These are the two most anticipated obesity drugs not yet on the market, and they represent the two competing strategies for what comes after GLP-1.
Retatrutide stacks receptors into one molecule: it activates GIP, GLP-1, and glucagon receptors — a triple agonist. CagriSema combines two separate molecules acting on two hormone systems, pairing the GLP-1 drug semaglutide with the amylin analog cagrilintide. One adds pathways inside a single peptide; the other combines finished drugs. Neither is approved.
At a glance
| Retatrutide | CagriSema | |
|---|---|---|
| Strategy | One molecule, three receptors | Two molecules, two hormone systems |
| Receptors | GIP + GLP-1 + glucagon | GLP-1 (semaglutide) + amylin (cagrilintide) |
| Developer | Eli Lilly | Novo Nordisk |
| Reported weight loss | Among the largest seen in obesity trials | ~22.7% at 68 weeks (REDEFINE 1) |
| Development stage | Phase 3 TRIUMPH programme completed | NDA filed with FDA Dec 2025 |
| Expected timeline | FDA filing expected 2027 | FDA decision expected late 2026 |
| Head-to-head data | None against CagriSema | Lost on non-inferiority to tirzepatide in REDEFINE 4 |
| FDA status | Not approved | Not approved |
The bottom line
Bottom line: CagriSema is further along the regulatory path — filed, with a decision expected sooner — while retatrutide has produced some of the largest weight reductions recorded in obesity trials and is expected to file later. They have never been compared head-to-head, so any ranking is inference across different trials with different populations. The one relevant head-to-head we do have is unflattering for CagriSema: it did not match tirzepatide, which sets a benchmark retatrutide will also have to clear. Neither drug is available, and neither should be sourced from anywhere claiming otherwise.
Frequently asked questions
Which is stronger, retatrutide or CagriSema?
There is no head-to-head trial, so this cannot be answered directly. Retatrutide's triple-agonist trials produced some of the largest weight reductions reported in obesity research; CagriSema produced about 22.7% at 68 weeks in REDEFINE 1. Comparing across trials with different designs is unreliable.
Which will be available first?
CagriSema is further along. Novo Nordisk filed with the FDA in December 2025 with a decision expected in late 2026, while retatrutide's filing is expected around 2027. Regulatory timelines slip, so neither date is a guarantee.
What is a triple agonist?
A single molecule engineered to activate three hormone receptors at once — in retatrutide's case GIP, GLP-1, and glucagon. Adding glucagon receptor activity is thought to increase energy expenditure on top of the appetite suppression the incretin receptors provide.
Can I buy retatrutide or CagriSema?
No. Both are investigational and not approved anywhere. Neither is available by prescription. Both names appear on grey-market research-chemical sites; those products are unregulated, unverified, and bear no relationship to the material used in the trials.
References
Combined peer-reviewed sources from both peptide guides. Inclusion is not endorsement.
- Jastreboff AM, Kaplan LM, Frias JP, et al. Triple-Hormone-Receptor Agonist Retatrutide for Obesity - A Phase 2 Trial. N Engl J Med. 2023. Peer-reviewed study
- Rosenstock J, Frias J, Jastreboff AM, et al. Retatrutide, a GIP/GLP-1/glucagon receptor agonist, in people with type 2 diabetes: a randomised phase 2 trial. Lancet. 2023. Peer-reviewed study
- Katsi V, Koutsopoulos G, Fragoulis C, et al. Retatrutide-A Game Changer in Obesity Pharmacotherapy. Biomolecules. 2025. Peer-reviewed study
- Abdul-Rahman T, Roy P, Ahmed FK, et al. The power of three: Retatrutide's role in modern obesity and diabetes therapy. Eur J Pharmacol. 2024. Peer-reviewed study
- Giblin K, Kaplan LM, Somers VK, et al. Retatrutide for the treatment of obesity, obstructive sleep apnea and knee osteoarthritis: Rationale and design of the TRIUMPH registrational clinical trials. Diabetes Obes Metab. 2026. Peer-reviewed study
- Sanyal AJ, Kaplan LM, Frias JP, et al. Triple hormone receptor agonist retatrutide for metabolic dysfunction-associated steatotic liver disease: a randomized phase 2a trial. Nat Med. 2024. Peer-reviewed study
- Garvey WT, Blüher M, Osorto Contreras CK, et al. Coadministered Cagrilintide and Semaglutide in Adults with Overweight or Obesity. N Engl J Med. 2025. Peer-reviewed study
- Davies MJ, Bajaj HS, Broholm C, et al. Cagrilintide-Semaglutide in Adults with Overweight or Obesity and Type 2 Diabetes. N Engl J Med. 2025. Peer-reviewed study
- Frias JP, Deenadayalan S, Erichsen L, et al. Efficacy and safety of co-administered once-weekly cagrilintide with once-weekly semaglutide in type 2 diabetes: a phase 2 trial. Lancet. 2023. Peer-reviewed study