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Eloralintide vs Cagrilintide: Two Amylin Analogues Compared

Eloralintide vs cagrilintide: Lilly’s selective amylin agonist vs Novo Nordisk’s non-selective one. Receptor selectivity, half-life, 20.1% vs 10.8% weight loss, CagriSema and amycretin.

Updated 8 November 2026 6 min read 9 primary sources

Key facts

  • Both are long-acting amylin analogues. Eloralintide (Lilly) is selective for amylin receptors; cagrilintide (Novo Nordisk) activates amylin and calcitonin receptors with similar potency.[1][2]
  • Half-life: eloralintide 310 to 366 hours vs cagrilintide 159 to 195 hours.[1]
  • Monotherapy weight loss: eloralintide 20.1% at 48 weeks vs cagrilintide up to 10.8% at 26 weeks in phase 2.[3][5]
  • Cagrilintide is paired with semaglutide as CagriSema (20.4% in REDEFINE 1); eloralintide is paired with tirzepatide as EloraTZP.[6][8]

What Is the Difference Between Eloralintide and Cagrilintide?

The key difference is selectivity: eloralintide is about 12 times more potent at the amylin 1 receptor than at the calcitonin receptor, while cagrilintide activates both with similar potency.[1][2]

FeatureEloralintideCagrilintide
DeveloperEli LillyNovo Nordisk
ReceptorsAmylin, selective for AMY1R[1]Amylin and calcitonin, non-selective[2]
Half-life310 to 366 hours[1]159 to 195 hours (cited in [1])
Best monotherapy result-20.1% at 48 wk, 9 mg[3]-10.8% at 26 wk, 4.5 mg[5]
Main combinationEloraTZP (with tirzepatide)CagriSema (with semaglutide)
Status (Nov 2026)Phase 3CagriSema filed with FDA Dec 2025[9]

Lilly’s preclinical work found that eloralintide caused significantly less conditioned taste avoidance in rats than cagrilintide. This lab marker of nausea-like effects was part of the reason for designing a selective molecule.[1]

Eloralintide vs Cagrilintide Weight Loss

Eloralintide reached 20.1% mean weight loss at 48 weeks in phase 2, while cagrilintide alone reached 6.0% to 10.8% at 26 weeks in its phase 2 trial, so the trials differ in length as well as result.[3][5]

Best reported mean weight loss, separate trials
Cagrilintide 4.5 mg (26 wk)10.8%Eloralintide 9 mg (48 wk)20.1%CagriSema (68 wk)20.4%

Different trial lengths and estimands: eloralintide 48 weeks; cagrilintide 26 weeks; CagriSema 68 weeks (treatment-policy). Not head-to-head.

CagriSema (cagrilintide 2.4 mg plus semaglutide 2.4 mg) gave 20.4% weight loss at 68 weeks against 3.0% on placebo in REDEFINE 1, or 22.7% if everyone stayed on treatment.[6]

Nausea and Side Effects Compared

Nausea affected 20% to 47% of people on cagrilintide in its phase 2 trial (placebo 18%) and 11% to 64% across eloralintide doses in its phase 2 (placebo 14%), with eloralintide lowest at 1 mg and 3 mg.[5][4]

Lilly reports that GI effects with eloralintide were similar to placebo at 1 mg and 3 mg and lower with slower dose escalation.[3] Full detail in eloralintide side effects.

Where Does Amycretin Fit In?

Amycretin, now named zenagamtide, is Novo Nordisk’s single molecule acting on both GLP-1 and amylin receptors, and it reached 24.3% weight loss at 36 weeks at 60 mg in a phase 1b/2a trial.[7]

Eloralintide takes the opposite approach: a pure amylin agonist that Lilly tests alone and next to tirzepatide, rather than one molecule that hits several receptors.

Frequently Asked Questions

Is eloralintide better than cagrilintide?

On monotherapy results, eloralintide reached more weight loss (20.1% at 48 weeks vs up to 10.8% at 26 weeks), but the trials differ in length and design. No head-to-head trial exists.

Are eloralintide and cagrilintide the same type of drug?

Both are long-acting amylin analogues. Eloralintide is selective for amylin receptors; cagrilintide also activates the calcitonin receptor.

Which lasts longer, eloralintide or cagrilintide?

Eloralintide. Its human half-life is 310 to 366 hours, against 159 to 195 hours cited for cagrilintide. Both are dosed once weekly.

What is CagriSema?

CagriSema combines cagrilintide 2.4 mg with semaglutide 2.4 mg. It gave 20.4% weight loss at 68 weeks in REDEFINE 1 and was submitted to the FDA in December 2025.

Sources

  1. Briere DA, et al. Discovery and first-in-human study of eloralintide. Molecular Metabolism 2025;102:102271. DOI 10.1016/j.molmet.2025.102271
  2. Bhattachar S, et al. Eloralintide 12-week multiple-dose phase 1. Diabetes, Obesity and Metabolism 2026;28(4):2651-2660. DOI 10.1111/dom.70439
  3. Eli Lilly press release, 6 Nov 2025: eloralintide phase 2 results
  4. Billings LK, et al. Eloralintide phase 2, 48-week trial. The Lancet 2025;406:2631-2643. DOI 10.1016/S0140-6736(25)02155-5
  5. Lau DCW, et al. Cagrilintide phase 2. The Lancet 2021;398:2160-2172. DOI 10.1016/S0140-6736(21)01751-7
  6. Garvey WT, et al. CagriSema REDEFINE 1. N Engl J Med 2025;393:635-647. DOI 10.1056/NEJMoa2502081
  7. Dahl K, et al. Amycretin phase 1b/2a. The Lancet 2025;406:149-162. DOI 10.1016/S0140-6736(25)01185-7
  8. Eli Lilly press release, 30 Sep 2026: EloraTZP (eloralintide + tirzepatide) phase 2b results
  9. Novo Nordisk company announcement: CagriSema submitted to the US FDA, December 2025

For research use only. Not for human or veterinary consumption. This guide summarises published research for information only. It is not medical advice and does not describe any use of products sold on this site.

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Basics

What Is Eloralintide? The Selective Amylin Agonist Explained

Eloralintide (LY3841136) is Eli Lilly’s once-weekly selective amylin receptor agonist, in phase 3 for obesity. How it works, its half-life, trial results and status.

Comparisons

Eloralintide vs Tirzepatide, and the EloraTZP Combination

Eloralintide vs tirzepatide (Zepbound, Mounjaro): amylin vs GIP/GLP-1, 20.1% at 48 weeks vs 20.9% at 72 weeks, and EloraTZP, the combination that reached 23.3% in type 2 diabetes.

Safety

Eloralintide Side Effects: What the Trials Reported

Eloralintide side effects from the phase 1 and phase 2 trials: nausea 11% to 64% by dose, fatigue, vomiting, heart rate and mood events, with every figure linked to its source.