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Standard Cagrilintide Monotherapy Protocol Phase 1: Initiation (Weeks 1-2) Dose: 0.6 mg once weekly Goal: Establish tolerance to amylin activation Expected effects: Mild appetite reduction, possible mild nausea Adjustments: Extend this phase if significant GI effects occur Phase 2: First Escalation (Weeks 3-4) Dose: 1.2 mg once weekly Goal: Increase therapeutic effect Expected effects: Notable appetite suppression, improved satiety Adjustments: May stay at this dose if excellent results achieved Phase 3: Second Escalation (Weeks 5-8) Dose: 2.4 mg once weekly Goal: Approach optimal therapeutic range Expected effects: Significant appetite control, steady weight loss Adjustments: Many researchers find this dose optimal long-term Phase 4: Optimization (Weeks 9-12) Dose: 3.0 mg once weekly Goal: Maximize therapeutic benefit Expected effects: Peak appetite suppression Adjustments: Only escalate if 2.4 mg insufficient and well-tolerated Phase 5: Maintenance (Week 13+) Dose: 3.0-4.5 mg once weekly Goal: Sustain long-term effects Expected effects: Stable appetite control and weight management Adjustments: Find minimum effective dose for maintenance Cagrilintide Dosage with Retatrutide: Combination Protocol When combining cagrilintide with retatrutide, a more conservative escalation approach minimizes overlapping side effects: Weeks 1-2: Single Agent Start Cagrilintide: 0.6 mg weekly Retatrutide: None (or 0.6 mg if starting both) Rationale: Establish tolerance to one compound first Weeks 3-4: Gentle Combination Cagrilintide: 0.6-1.2 mg weekly Retatrutide: 2 mg weekly Rationale: Introduce second compound at low dose Weeks 5-8: Dual Escalation Cagrilintide: 1.2-2.4 mg weekly Retatrutide: 4 mg weekly Rationale: Gradually increase both compounds Weeks 9-12: Therapeutic Range Cagrilintide: 2.4 mg weekly Retatrutide: 6-8 mg weekly Rationale: Approach optimal combination dosing Weeks 13+: Optimized Maintenance Cagrilintide: 2.4-3.0 mg weekly Retatrutide: 8-12 mg weekly Rationale: Maintain therapeutic effects long-term Researchers can access properly dosed cagrilintide 10mg vials that allow flexible dosing across this range

Figure 2 Pharmacokinetics The pharmacokinetics in healthy volunteers and patients with T2D are comparable ( via the urine and feces

doi: 10.1111/j.1365-2265.2007.03091.x 66 LentiMVLahnerEBergamaschiGMiceliEContiLMassironiSet al