Cagrilintide vs Exenatide
A detailed comparison to help you understand the differences and choose the right peptide for your research goals.
Cagrilintide
Cagrilintide is a long-acting amylin analog in development, showing promising results when combined with semaglutide (CagriSema). Amylin is a hormone co-secreted with insulin that promotes satiety.
Full details →Exenatide
Exenatide was the first GLP-1 receptor agonist approved in the US, derived from a compound found in Gila monster saliva. Available as Byetta (twice daily) and Bydureon (once weekly extended-release).
Full details →Side-by-Side Comparison
| Aspect | Cagrilintide | Exenatide |
|---|---|---|
| Dose Range | 300 mcg–4.5 mg | 5 mcg–10 mcg |
| Frequency | Less than daily | 2x daily |
| Cycle Length | 26–68 weeks | 8–24 weeks |
| Route | subcutaneous | subcutaneous |
| Mechanism | Activates amylin receptors (calcitonin receptor with RAMP proteins) to slow gastric emptying, suppress glucagon secretion, and reduce food intake through central satiety mechanisms distinct from GLP-1. | Synthetic version of exendin-4, which activates GLP-1 receptors to enhance glucose-dependent insulin secretion, suppress glucagon, slow gastric emptying, and promote satiety. |
| Typical Dosage | Clinical trials: 2.4mg weekly as monotherapy or in combination with semaglutide 2.4mg (CagriSema). Optimal dosing still being determined. | Byetta: 5mcg twice daily for 1 month, then 10mcg twice daily. Bydureon: 2mg subcutaneously once weekly. |
| Administration | Subcutaneous injection once weekly. Currently only available in clinical trials - not yet FDA approved. | Byetta: Inject within 60 minutes before morning and evening meals. Bydureon: Any time of day, with or without meals. Do not mix with insulin in same syringe. |
| Side Effects | Nausea, vomiting, diarrhea, constipation similar to other incretin-based therapies. Combination with semaglutide may increase GI effects initially. | Nausea (especially initially), vomiting, diarrhea, dizziness, headache, and injection site reactions (particularly with Bydureon). |
| Best For |
What They Have in Common
Cagrilintide, Exenatide are both commonly used for:
Which Has Stronger Evidence?
| Goal | Cagrilintide | Exenatide |
|---|---|---|
| Fat Loss | high | high |
Key Studies
Cagrilintide
- Efficacy and safety of co-administered cagrilintide and semaglutide versus semaglutide alone in adults with overweight or obesity with or without type 2 diabetes in Japan and Taiwan (REDEFINE 5): a multicentre, randomised, active-controlled, phase 3a trial.
The lancet. Diabetes & endocrinology, 2026
- A cross-species atlas of the dorsal vagal complex reveals neural mediators of the effects of cagrilintide on energy balance.
Nature metabolism, 2026
- Cagrilintide-Semaglutide in Adults with Overweight or Obesity and Type 2 Diabetes.
The New England journal of medicine, 2025
Exenatide
- Exenatide Once Weekly in the Treatment of Patients with Multiple System Atrophy.
Annals of neurology, 2025
- The effect of GLP-1RA exenatide on idiopathic intracranial hypertension: a randomized clinical trial.
Brain : a journal of neurology, 2023
- Exenatide, Dapagliflozin, or Phentermine/Topiramate Differentially Affect Metabolic Profiles in Polycystic Ovary Syndrome.
The Journal of clinical endocrinology and metabolism, 2021
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