Cagrilintide vs Tirzepatide
Comparing Novo Nordisk's amylin analog cagrilintide with Eli Lilly's dual GIP/GLP-1 agonist tirzepatide.
Last updated: February 1, 2026
Dossier labels summarize each dossier's research scope. They do not establish comparative treatment benefit or safety. Read the comparison below in that context.
Cagrilintide
Dossier overview
Tirzepatide
Dossier overview
Overview
Cagrilintide and tirzepatide target obesity through entirely different mechanisms. Cagrilintide is a long-acting amylin analog developed as a combination partner (CagriSema), while tirzepatide is a dual GIP/GLP-1 agonist that achieved record weight loss in trials. This comparison highlights different pharmaceutical strategies in obesity treatment.
Mechanism Comparison
| Aspect | Cagrilintide | Tirzepatide |
|---|---|---|
| Target Receptors | Amylin (AMY1-3) | GIP + GLP-1 |
| Hormone Class | Amylin analog | Incretin dual agonist |
| Primary Brain Site | Area postrema | Hypothalamus |
| Insulin Effect | Indirect | Direct enhancement |
Different Satiety Pathways
Cagrilintide:
- Amylin signals meal-ending satiety
- Acts on area postrema and nucleus tractus solitarius
- Slows gastric emptying
- Complements GLP-1 effects
Tirzepatide:
- GLP-1 provides appetite suppression
- GIP adds metabolic benefits
- Acts primarily on hypothalamus
- Enhances insulin sensitivity
Evidence Comparison
| Aspect | Cagrilintide | Tirzepatide |
|---|---|---|
| Monotherapy Trials | Phase 2 | Phase 3 + Approved |
| Regulatory Status | Investigational | FDA Approved |
| Primary Strategy | Combination (CagriSema) | Standalone |
| Evidence Base | Moderate | Extensive |
Efficacy Comparison
Cagrilintide Monotherapy (Phase 2)
| Dose | Weight Loss (26 weeks) |
|---|---|
| 2.4mg | ~9% |
| 4.5mg | ~11% |
CagriSema (Cagrilintide + Semaglutide)
| Comparison | Weight Loss |
|---|---|
| CagriSema | ~15-22% |
| Semaglutide alone | ~15% |
Tirzepatide (SURMOUNT-1)
| Dose | Weight Loss (72 weeks) |
|---|---|
| 10mg | ~19.5% |
| 15mg | ~22.5% |
Comparison: Tirzepatide monotherapy achieves similar or better results than cagrilintide + semaglutide combination.
Strategic Positioning
| Factor | Cagrilintide | Tirzepatide |
|---|---|---|
| Company | Novo Nordisk | Eli Lilly |
| Standalone Viability | Low | Yes |
| Combination Partner | Primary value | Not needed |
| Competitive Response | To tirzepatide | First-in-class |
The Cagrilintide Strategy
Novo Nordisk’s response to tirzepatide:
- Semaglutide alone ~15% weight loss
- Tirzepatide ~22% weight loss (competitive threat)
- CagriSema (semaglutide + cagrilintide) targets ~20%+ weight loss
- Maintains Novo’s competitive position
Regulatory Status
| Aspect | Cagrilintide | Tirzepatide |
|---|---|---|
| FDA Status | Investigational | Approved |
| Brand Names | N/A | Mounjaro, Zepbound |
| CagriSema Status | Phase 3 | N/A |
| Timeline | CagriSema 2025-2026 | Available now |
Side Effect Profile
| Effect | Cagrilintide | Tirzepatide |
|---|---|---|
| Nausea | Common | Common |
| Vomiting | Common | Common |
| Constipation | More prominent | Less prominent |
| Overall GI | Class effects | Class effects |
Administration
| Aspect | Cagrilintide | Tirzepatide |
|---|---|---|
| Route | Subcutaneous | Subcutaneous |
| Combination | With semaglutide (CagriSema) | Standalone |
| Injection Burden | 1 (fixed combo) | 1 |
Cost and Access Considerations
| Factor | CagriSema (Future) | Tirzepatide |
|---|---|---|
| Pricing | Premium expected | ~$1,000+/month |
| Complexity | Two peptides | One peptide |
| Supply | TBD | Current shortages |
Key Differences
- Mechanism: Amylin vs dual incretin agonism
- Standalone efficacy: Cagrilintide moderate alone, tirzepatide highly effective alone
- Strategy: Cagrilintide is a combination partner; tirzepatide is standalone
- Approval status: Tirzepatide approved; cagrilintide investigational
- Company: Novo Nordisk vs Eli Lilly
Summary
- Cagrilintide is an amylin analog primarily valuable as part of CagriSema combination
- Tirzepatide is the first dual GIP/GLP-1 agonist with class-leading efficacy
- CagriSema (cagrilintide + semaglutide) aims to match tirzepatide’s efficacy
- Different mechanisms represent distinct approaches to obesity
- Tirzepatide’s approval and efficacy make it the current benchmark
This comparison is for educational purposes only. Cagrilintide is investigational. Consult a healthcare provider for treatment decisions.
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Disclaimer: This comparison is for educational purposes only and does not constitute medical advice. Individual responses to medications vary. Always consult a qualified healthcare provider before making treatment decisions.