s programme combines weight-loss medication support with personalised nutrition guidance from registered dietitians and nutritionists.
The plan is built around a balanced plate of half vegetables, a quarter protein, a quarter complex carbohydrates, plus a serving of fat.
A peer-reviewed study published in JMIR Formative Research found that active subscribers on Second Nature’s semaglutide-supported programme lost an average of 19.1% of their body weight at 12 months, with 77.7% achieving at least 10% weight loss.4
Second Nature's Mounjaro and Wegovy programmes
Second Nature provides Mounjaro or Wegovy as part of our Mounjaro and Wegovy weight-loss programmes.
Why choose Second Nature over other medication providers, assuming you're eligible?
Because peace of mind matters.
We've had the privilege of working with the NHS for over eight years, helping people across the UK take meaningful steps toward a healthier, happier life.
Our programmes are designed to meet people where they are, whether that means support with weight loss through compassionate one-to-one health coaching, or access to the latest weight-loss medications (like Mounjaro and Wegovy) delivered alongside expert care from a multidisciplinary team of doctors, psychologists, dietitians, and personal trainers.
At the heart of everything we do is a simple belief: real, lasting change comes from building better habits, not relying on quick fixes. We're here to support that change every step of the way.
With over a decade of experience, thousands of lives changed, and a long-standing record of delivering programmes used by the NHS, we believe we're the UK's most trusted weight-loss programme.
We hope to offer you something invaluable: peace of mind, and the support you need to take that first step.
References
- Garvey, W.T. et al. (2025). Coadministered Cagrilintide and Semaglutide in Adults with Overweight or Obesity. New England Journal of Medicine, 393(7), 635-647.
- Davies, M.J. et al. (2025). Cagrilintide-Semaglutide in Adults with Overweight or Obesity and Type 2 Diabetes. New England Journal of Medicine, 393(7), 648-659.
- Novo Nordisk. (2026). CagriSema demonstrated 23% weight loss in an open-label head-to-head REDEFINE 4 trial in people with obesity, the primary endpoint was not achieved. Novo Nordisk press release, 23 February 2026.
- Richards, R. et al. (2025). A Remotely Delivered GLP-1RA-Supported Specialist Weight Management Program in Adults Living With Obesity: Retrospective Service Evaluation. JMIR Formative Research, 9(1), e72577.
- Novo Nordisk. (2025). Novo Nordisk files for FDA approval of CagriSema, the first once-weekly combination of GLP-1 and amylin analogues for weight management. Novo Nordisk press release, 18 December 2025.
- NICE. (2024). Tirzepatide for managing overweight and obesity. Technology Appraisal TA1026.
- NICE. (2023). Semaglutide for managing overweight and obesity. Technology Appraisal TA875.
