GLP-1 drugs like semaglutide and tirzepatide changed obesity treatment. The next wave pairs them with, or builds on, a different hormone: amylin. Here’s what amylin does and where the three most-discussed amylin compounds stand.
Key takeaways
- Amylin is released with insulin after meals and signals fullness.
- CagriSema (cagrilintide + semaglutide) averaged 20.4% weight loss at 68 weeks in REDEFINE 1.
- Eloralintide averaged up to 20.1% at 48 weeks in Phase 2.
- None of the long-acting amylin drugs had FDA approval at our last review.
What amylin does
Amylin is released by the pancreas’s beta cells along with insulin after a meal. It slows stomach emptying, signals fullness through the brainstem, and lowers glucagon after meals. GLP-1 acts on overlapping but different signals, which is why researchers expect the two to work well together.
Pramlintide: the first amylin drug
Pramlintide (Symlin) was FDA approved in 2005 for people with diabetes who use mealtime insulin. It is short-acting and injected before meals. The newer compounds are designed to last a week.
Cagrilintide
Cagrilintide is Novo Nordisk’s long-acting, once-weekly amylin analog. In the Phase 3 REDEFINE 1 trial, cagrilintide alone produced about 11.8% average weight loss at 68 weeks, compared with 3.0% on placebo. It is not approved as a standalone medicine.
CagriSema
CagriSema combines cagrilintide 2.4 mg and semaglutide 2.4 mg in one weekly injection. In REDEFINE 1 it produced 20.4% average weight loss at 68 weeks (22.7% among people who stayed on treatment), compared with 3.0% on placebo. GI side effects affected about 80% of participants, mostly nausea, constipation, and vomiting. Novo Nordisk filed for FDA approval in December 2025.
Eloralintide
Eloralintide is Eli Lilly’s selective amylin-receptor agonist. In a 48-week Phase 2 trial published in The Lancet (2025), weekly doses of 1, 3, 6, and 9 mg produced 9.5%, 12.4%, 17.6%, and 20.1% average weight loss, compared with 0.4% on placebo. GI effects and fatigue were more common at higher doses and less common with gradual escalation. Phase 3 trials are underway.
What to keep in mind
- Trial results are averages from screened, monitored participants. Individual results vary widely.
- None of the long-acting amylin drugs above had FDA approval as of our last review. Check the FDA’s current status.
- Products sold as fixed “cagrilintide + semaglutide” blends lock the ratio. They are not the same as the product being reviewed by the FDA.
See the new entries in our Compound Library and the amylin section of our GLP-1, GIP & glucagon guide.
Medical disclaimer: Pep Guide is for educational purposes only. It is not medical advice, diagnosis or treatment. Research changes over time. Talk to a licensed healthcare provider before starting, stopping or changing any medication or compound.