Adding Cagrilintide to Tirzepatide

[cythehun]

I would like to hear from those who added Cagrilintide to Tirzepatide. What was your motivation? What dosing schedule did you follow? How are the results?

Currently I am on 10mg/week of Tirzepatide. While it is mostly working well, the on-going "food noise" is sabotaging my efforts to maintain my eating discipline. Before I continuing upping my TZ dose, I would like to see if adding Cagrilintide will provide the needed appetite suppression to allow me to meet my intake goals.

 

[Mayostardayonnaise]

I’m up to 6 mg Tirz (started July ‘25 at 2.125mg) - added Cagri 6 weeks ago, trying to stay at 6 mg longer/a 2 day bridge to shot day.

The stuff works too good, at least for me. Other people are already at 1 or 2 mg with no problems.

A real struggle to eat for 3ish days after. Not nausea at all, but the mechanical process of eating is just blah. Then it seems to wear off faster than Tirz but it MORE than carries me to Tirz shot day. I never got nauseous or experienced any extra fatigue. My titration was not the standard, I was too scared of the anecdotals I was reading - so I went .10, .25, .25, .39, .5, and Sunday I did .67. I lost 4 lbs last week, but then none the week before? I’m not sure how much the addition of Cag is really helping me, if I can’t eat enough. I’m thinking split dosing may be in the cards for me. Tomorrow is weigh in, so we’ll see

 

[cythehun]

I’m up to 6 mg Tirz (started July ‘25 at 2.125mg) - added Cagri 6 weeks ago, trying to stay at 6 mg longer/a 2 day bridge to shot day.

The stuff works too good, at least for me. Other people are already at 1 or 2 mg with no problems.

A real struggle to eat for 3ish days after. Not nausea at all, but the mechanical process of eating is just blah. Then it seems to wear off faster than Tirz but it MORE than carries me to Tirz shot day. I never got nauseous or experienced any extra fatigue. My titration was not the standard, I was too scared of the anecdotals I was reading - so I went .10, .25, .25, .39, .5, and Sunday I did .67. I lost 4 lbs last week, but then none the week before? I’m not sure how much the addition of Cag is really helping me, if I can’t eat enough. I’m thinking split dosing may be in the cards for me. Tomorrow is weigh in, so we’ll see

One on-line site recommends when adding Cag to an existing 10mg Tirz dosing schedule to use 0.6mg of Cag. I'm thinking of starting with that dose. So far, the only side-effects I've experienced with Tirz alone is fatigue.

 

[Devilseye]

I did the same thing. At tirz 10mg and added cagri. With cagri i went slow initially going from 0.25 to 0.5 to now 2.4. Initially it worked wonders especially the day after injection but the effects tapered rather quickly. So i raised the dosage until 2.4 which is where ill stay until i finish my stack. Not planning on reordering though.

 

[beamero]

T- 12.5mg on Sundays, Cagri (currently 1.2mg) on Wednesdays. This will be week 6. Works great, but the fatigue on week 1 and 2 was palpable. Cagri was 400mcg, 750mcg, 750mcg, 1.2mg, 1.2mg. This week will move to 1.7mg.

 

[Mara_aa]

I did the same thing. At tirz 10mg and added cagri. With cagri i went slow initially going from 0.25 to 0.5 to now 2.4. Initially it worked wonders especially the day after injection but the effects tapered rather quickly. So i raised the dosage until 2.4 which is where ill stay until i finish my stack. Not planning on reordering though.

Would you not reorder because the effect wears off quickly, or for what reason?

 

[Mara_aa]

I’m up to 6 mg Tirz (started July ‘25 at 2.125mg) - added Cagri 6 weeks ago, trying to stay at 6 mg longer/a 2 day bridge to shot day.

The stuff works too good, at least for me. Other people are already at 1 or 2 mg with no problems.

A real struggle to eat for 3ish days after. Not nausea at all, but the mechanical process of eating is just blah. Then it seems to wear off faster than Tirz but it MORE than carries me to Tirz shot day. I never got nauseous or experienced any extra fatigue. My titration was not the standard, I was too scared of the anecdotals I was reading - so I went .10, .25, .25, .39, .5, and Sunday I did .67. I lost 4 lbs last week, but then none the week before? I’m not sure how much the addition of Cag is really helping me, if I can’t eat enough. I’m thinking split dosing may be in the cards for me. Tomorrow is weigh in, so we’ll see

Yes, please keep me updated, I’m really interested. I’d also love to know whether you’re in the Bac water ONLY team, or in the team that takes the extra step of using AA because of the pH.

 

[Mara_aa]

T- 12.5mg on Sundays, Cagri (currently 1.2mg) on Wednesdays. This will be week 6. Works great, but the fatigue on week 1 and 2 was palpable. Cagri was 400mcg, 750mcg, 750mcg, 1.2mg, 1.2mg. This week will move to 1.7mg.

Has the fatigue eased by now? And can I also ask you how do you reconstitute it? Do you use just BAC water, or do you also use AA?

 

[Mayostardayonnaise]

Yes, please keep me updated, I’m really interested. I’d also love to know whether you’re in the Bac water ONLY team, or in the team that takes the extra step of using AA because of the pH.

Eh, I’m on the “I’m using bac, 70% for lazy reasons and 30% for not believing it causes fibrils that would do lasting damage” team. I’m sure someone will come to tell me I’m irresponsible and I might be, there’s no way to know. My risk tolerance is really…nuanced? Lol

 

[beamero]

Has the fatigue eased by now? And can I also ask you how do you reconstitute it? Do you use just BAC water, or do you also use AA?

