CagriSema is not approved anywhere and is not registered in Singapore: it is an investigational once-weekly injection from Novo Nordisk that combines semaglutide with cagrilintide, an amylin analogue. In REDEFINE 1, average weight change at 68 weeks was −20.4% on CagriSema against −3.0% on placebo (Garvey 2025); individual results vary. A US decision, expected by late 2026, would not register it here (Novo, December 2025).
Availability in Singapore. CagriSema is not available in Singapore, even in a trial: it is not registered with Singapore's Health Sciences Authority (HSA register), and no CagriSema study lists a site here (ClinicalTrials.gov), so it cannot be prescribed or supplied here. It is not approved anywhere yet. Novo Nordisk applied to the US Food and Drug Administration in December 2025 (Novo, December 2025) and expects a US decision in the fourth quarter of 2026 (Novo, August 2026). Until a regulator approves it, it is given only to people taking part in its clinical trials, and anything offered for sale under this name is not what the trials studied.
Education only. This page is general education about a medicine that is not registered in Singapore. It is not an advertisement or an offer. GetLean does not prescribe or supply CagriSema or cagrilintide, and nothing here recommends using either.
Amylin analogue: a lab-made, longer-acting version of amylin, a hormone the pancreas releases with insulin when food is eaten. Cagrilintide is a long-acting amylin analogue (Novo, June 2026).
What is CagriSema?
CagriSema is a fixed-dose combination of semaglutide 2.4 mg and cagrilintide 2.4 mg, injected once a week. Novo describes the aim as reducing hunger and increasing fullness so that people eat less (Novo, February 2026). Semaglutide on its own is already registered in Singapore for weight management (Singapore NDF); cagrilintide on its own is still in phase 3 trials (ClinicalTrials.gov). The status table of new weight-loss medicines shows how CagriSema sits beside the others.
Is CagriSema available in Singapore?
No. A full download of Singapore's register of therapeutic products, read on 9 October 2026, holds 5,511 records with approvals up to 8 July 2026, and none names CagriSema or cagrilintide (HSA register). HSA's listing of approvals, updated 30 September 2026, has no entry for either (HSA approvals), and no CagriSema or cagrilintide study lists a site in Singapore (ClinicalTrials.gov). On 25 September 2026 HSA warned that unapproved injectable peptides still in clinical development, such as retatrutide and cagrilintide, are being marketed online, and that no regulator, including HSA, has approved them as medicines (HSA 2026).
Where is CagriSema with the US FDA?
Under review, not approved. Novo submitted a New Drug Application on 18 December 2025, based on REDEFINE 1 and REDEFINE 2 (Novo, December 2025). It said in February 2026 that a decision was anticipated by late 2026 (Novo, February 2026), and its August 2026 report lists a CagriSema US decision among the fourth-quarter milestones (Novo, August 2026). No decision had been announced by 9 October 2026.
What did the phase 3 trials report?
| Trial | Who took part | Weeks | CagriSema | Comparator |
|---|---|---|---|---|
| REDEFINE 1 (phase 3a, double-blind) | 3,417 adults with obesity, or overweight with a related condition, without diabetes | 68 | −20.4% counting everyone; −22.7% if everyone stayed on treatment | Placebo: −3.0% and −2.3% |
| REDEFINE 4 (phase 3, open-label) | 809 adults with obesity and one or more related conditions | 84 | −20.2% counting everyone; −23.0% if everyone stayed on treatment | Tirzepatide 15 mg: −23.6% and −25.5% |
REDEFINE 1: counting everyone is the treatment-policy estimand (Garvey 2025); the second figure is Novo's if-everyone-stayed-on-treatment analysis (Novo, December 2025). REDEFINE 4: treatment-regimen estimand (counting everyone regardless of adherence) and efficacy estimand (as if all adhered), company-announced (Novo, February 2026). Individual results vary and are not guaranteed.
REDEFINE 4 did not show CagriSema matching tirzepatide. Its primary goal was to show that CagriSema 2.4 mg/2.4 mg was no worse than tirzepatide 15 mg on weight loss at 84 weeks, and that was not achieved. Open-label means everyone knew which medicine they were taking. The figures come from Novo's announcement (Novo, February 2026); a PubMed search on 9 October 2026 found no peer-reviewed paper on REDEFINE 4.
In type 2 diabetes the same two medicines were compared again, with a different result. REIMAGINE 4, an open-label 68-week trial in adults with type 2 diabetes, reported that CagriSema 2.4 mg/2.4 mg was non-inferior to tirzepatide 15 mg for weight reduction but not for HbA1c reduction; if everyone had adhered, weight loss was 15.2% against 15.8% (Novo, August 2026). That is a different population from REDEFINE 4.
A pooled comparison puts the two close at one year. A 2026 network meta-analysis of 262 trials and 99,791 participants estimated weight change against lifestyle modification alone at −14.8% for cagrilintide-semaglutide and −14.9% for tirzepatide, with moderate to high certainty. It also found stopping because of side effects was highest with six drugs, CagriSema among them (Nong 2026).
