CagriSema: what we know and when it might reach Spain

What is CagriSema, and what does it add to semaglutide?

CagriSema combines two substances in a once-weekly injection. Cagrilintide, which is still being investigated, mimics amylin, a pancreatic hormone linked to feelings of fullness. Semaglutide activates the GLP-1 hormone receptor. They act through different pathways that influence appetite and how much you eat [1].

If you know semaglutide (Ozempic, Wegovy), you’ll recognise one of the two molecules. The combination adds cagrilintide, so the semaglutide products already on sale are not the same as CagriSema. In our guide to semaglutide, we explain what each product is used for. Decisions about medicines should always be made with the healthcare professional treating you.

Where does it stand in the authorisation process?

Regulatory status changes as decisions are made by the relevant agencies. The manufacturer applied for authorisation from the US FDA in December 2025, based on the REDEFINE 1 and 2 results [2]. As of 26 September 2026, no decision is recorded. It is not authorised in the European Union. Being under review is not the same as approval, and does not tell us when it might reach Spain.

You may see headlines giving an expected decision date in the United States. That forecast is not a decision, and does not set a date for the European Union to decide. Commercial launch and availability in Spanish pharmacies would still follow. That is why it is worth checking the status before deciding to wait.

What do the REDEFINE trials show?

In REDEFINE 1, average weight loss at 68 weeks was 20.4% with the combination, compared with 3.0% with placebo [1]. Participants were adults without diabetes who had obesity, or overweight with an associated complication. Both groups received support to change their habits. This is an average from the study; each person responds differently.

In REDEFINE 2, involving people with type 2 diabetes and obesity or overweight, average weight loss at 68 weeks was 13.7%. With placebo it was 3.4% [3]. The populations differ, so these percentages cannot be used to compare people with and without diabetes.

REDEFINE 4 compared CagriSema with tirzepatide (Mounjaro) over 84 weeks in an open-label trial, in which each person knew what they were receiving. It aimed to show that CagriSema did not achieve clearly less weight loss than tirzepatide, but it did not succeed [4]. This result does not call into question its effect compared with placebo, which was studied in REDEFINE 1 and 2.

Trial results help us understand a potential future option; your next decision depends on authorised treatments and your individual circumstances.

Our guide to GLP-1 medicines covers the options that are already authorised. Figures from different studies cannot be used to rank medicines: the participants, duration and comparison treatments vary. In a consultation, we first look at what you’re hoping to achieve, what you take and how it affects your eating.

What you can focus on while you wait

Eating well is something you can work on today, whether you already take an authorised medicine or are discussing options with your doctor. An adequate, flexible eating plan can help you look after your nutrition as your appetite changes. Recommendations for people receiving GLP-1 treatment include advice on food, activity and follow-up [5].

A small meal can include a protein food, vegetables and a source of carbohydrate. For example, lentils with vegetables and rice, or fish with potatoes and salad. The amount can be adjusted to your appetite, activity and clinical circumstances. If a prescribed treatment makes you feel nauseous, having smaller meals more often may help [5]. Discuss persistent symptoms with the person who prescribed it.

Our weekly menu for eating while taking a GLP-1 gives examples of balanced meals. It is for general guidance and needs adjusting if you have diabetes, digestive problems or other needs. You do not need to start a new medicine to organise your meals better.

Protein, strength and follow-up

Weight loss can include a loss of lean mass, which includes muscle and other tissues. Joint guidance on GLP-1 treatment recommends assessing protein intake and strength activity to help protect physical function [5]. It is not enough to look at weight: strength, energy and your ability to manage everyday tasks also matter.

Our guide to protein and muscle with GLP-1 explains how to spread protein sources across the day and get started with strength activity, based on where you are starting from. In consultations, we sometimes find that when appetite falls, the most complete meal of the day is the first to disappear. We ask about what you actually eat and look for ways to bring variety back without forcing large portions.

What we see in consultations

Waiting for a medicine can put off changes that are already within your reach. People often ask, “Should I start now or wait until it becomes available?” We can review your routine, foods you tolerate, strength activity and medical history while your doctor considers the available options. We do not prescribe medicines or change doses.

Another question is whether an average trial result guarantees the same change for you. It does not. Your starting point, how well you tolerate treatment and the consistency of follow-up all play a part. If you have a prescribed treatment, it is most helpful to coordinate your eating plan with the professional overseeing it and not change it yourself.

If you have had an eating disorder, discuss it before starting or changing a weight treatment. Your doctor and mental health team can consider the full picture with you. Your nutrition plan should also protect your relationship with food.

Your first step this week. Note which meal feels a bit lacking and which protein food would be easy for you to add.

If you would like support with eating during a treatment prescribed by your doctor, find out about our GLP-1 nutrition support. We work on your eating plan, strength and follow-up alongside your medical team.