Carl read the papersWhat it actually is
Amycretin is a single peptide that activates GLP-1 receptors and amylin receptors; the 2026 papers describe it as an agonist of GLP-1, amylin and calcitonin receptors. Its official name is now zenagamtide.
Novo Nordisk is developing it two ways: a weekly injection and a daily tablet. Both are investigational. The phase 3 programme (AMAZE) began recruiting in February 2026.
How it’s thought to work
- GLP-1 receptor — Appetite and fullness signals plus blood sugar control, as with semaglutide.
- Amylin receptor — The meal-ending signal that cagrilintide uses. A second appetite pathway, which is why the two add together.
- One molecule, two jobs — CagriSema is two drugs in one pen. Amycretin does both jobs with one peptide.
- Oral version — The daily tablet used 6 to 50 mg a day in the diabetes trial, far more drug per week than the weekly injection needs.
What the research says
Early but eye-catching. In a single-site phase 1b/2a injection study (125 people), weight fell 22.0% at 36 weeks on 20 mg and 24.3% on 60 mg, against small changes on placebo, though a large number of people withdrew. In type 2 diabetes phase 2 trials, the injection cut HbA1c by up to 1.7 points and weight by up to 14.5% at 36 weeks; the daily tablet cut HbA1c by up to 1.4 points and weight by up to 10.1%. Phase 3 started in 2026, so the big multi-centre answers are still years away.
- Phase 1b/2a injection (n=125, one US site): -22.0% at 36 wks on 20 mg vs +1.9% placebo; -24.3% on 60 mg.
- Same study: -16.2% on 5 mg (28 wks) and -9.7% on 1.25 mg (20 wks); many withdrawals.
- Phase 2 type 2 diabetes: HbA1c down up to 1.7 points (injection) and 1.4 points (tablet) at 36 wks.
- Phase 3 AMAZE programme began recruiting February 2026; nothing approved.
Reported protocols
These are the doses the peptide community actually reports running (Reddit & forums), alongside published research — logged for education, not as a recommendation to use.
| Parameter | Commonly reported range |
|---|---|
| Clinical ladder (injection) | Started at 0.2 to 0.3 mg weekly and stepped up (every 4 weeks in the diabetes trial) to maintenance doses from 0.4 to 60 mg, depending on the study |
| Clinical ladder (tablet) | Started at 1.5 mg daily, stepped up every 4 weeks to 6, 25 or 50 mg |
| Community dose | Not established. It is sold online (JAMA reported a black market in October 2026), but we found no vendor-independent dose reports we could verify |
| Frequency | Weekly (injection) or daily (tablet) |
| Route | Subcutaneous or oral |
| Note | Injection doses in trials span 0.4 to 60 mg, a 150-fold range. Without a known purity and a known amount in the vial, those numbers tell you very little. |
Common use cases
| Goal | Community protocol notes |
|---|---|
| Weight loss | the main phase 3 target (AMAZE trials) |
| Type 2 diabetes | phase 2 complete; phase 3 (AMBITION) under way |
| Heart failure with obesity | a phase 3 trial (HF-POLARIS) started in 2026 |
Mixing it (reconstitution)
Freeze-dried peptides must be reconstituted with bacteriostatic water before they can be measured. Carl’s calculator turns “mg in the vial + ml of water + target dose” into “units on the syringe” — and tells you how long the vial lasts.
→ Open the Reconstitution Calculator
Injection & handling
Two routes exist in trials. The injection is subcutaneous, once weekly, started very low (0.2 to 0.3 mg) and stepped up every 4 weeks; the tablet is once daily, started at 1.5 mg. Stomach side effects rose with dose across the studies, which is why the trials climbed so slowly. There is no established community protocol. Reconstituted, keep it cold.
Stacks it appears in
- Do not add a GLP-1 — It already is one. Adding semaglutide or tirzepatide doubles the same receptor and the same side effects.
- Versus CagriSema — Same two mechanisms. CagriSema has published phase 3 results (20.4% weight loss at 68 weeks in REDEFINE 1); amycretin is only now in phase 3.
Sources
- Subcutaneous phase 1b/2a, Lancet 2025 (PMID 40550231)
- Oral phase 2 in T2D, Lancet 2026 (PMID 42532079)
- Subcutaneous phase 2 in T2D, Lancet 2026 (PMID 42532080)
- Novo Nordisk press release, phase 2 T2D results (25 Nov 2025)
- JAMA news 2026: retatrutide and zenagamtide sold online (PMID 42853576)
- ClinicalTrials.gov AMAZE 1 (NCT07339423)
- SAHPRA, Peptide Products: Public Information (published 26 May 2026)
- WADA 2026 Prohibited List (S0 non-approved substances; S6.B specified stimulants)
- REDEFINE 1, cagrilintide-semaglutide, NEJM 2025 (PMID 40544433)