Yes, fatigue is much better. Recon with only Hospira.

 

[Devilseye]

Would you not reorder because the effect wears off quickly, or for what reason?

Because after a while it feels like its doing nothing. I can take a full dose and be hungry the next morning. I can skip a dose and not feel a difference. If i take tirz for instance I can definitely feel my hunger reduced and if i skip a dose of tirz hunger gradually comes back too. So yeah, i wont reorder it because its just not that effective long term for weight loss. Short term thats a different story.

 

[Devilseye]

Yes, fatigue is much better. Recon with only Hospira.

x2. Fatigue is mostly a short term effect of cagri and resolves itself after a few doses. I also only reconned with hospira BAC and never had any gelling problems though I use it within 2-3 weeks max.

 

[arborealtrout]

I added cagrilintide to tirzepatide about 8 months ago. I currently divide the doses and take each one twice a week on different days (so 4 total injections between the two peptides). I've been pretty satisfied with the results. As of yesterday I'm down 100 pounds/45 Kg over the year since I started (the first 4 months on tirzepatide alone). I was starving all the time before I added cagrilinitide. Now I sometimes forget to eat. Being diagnosed with T2D was the impetus for starting this. I'm not sure whether I'd still meet any critieria for that since my glycohemoglobin level has been well within the normal range for months. However, because of this diagnosis I use a continuous glucose monitor. Often its warning of low blood glucose is my reminder that I haven't eaten. I've recognized no adverse effects.

 

[cythehun]

I added cagrilintide to tirzepatide about 8 months ago. I currently divide the doses and take each one twice a week on different days (so 4 total injections between the two peptides). I've been pretty satisfied with the results. As of yesterday I'm down 100 pounds/45 Kg over the year since I started (the first 4 months on tirzepatide alone). I was starving all the time before I added cagrilinitide. Now I sometimes forget to eat. Being diagnosed with T2D was the impetus for starting this. I'm not sure whether I'd still meet any critieria for that since my glycohemoglobin level has been well within the normal range for months. However, because of this diagnosis I use a continuous glucose monitor. Often its warning of low blood glucose is my reminder that I haven't eaten. I've recognized no adverse effects.

Wow! This is what I'm hoping to achieve. Can you share what your dose schedule has been for the last 4 months? Thanks!

 

[Mayostardayonnaise]

I weighed 179 this morning, so 3.6 lbs lost - so the Cag definitely helped the lbs along But damn! I think I’ll drop it and maybe start attempting to lower the Tirz, because I’ve only got about 20-30 lbs left to lose. I’d buy it again if needed, but not a whole kit (unless someone has a kit of 5 mg for 60 or less ).

 

[Mara_aa]

Eh, I’m on the “I’m using bac, 70% for lazy reasons and 30% for not believing it causes fibrils that would do lasting damage” team. I’m sure someone will come to tell me I’m irresponsible and I might be, there’s no way to know. My risk tolerance is really…nuanced? Lol

“nuanced risk tolerance” is where most of us actually sit…

I’m asking because I’m digging into cagrilintide and trying to make sense of the pH discussion beyond theory.

I’m somewhat skeptical about the fibrils (lasting damage narrative) but degradation over time is a different story.

What I’m really trying to understand is whether people who’ve used it long enough have noticed any actual drop in effectiveness over a few weeks, or if most of this is still theoretical extrapolation.

The gap between “stable for 3–4 weeks” and “2 weeks max” is pretty significant in practice.

If real-world experience points closer to 2 weeks, that changes things quite a bit for me.

Also, from a practical standpoint, having to discard a vial after just a couple of injections would be hard to justify for my use.

 

[Calm Logic]

Yeah, the loss in effectiveness doesn't really make sense with the CagriSema studies, including one of 68 weeks:

https://www.medicalnewstoday.com/ar...-more-effective-than-wegovy-in-clinical-trial

One study with cagri by itself :https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)01751-7/abstract

 

[Mara_aa]

Yes, fatigue is much better. Recon with only Hospira.

Nice, glad the fatigue is better.

How long do you usually keep a vial, and does it stay consistent for you over time?

 

[Mara_aa]

I weighed 179 this morning, so 3.6 lbs lost - so the Cag definitely helped the lbs along But damn! I think I’ll drop it and maybe start attempting to lower the Tirz, because I’ve only got about 20-30 lbs left to lose. I’d buy it again if needed, but not a whole kit (unless someone has a kit of 5 mg for 60 or less ).

I’m also looking for a 5 mg kit, just to try it out.

 

[Mayostardayonnaise]

“nuanced risk tolerance” is where most of us actually sit…

I’m asking because I’m digging into cagrilintide and trying to make sense of the pH discussion beyond theory.

I’m somewhat skeptical about the fibrils (lasting damage narrative) but degradation over time is a different story.

What I’m really trying to understand is whether people who’ve used it long enough have noticed any actual drop in effectiveness over a few weeks, or if most of this is still theoretical extrapolation.

The gap between “stable for 3–4 weeks” and “2 weeks max” is pretty significant in practice.

If real-world experience points closer to 2 weeks, that changes things quite a bit for me.

Also, from a practical standpoint, having to discard a vial after just a couple of injections would be hard to justify for my use.

I don’t blame anyone being trepidatious about Cagri, I’m just ridiculous sometimes and my desire to try it overrode my fear of the fibrils deal I didn’t have AA on hand and the curiosity was too much to bear. And then I just kept using bac. My nuanced risk tolerance, admittedly, doesn’t make much sense lol. I’ve already pivoted away from things I said on here a month ago like “I think I’ll stick with only FDA approved stuff”.