Cagrilintide vs Tirzepatide: How They Differ
Cagrilintide is a long-acting analogue of amylin, a satiety hormone made in the pancreas, while tirzepatide is a dual agonist at the GIP and GLP-1 incretin receptors. Both are once-weekly peptides studied for body weight, but they act on different hormone systems. Tirzepatide is an approved medicine with completed phase 3 programs in obesity and type 2 diabetes; cagrilintide is still investigational, studied alone and paired with the GLP-1 agonist semaglutide. Here is how the two molecules differ, what the human trials found, and what the first head-to-head data showed.
Findings
- Cagrilintide is a lipidated, long-acting amylin analogue, engineered to resist the fibril formation that makes natural amylin hard to use, with a half-life of 159 to 195 hours in a phase 1b study.
- In a 26-week phase 2 trial of 706 adults, the highest cagrilintide dose lowered body weight 10.8% against 9.0% with liraglutide 3.0 mg and 3.0% with placebo (2021).
- Tirzepatide is a 39-amino-acid GIP-based peptide that activates both GIP and GLP-1 receptors and has a half-life of about 5 days.
- In a 72-week trial of 2,539 adults with obesity, tirzepatide groups lost 15.0% to 20.9% of body weight against 3.1% on placebo (2022).
What is cagrilintide?
Amylin is a pancreatic hormone released alongside insulin that induces satiety (Lau et al., Lancet, 2021). Natural amylin readily forms amyloid fibrils, and the earlier analogue pramlintide needs three injections a day because of its short half-life. Cagrilintide was designed to solve both problems: a stable, lipidated analogue selected after structure-activity work for once-weekly use in obesity research (Kruse et al., J Med Chem, 2021). In a phase 1b study alongside semaglutide, its half-life was 159 to 195 hours, with peak levels 24 to 72 hours after each dose (Enebo et al., Lancet, 2021).
The human trials
The dose-finding phase 2 trial randomised 706 adults without diabetes at 57 sites in ten countries, Canada included, to one of five once-weekly cagrilintide doses, daily liraglutide 3.0 mg or placebo for 26 weeks. Every cagrilintide dose produced more weight loss than placebo, from 6.0% to 10.8%, and the top dose beat liraglutide by 1.8 percentage points. Gastrointestinal events, mostly nausea, were the most common side effects (Lau et al., Lancet, 2021). The lead investigator was based at the University of Calgary.
The largest data set comes from a 68-week phase 3 trial of 3,417 adults with overweight or obesity. Cagrilintide 2.4 mg combined with semaglutide 2.4 mg lowered body weight 20.4% against 3.0% with placebo (Garvey et al., N Engl J Med, 2025). The same trial included a cagrilintide-only arm of 302 participants; in a sub-analysis presented in September 2025, cagrilintide alone produced 11.8% weight loss among adherent participants against 2.3% with placebo (11.5% against 3.0% regardless of adherence), a company-reported figure (Patient Care, 2025).
What is tirzepatide?
Tirzepatide is a 39-amino-acid modified peptide based on the GIP sequence, with a C20 fatty diacid side chain that binds albumin and gives a half-life of about 5 days (US prescribing information, 2022). It activates both the GIP and GLP-1 receptors, the targets of the two incretin hormones that drive insulin release after a meal and influence appetite. In the discovery work it reduced food intake and body weight in mice more than a selective GLP-1 agonist (Coskun et al., Mol Metab, 2018).
The human trials
In a phase 3, double-blind trial of 2,539 adults with obesity and without diabetes, 72 weeks of tirzepatide lowered body weight by 15.0%, 19.5% and 20.9% across the three dose groups against 3.1% with placebo (Jastreboff et al., N Engl J Med, 2022). Against semaglutide in 751 adults with obesity, tirzepatide produced 20.2% weight loss against 13.7% over 72 weeks, with a larger reduction in waist circumference (Aronne et al., N Engl J Med, 2025). More is in Tirzepatide trials: weight and diabetes.
What did the head-to-head trial show?
Cagrilintide has not been tested alone against tirzepatide. The direct comparison used the cagrilintide and semaglutide combination: an 84-week, open-label phase 3 trial of 809 adults with obesity against tirzepatide 15 mg. In topline results announced in February 2026, the combination produced 23.0% weight loss against 25.5% for tirzepatide among participants on treatment, and the trial did not meet its non-inferiority goal (Drug Topics, 2026). These were company-reported results; a journal publication had not appeared as of October 2026. Two further head-to-head trials in type 2 diabetes, each of about 1,000 participants, are listed as completed on ClinicalTrials.gov without published results.
How do cagrilintide and tirzepatide compare side by side?
| Question | Cagrilintide | Tirzepatide |
|---|---|---|
| What is it? | Long-acting amylin analogue | Dual GIP and GLP-1 receptor agonist |
| Structure | Lipidated, fibril-resistant amylin analogue | 39 amino acids plus a C20 fatty diacid |
| Hormone system | Amylin (pancreatic satiety hormone) | Incretins (gut hormones) |
| Half-life | 159 to 195 hours (phase 1b) | About 5 days (label) |
| Main research area | Body weight, alone and with semaglutide | Body weight and type 2 diabetes |
| Human evidence | Phase 2 (706) and phase 3 (3,417) trials | Multiple phase 3 trials, up to 2,539 adults each |
| Status | Investigational | Approved medicine |
| Forms we supply | 10 mg lyophilised vial | 10 mg and 20 mg lyophilised vials |
Which one fits which research question?