Digestive side effects were the most common. In REDEFINE 1 they affected 79.6% on CagriSema and 39.9% on placebo, mostly transient and mild to moderate; nausea was 55% against 12.6%, and 5.9% stopped because of side effects against 3.5% on placebo (Garvey 2025; Novo, December 2025).
What is still being tested?
A phase 3 trial of a higher dose, CagriSema 2.4 mg/7.2 mg, has started and is expected to read out in the first half of 2028 (Novo, August 2026). Other results in type 2 diabetes sit in Novo's REIMAGINE programme (Novo, June 2026) and are not covered here.
What do the trials say about stopping CagriSema?
No CagriSema results on stopping have been reported. Two Novo trials are set up to ask. In REDEFINE 8, people who had CagriSema for two years are randomised for a further year to continue or to have the dose slowly reduced, with primary completion estimated for August 2028; REDEFINE 11 includes an 80-week extension to look at maintaining weight loss (ClinicalTrials.gov; Novo, February 2026).
For semaglutide, one of CagriSema's two components, the reference is the STEP 1 extension. The medication and the lifestyle support were stopped overnight at week 68, with no taper, and about two-thirds of the lost weight came back within a year (Wilding 2022).
At GetLean, the programme is designed to end: our philosophy is that GLP-1 medication should act as a catalyst — not something to depend on indefinitely. The plan for coming off is the GetLean GLP-1 Taper Plan: after hitting your goal weight with the right nutrition and exercise habits built, the dose is stepped down at Dr Quek's monthly reviews towards your lowest effective dose and, where clinically appropriate, off the medication. While the medication keeps appetite quiet, daily WhatsApp coaching builds the eating pattern and the training habit that hold the result, and Dr Quek brings the dose down at the monthly reviews rather than stopping it overnight. After the taper, coaching and reviews can continue. Individual results vary, and a prescribed medicine should never be stopped or changed on one's own. How to come off GLP-1 in Singapore sets out the plan; how a planned taper works and how much weight comes back after stopping cover it in more detail.
For someone starting a GLP-1 for the first time
CagriSema cannot be prescribed in Singapore, and no date has been announced for registration here. Medicines registered here for weight management already exist, and which one suits a person, if any does, is decided by the doctor who assesses them. Whether to do something now, or nothing, is a conversation to have with a doctor rather than a decision to make against a calendar that has not been published.
For someone already on a GLP-1 with another doctor
CagriSema would add amylin to semaglutide. It would not change that the treatment is a weekly injection, that digestive side effects are the most common, or that a plan for bringing the dose down is part of any course of treatment. Which medicine and dose suit a person is the prescribing doctor's decision, and nothing here is a reason to stop or change a prescribed medicine.
Common questions
Is CagriSema approved anywhere, and is it available in Singapore?
No. CagriSema was submitted to the US FDA in December 2025 and has not been approved, and it is not on Singapore's register of therapeutic products, checked 9 October 2026 (Novo, December 2025; HSA register). A US approval would not register it here; that is a separate decision by HSA.
How much weight did people lose on CagriSema in the trials?
In REDEFINE 1, a phase 3a trial, average weight change at 68 weeks was −20.4% on CagriSema against −3.0% on placebo, counting everyone regardless of whether they kept taking it (Garvey 2025); Novo's figure if everyone had stayed on treatment is −22.7% against −2.3% (Novo, December 2025). Individual results vary and are not guaranteed.
Is CagriSema better than tirzepatide?
REDEFINE 4 compared them directly in people with obesity, and CagriSema did not meet its primary goal of showing it was no worse than tirzepatide 15 mg: −20.2% against −23.6% at 84 weeks counting everyone, and −23.0% against −25.5% if everyone stayed on treatment (Novo, February 2026). In type 2 diabetes, the separate REIMAGINE 4 trial reported CagriSema as non-inferior to tirzepatide 15 mg for weight reduction (Novo, August 2026); both are company-announced, open-label results.
Should I wait for CagriSema before starting a GLP-1?
No date has been announced for CagriSema in Singapore, and a US decision would not set one. Medicines registered here for weight management already exist, and which one suits a person, if any does, is decided by the doctor who assesses them; whether to start now is a conversation with that doctor rather than a decision against a calendar.
I'm already on a GLP-1 with another doctor. Would CagriSema change anything?
It cannot be prescribed in Singapore, so it changes nothing today. If it were ever registered, it would add amylin to semaglutide, and REDEFINE 4 did not show it matching tirzepatide 15 mg on weight loss. Which medicine and dose suit someone is the prescribing doctor's decision, and a prescribed medicine should never be stopped or changed on one's own.
What happens to weight when CagriSema is stopped?
No CagriSema results on stopping have been reported; Novo's REDEFINE 8 and REDEFINE 11 are set up to look at slowly reducing the dose and at maintaining weight loss (ClinicalTrials.gov). For semaglutide, one of its two components, the STEP 1 extension stopped the medication overnight with no taper, and about two-thirds of the lost weight came back within a year (Wilding 2022).