Which is better, liraglutide or cagrilintide?
Cagrilintide beat liraglutide on weight in the direct comparison and needs one injection a week instead of seven, but the margin was small and the trial lasted only 26 weeks. Liraglutide can be prescribed today, is sold as a lower cost generic, and has LEADER cardiovascular outcomes data; cagrilintide cannot be lawfully obtained outside a trial. [1] [2] [3] [4]
How do liraglutide and cagrilintide compare?
| Dimension | Liraglutide | Cagrilintide |
|---|---|---|
| Head-to-head evidence [1] | Liraglutide 3.0 mg daily: 9.0% (9.6 kg) weight loss at 26 weeks. | Cagrilintide 4.5 mg weekly: 10.8% (11.5 kg) weight loss at 26 weeks; lower doses (0.3 to 2.4 mg) produced smaller losses, from 6.0%. |
| Note: Phase 2 trial of 706 adults without diabetes; placebo produced 3.0%. The difference between cagrilintide 4.5 mg and liraglutide was 1.8 points (p = 0.03). | ||
| Mechanism [1] [5] | GLP-1 receptor agonist. | Long acting amylin analog that increases satiety through the amylin pathway. |
| Longer term evidence [2] [6] [7] | SCALE (3,731 adults, 56 weeks): 8.4 kg versus 2.8 kg on placebo. LEADER: major adverse cardiovascular events hazard ratio 0.87 in type 2 diabetes. | Mainly in combination with semaglutide: REDEFINE 1 (3,417 adults, 68 weeks) showed 20.4% weight loss versus 3.0% on placebo. |
| Side effects [1] [5] | Nausea, diarrhea, constipation, and vomiting, highest during weekly dose escalation; boxed warning for thyroid C-cell tumors. | Gastrointestinal adverse events in 41% to 63% versus 32% on placebo, mainly nausea (20% to 47% versus 18%); injection site reactions. |
| Regulatory status [3] [4] [5] [8] | FDA approved (Victoza 2010, Saxenda 2014); generic liraglutide approved from December 2024. | Not FDA approved alone. A new drug application for the fixed combination with semaglutide was submitted to FDA in December 2025. Not eligible for compounding. |
| WADA status [9] | Not on the WADA Prohibited List. | Prohibited under section S0 while not approved by any regulator. |
| Dosing frequency [1] [5] [7] | Once daily injection, 0.6 mg escalated weekly to 3.0 mg. | Once weekly injection in trials (up to 4.5 mg alone, 2.4 mg in the semaglutide combination). |
Evidence grade and regulatory status
Pulled from each peptide’s own record, so it stays in step with the peptide pages.
| Attribute | Liraglutide | Cagrilintide |
|---|---|---|
| Class | GLP-1 receptor agonist (acylated analog of human GLP-1, 97% sequence homology, once daily dosing) | Investigational long acting amylin analog (acylated, once weekly), developed alone and in fixed combination with semaglutide 2.4 mg |
| What it is | First daily GLP-1 drug: FDA approved since 2010, about 8% weight loss at 3 mg over 56 weeks, proven heart benefit, now available as a generic. | Experimental weekly copy of the appetite hormone amylin: 10.8% weight loss alone at 26 weeks and 20.4% with semaglutide at 68 weeks; not FDA approved. |
| Evidence | Evidence: Human RCT evidence | Evidence: Human RCT evidence |
| FDA status | Regulatory: FDA approved | Regulatory: Not eligible for compounding |
| Compounding | FDA approved products (Victoza January 2010, Saxenda December 2014). FDA approved the first generic liraglutide referencing Victoza in December 2024, and generic products referencing Saxenda followed in 2025, so branded, generic, and authorized generic pens are all on the market. FDA listed liraglutide injection as in shortage in its October 2024 and February 2025 GLP-1 updates, and FDA's Drug Shortages database still lists it as of September 27, 2026 (first posted July 18, 2023; updated September 22, 2026), with Victoza and Saxenda presentations at limited availability and unbranded presentations available. FDA states that a compounded drug may not be identical or nearly identical to an FDA-approved drug unless the approved drug is on FDA's drug shortage list. On April 30, 2026 FDA proposed not to include liraglutide on the 503B bulks list; that proposal was not final as of September 2026. Ask any pharmacy offering compounded liraglutide which FDA rule it relies on. | Not FDA approved as of the last verification date, either alone or in the fixed combination with semaglutide. Because cagrilintide is not a component of an approved drug, has no USP monograph, and is not on the 503A bulks list, it cannot lawfully be compounded. Any product sold as cagrilintide or CagriSema outside a clinical trial is an unapproved drug. Check FDA for the status of any marketing application before relying on this record. |
| WADA | WADA: Not WADA prohibited | WADA: WADA prohibited |
| Routes | Subcutaneous injection once daily (prefilled pen) | Subcutaneous injection once weekly (clinical trials only) |
| Typical cost | Manufacturer list price is 1,349.02 USD per month for Saxenda and 543.51 to 815.27 USD per month for Victoza depending on the daily dose (checked 2026-09-22). Generic liraglutide pens cost from about 112 USD per month for the diabetes strength and about 372 USD for the 3 mg weight management generic with a discount card, against average retail prices of about 616 to 924 USD. With commercial insurance the Saxenda savings card can bring a covered prescription to 25 USD. Medicare Part D covers liraglutide for type 2 diabetes but generally not for weight loss alone, and the Medicare GLP-1 Bridge does not include it. | Not available through licensed channels. Products sold as research chemicals are not lawful for human use and are not verified for identity or purity. |
| Last verified |
Has liraglutide been tested directly against cagrilintide?