- Amylin signalling and satiety: cagrilintide, the only one of the two acting through the amylin system.
- Incretin pharmacology, insulin secretion and glucose control: tirzepatide, whose trials include HbA1c as a primary end point in type 2 diabetes.
- Combination designs with a GLP-1 agonist: cagrilintide, which has its largest human data set as a partner to semaglutide.
- Magnitude of weight change in a single molecule: tirzepatide, with 72-week placebo-controlled and head-to-head data.
Can cagrilintide and tirzepatide be studied together?
The two act through different hormone systems, which is the same rationale that led researchers to pair cagrilintide with semaglutide, a GLP-1 agonist. Our search of ClinicalTrials.gov in October 2026 found the trials comparing the cagrilintide and semaglutide combination with tirzepatide, but none giving cagrilintide and tirzepatide together, so there is no combined human data to cite. Any laboratory pairing rests on each compound’s own literature. Related comparisons: Retatrutide vs Cagrilintide and Tirzepatide vs Semaglutide.
How are cagrilintide and tirzepatide supplied?
Cagrilintide comes as a 10 mg lyophilised vial, and tirzepatide as 10 mg and 20 mg vials. Both are reconstituted with bacteriostatic water; the method is in how to reconstitute peptides, the tirzepatide arithmetic is in the tirzepatide reconstitution guide, and the peptide calculator handles any vial size. Storage after mixing is covered in how long tirzepatide lasts. Certificates of analysis are on the lab reports page, and every order ships from within Canada by Canada Post Xpresspost.
Cagrilintide and tirzepatide are supplied by Vistara Labs for laboratory research use only. The studies above were clinical research using pharmaceutical preparations.
Frequently asked questions
What is the difference between cagrilintide and tirzepatide?
Cagrilintide is a long-acting analogue of amylin, a pancreatic satiety hormone. Tirzepatide is a 39-amino-acid peptide that activates the GIP and GLP-1 incretin receptors. Both were developed for once-weekly use in weight research.
Is tirzepatide stronger than cagrilintide?
No trial has compared them alone. Across separate trials, cagrilintide alone lowered weight 10.8% at 26 weeks and 11.8% at 68 weeks, and tirzepatide 15.0% to 20.9% at 72 weeks. In a company-reported head-to-head trial, cagrilintide plus semaglutide produced 23.0% against 25.5% for tirzepatide.
What is CagriSema?
CagriSema is the name used for cagrilintide combined with semaglutide. In a 68-week trial of 3,417 adults, the combination lowered body weight 20.4% against 3.0% with placebo.
Can cagrilintide and tirzepatide be studied together?
They act on different hormone systems, amylin and the incretins. No human trial giving the two together was registered on ClinicalTrials.gov as of October 2026, so there is no combined human data.
Where can I buy cagrilintide and tirzepatide in Canada?
Vistara Labs supplies cagrilintide as a 10 mg lyophilised vial and tirzepatide as 10 mg and 20 mg vials, with certificates of analysis online, shipped from within Canada by Canada Post Xpresspost.
Product details from vistaralabs.ca, October 2026. Sources: Kruse T et al. Development of cagrilintide, a long-acting amylin analogue. J Med Chem. 2021. PMID 34288673. Enebo LB et al. Safety, tolerability, pharmacokinetics, and pharmacodynamics of concomitant administration of multiple doses of cagrilintide with semaglutide 2.4 mg for weight management: a randomised, controlled, phase 1b trial. Lancet. 2021. PMID 33894838. Lau DCW et al. Once-weekly cagrilintide for weight management in people with overweight and obesity: a multicentre, randomised, double-blind, placebo-controlled and active-controlled, dose-finding phase 2 trial. Lancet. 2021. PMID 34798060. Garvey WT et al. Coadministered cagrilintide and semaglutide in adults with overweight or obesity. N Engl J Med. 2025. PMID 40544433. Amylin injectable cagrilintide demonstrates weight loss of 11.8% in late-stage trial. Patient Care. September 2025. Article. US prescribing information for tirzepatide, initial approval 2022. FDA label. Coskun T et al. Tirzepatide from discovery to clinical proof of concept. Mol Metab. 2018;18:3-14. PMID 30473097. Jastreboff AM et al. Tirzepatide once weekly for the treatment of obesity. N Engl J Med. 2022. PMID 35658024. Aronne LJ et al. Tirzepatide as compared with semaglutide for the treatment of obesity. N Engl J Med. 2025. PMID 40353578. CagriSema did not meet primary end point of noninferiority to tirzepatide. Drug Topics. 24 February 2026. Article. ClinicalTrials.gov: NCT06131437, NCT06221969, NCT06534411.
More on this: Peptides for Weight Loss: What People Actually Mean.
All products supplied by Vistara Labs are intended for laboratory research use only. They are not drugs, are not approved for human or veterinary use, and are not intended to diagnose, treat, cure or prevent any condition. Nothing on this page constitutes medical advice or guidance for use in humans.
