Combining Cagrilintide With Tirzepatide

[Wallydog]

cythehun said:

I'd like to hear from people who have stacked Cagrilintide on top of Tirzepatide. What drove you to try it? What dosing protocol did you use? And what kind of results did you get?

Right now my Tirzepatide dose sits at 10mg/week. It's largely doing its job, but the persistent "food noise" keeps wrecking my attempts to stay disciplined with eating. Rather than keep pushing my TZ dose higher, I want to find out whether bringing Cagrilintide into the mix can deliver the appetite suppression I need to hit my intake targets.

My progress had flatlined, I still needed to drop roughly 10# to hit my target, and since tirzepatide was already at its ceiling (15mg), I brought Cagri into the mix. Early on the response was minimal, nothing really happened, but once I reached 2.4 it got things moving again (I spaced them on different days).

Lately I've been experimenting to land on a maintenance dose or routine, though it's proven somewhat unpredictable. My approach is basically to hold off until the food noise returns, then take a dose, which tends to be around every 4 weeks. Dropping down to tirzepatide 10mg by itself, however, wasn't enough. So after a few more weeks I returned to 15 mg tirzepatide plus 2.4mg cagri on the same day. Oof. It hit me hard. I dosed on a Thursday. By Friday I felt awful, and early Sunday morning I even threw up food I'd eaten back on Thursday. I didn't consume anything until Monday, and even then only a little. Roughly a month earlier I'd had a nasty colitis episode that the MDs attributed to a virus, so perhaps my GIT wasn't prepared for tirz/cag, but I'll say this much: it definitely stopped me from eating!

 

[Mara_aa]

Devilseye said:

Mara_aa said:

Devilseye said:

I followed that same path. When my tirz was at 10mg, I brought cagri into the mix. My cagri approach was gradual: 0.25, then 0.5, and at this point 2.4. At the start it felt remarkable, particularly the day following the shot, yet the benefits faded pretty fast. That is why I kept increasing the dose, landing at 2.4, and I will remain there until my stack runs out. I do not intend to order more, though.

Is it because the effect fades fast that you wouldn't order it again, or is there another reason?

After some time passes, it seems to have no effect at all. Even at a full dose, I wake up hungry. Skipping a dose makes no noticeable difference. Tirzepatide, by contrast, clearly blunts my hunger, and missing a dose brings the hunger creeping back. So no, I won't be ordering it again—for weight loss over the long haul it simply doesn't deliver. Over the short term, though, that's another matter.

Understood, I appreciate you laying that out. Truth be told, I'd been thinking about using it alongside tirz.

If it really fades that fast, that's disappointing.

 

[Mara_aa]

arborealtrout said:

Roughly 8 months back, I introduced cagrilintide into my tirzepatide regimen. My current approach splits each peptide's dose into 2 weekly administrations on separate days, resulting in 4 shots per week overall. The outcome has left me quite pleased. Yesterday's weigh-in showed a total loss of 100 pounds/45 Kg across the year since I began, with the initial 4 months being tirzepatide by itself. Prior to starting cagrilintide, I felt constant hunger. These days, eating sometimes slips my mind entirely. The trigger for embarking on this was a T2D diagnosis. Whether I'd still satisfy any diagnostic criteria now is unclear, as my glycohemoglobin has stayed comfortably in the normal range for several months. Still, that diagnosis led me to wear a continuous glucose monitor. Its low blood sugar alerts frequently serve as the cue that I've gone without food. I haven't noticed any negative reactions.

That outcome is seriously impressive — massive congratulations, genuinely amazing.

It's really fascinating that the combination worked so well in your case. Do you use BAC alone when reconstituting? And if you're comfortable sharing, what are your doses for each? Also, how did you bring cagri in — what was your starting dose and how did you titrate up?

 

[Mara_aa]

Mayostardayonnaise said:

Mara_aa said:

Mayostardayonnaise said:

Mara_aa said:

Mayostardayonnaise said:

I've worked my way up to 6 mg of Tirz (began in July '25 at 2.125mg), and 6 weeks back I introduced Cagri. My goal is to stretch my time at 6 mg and create a 2 day bridge leading into shot day.