| Study | Design and population | Outcome | Grade |
|---|---|---|---|
| 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 trial2021 PMID 34798060 | Randomized, double blind, placebo and active (liraglutide 3.0 mg) controlled phase 2 trial, 26 weeksn = 706 Adults without diabetes with BMI 30 or higher, or 27 with hypertension or dyslipidemia | Weight loss 10.8% with cagrilintide 4.5 mg versus 9.0% with liraglutide 3.0 mg (difference 1.8 points, p = 0.03) and 3.0% with placebo | Evidence: Human RCT evidence |
What do liraglutide and cagrilintide cost?
| Dimension | Liraglutide | Cagrilintide |
|---|---|---|
| Typical cost | $112 to $1,349 per month | Not available through licensed channels. Products sold as research chemicals are not lawful for human use and are not verified for identity or purity. |
| Price detail | Liraglutide price by channel | Price index in progress |
Where a price index exists, the range is the cash price per month across branded, compounded, and telehealth channels, without insurance. The cost pages give each channel separately with its sources. Otherwise the typical cost from the peptide record is shown. Legal access depends on your state: see peptide legality by state.
Frequently asked questions
Does cagrilintide work better than liraglutide?
Slightly, in one 26 week phase 2 trial: 10.8% weight loss with cagrilintide 4.5 mg weekly versus 9.0% with liraglutide 3.0 mg daily. [1]
Can I get cagrilintide?
Not lawfully outside a clinical trial. It is not FDA approved and is not eligible for compounding; a combination with semaglutide has been submitted to FDA but was not approved on the verification date. [4] [8]
Is generic liraglutide available?
Yes. FDA approved the first generic liraglutide in December 2024, which lowers its cost relative to branded GLP-1 drugs. [3]
Do they work the same way?
No. Liraglutide activates the GLP-1 receptor; cagrilintide mimics amylin, a different satiety hormone, which is why it is being combined with the GLP-1 drug semaglutide. [1] [5] [7]
Conditions studied
Sources
Numbered citations above point to these primary sources. PubMed entries link to the indexed abstract.
- [1]Lau DCW et al. Once-weekly cagrilintide for weight management in people with overweight and obesity: a randomised, placebo and active-controlled, dose-finding phase 2 trial. Lancet 2021PubMed 34798060, 2021
- [2]Marso SP et al. Liraglutide and cardiovascular outcomes in type 2 diabetes. N Engl J Med 2016 (LEADER)PubMed 27295427, 2016
- [3]FDA: First generic drug approvals (includes liraglutide injection, December 2024)FDA
- [4]FDA: Bulk drug substances used in compounding under section 503A of the FD&C ActFDA
- [5]FDA prescribing information for Saxenda (liraglutide) injection, via DailyMedFDA
- [6]Pi-Sunyer X et al. A randomized, controlled trial of 3.0 mg of liraglutide in weight management. N Engl J Med 2015 (SCALE Obesity and Prediabetes)PubMed 26132939, 2015
- [7]Garvey WT et al. Coadministered cagrilintide and semaglutide in adults with overweight or obesity. N Engl J Med 2025 (REDEFINE 1)PubMed 40544433, 2025
- [8]Manufacturer press release: new drug application submitted to FDA for once weekly cagrilintide 2.4 mg plus semaglutide 2.4 mg for weight management (December 18, 2025), accessed 2026-09-222025
- [9]WADA Prohibited List (section S0 covers substances not approved by any government health authority)WADA
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