For me at least, this stuff is too effective. I've seen others sitting at 1 or 2 mg without any trouble.

For roughly 3 days afterward, eating becomes a genuine chore. It isn't nausea in the slightest, but going through the motions of eating just feels blah. After that, it appears to fade sooner than Tirz does, yet it still MORE than gets me through to Tirz shot day. Nausea never hit me, and I had no added fatigue. My titration wasn't the standard one; the anecdotes I kept reading scared me too much, so mine went .10, .25, .25, .39, .5, and on Sunday I took .67. Last week I dropped 4 lbs, but the week before that, nothing? If I can't eat enough, I'm unsure how much Cag is actually doing for me. Split dosing might be something I'll try. Weigh in is tomorrow, so we'll see

Absolutely, do keep me in the loop — I'm genuinely curious. Also, I'd like to hear if you belong to the crowd that sticks with Bac water exclusively, or to the group that goes the extra mile with AA for pH reasons.

Look, my stance is basically this: I go with bac. Part of that is just being lazy — that accounts for about 70% of it — and the other 30% is that I don't buy into the idea that it creates fibrils capable of causing damage that sticks around. No doubt somebody will show up to call me reckless, and maybe they're right, since there's no way to actually know. My approach to risk is pretty…layered? Lol

“nuanced risk tolerance” — that’s honestly where a lot of us land.

My reason for asking: I’m looking into cagrilintide and trying to follow the pH conversation in a way that goes past just the theory.

When it comes to the fibrils angle (the idea of permanent damage), I’m not fully convinced. But breakdown of the peptide as time passes feels like a separate issue.

What I’m trying to pin down: among people who’ve run it for a while, has there been a real, noticeable decline in how well it works after several weeks — or is this mostly still speculation based on extrapolation?

In practical terms, the difference between “holds up for 3–4 weeks” and “no more than 2 weeks” matters a lot.

If actual user experience tends to land nearer the 2-week mark, that would shift my thinking considerably.

And practically speaking, if a vial has to be thrown out after only a few shots, that’s tough to rationalize for the way I’d be using it.

Anyone feeling wary about Cagri — I get it, no judgment here. In my case, though, I can be a bit absurd, and wanting to give it a shot won out over my worries about that fibrils situation I hadn't gotten any AA beforehand, and my curiosity was just too strong to resist. After that, I simply continued with bac. My so-called nuanced risk tolerance genuinely doesn't add up, I'll admit lol. A month ago on here I was saying things like “I think I’ll stick with only FDA approved stuff,” and I've already moved away from that.

From “nothing but FDA-approved” all the way to simply diving in — that’s a pretty big turnaround.

I suppose risk tolerance differs from person to person, and occasionally people land at totally opposite ends of the spectrum.

 

[Mara_aa]

Calm Logic said:

Yeah, the drop in effectiveness doesn't line up with the CagriSema studies — one of which ran 68 weeks — so I don't buy it.

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

A separate study also looked at cagri on its own :https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)01751-7/abstract

Yeah, that's a fascinating point — I've seen comparable findings myself, so hearing such divergent outcomes is a little unexpected. I suppose there's a lot of individual variation at play. Fingers crossed I end up in the lucky group

 

[Mara_aa]

Wallydog said:

cythehun said:

I'd like to hear from people who have stacked Cagrilintide on top of Tirzepatide. What drove you to try it? What dosing protocol did you use? And what kind of results did you get?

Right now my Tirzepatide dose sits at 10mg/week. It's largely doing its job, but the persistent "food noise" keeps wrecking my attempts to stay disciplined with eating. Rather than keep pushing my TZ dose higher, I want to find out whether bringing Cagrilintide into the mix can deliver the appetite suppression I need to hit my intake targets.

My progress had flatlined, I still needed to drop roughly 10# to hit my target, and since tirzepatide was already at its ceiling (15mg), I brought Cagri into the mix. Early on the response was minimal, nothing really happened, but once I reached 2.4 it got things moving again (I spaced them on different days).

Lately I've been experimenting to land on a maintenance dose or routine, though it's proven somewhat unpredictable. My approach is basically to hold off until the food noise returns, then take a dose, which tends to be around every 4 weeks. Dropping down to tirzepatide 10mg by itself, however, wasn't enough. So after a few more weeks I returned to 15 mg tirzepatide plus 2.4mg cagri on the same day. Oof. It hit me hard. I dosed on a Thursday. By Friday I felt awful, and early Sunday morning I even threw up food I'd eaten back on Thursday. I didn't consume anything until Monday, and even then only a little. Roughly a month earlier I'd had a nasty colitis episode that the MDs attributed to a virus, so perhaps my GIT wasn't prepared for tirz/cag, but I'll say this much: it definitely stopped me from eating!

Wow, that reaction sounds awful. It really goes to show how potent that combination is.

While you were getting past the stall, did you inject tirz once a week and cagri once a week as well?

 

[Wallydog]

Mara_aa said:

Wallydog said:

cythehun said:

I'd like to hear from people who have stacked Cagrilintide on top of Tirzepatide. What drove you to try it? What dosing protocol did you use? And what kind of results did you get?

Right now my Tirzepatide dose sits at 10mg/week. It's largely doing its job, but the persistent "food noise" keeps wrecking my attempts to stay disciplined with eating. Rather than keep pushing my TZ dose higher, I want to find out whether bringing Cagrilintide into the mix can deliver the appetite suppression I need to hit my intake targets.

My progress had flatlined, I still needed to drop roughly 10# to hit my target, and since tirzepatide was already at its ceiling (15mg), I brought Cagri into the mix. Early on the response was minimal, nothing really happened, but once I reached 2.4 it got things moving again (I spaced them on different days).

Lately I've been experimenting to land on a maintenance dose or routine, though it's proven somewhat unpredictable. My approach is basically to hold off until the food noise returns, then take a dose, which tends to be around every 4 weeks. Dropping down to tirzepatide 10mg by itself, however, wasn't enough. So after a few more weeks I returned to 15 mg tirzepatide plus 2.4mg cagri on the same day. Oof. It hit me hard. I dosed on a Thursday. By Friday I felt awful, and early Sunday morning I even threw up food I'd eaten back on Thursday. I didn't consume anything until Monday, and even then only a little. Roughly a month earlier I'd had a nasty colitis episode that the MDs attributed to a virus, so perhaps my GIT wasn't prepared for tirz/cag, but I'll say this much: it definitely stopped me from eating!

Wow, that reaction sounds awful. It really goes to show how potent that combination is.

While you were getting past the stall, did you inject tirz once a week and cagri once a week as well?

Yep - Monday for 1 injection, and I believe Thursday for the other, if I remember right?

 

[Chunkomatic]

My tirzepatide dose sits around 11 mg taken once every 5 days. When appetite started returning, I decided to give Cagri a shot. At .25 there was no response at all, yet .50 hit me like the very first effective tirzepatide dose. Food became completely unappealing. These days I only reach for it when stress-related hunger starts building again, so my routine is more of an "as needed" thing. It has been a couple months since my last injection, but having it available for whenever hunger begins climbing again is reassuring.

 

[CJsMom]

How is it stored n betwen? Is a fresh vial reconstituted each time? Does it go in the freezer between uses? TIA.

 

[cythehun]

Chunkomatic said:

My tirzepatide dose sits around 11 mg taken once every 5 days. When appetite started returning, I decided to give Cagri a shot. At .25 there was no response at all, yet .50 hit me like the very first effective tirzepatide dose. Food became completely unappealing. These days I only reach for it when stress-related hunger starts building again, so my routine is more of an "as needed" thing. It has been a couple months since my last injection, but having it available for whenever hunger begins climbing again is reassuring.

That method appeals to me. Once you raised your Cag dose to .50, how much time passed before you noticed it working?

And regarding the "as needed" use — do you keep it at .50 each time? After taking one of those doses, how soon does the effect show up?