Amycretin
Phase 3 program began in the first half of 2026.
One peptide that does the job of both halves of CagriSema. Novo Nordisk has renamed it zenagamtide. Made by Novo Nordisk, also called Zenagamtide.
What the evidence shows
Side effects and risks
Who should avoid it: Anyone outside a clinical trial.
How it works
- Where it acts
- GLP-1 and amylin receptors, reached by one molecule.
- What it changes
- Both fullness signals from a single drug.
- What people notice
- Early trials showed large weight loss. Stomach side effects are common.
How it has been given in trials
Weekly injection under the skin or a daily tablet, with the dose raised in steps. There is no approved dose.
Getting it in the United States
The legal route for Amycretin
Not approved. The only lawful way to get it is to join a clinical trial.
Clinical trial enrolment only
Still experimental. Novo announced phase 3 trials of injectable and oral forms to start in 2026. Joining a trial is the only lawful route and may mean receiving placebo.
Source: BioPharma Dive, 2025-06
Routes people use for any peptide in the United States
Telehealth prescribing
Online clinics prescribe after a questionnaire, sometimes with no live doctor visit, and mail the drug. FDA moved in February 2026 to restrict mass-marketed compounded copies and claims that they are generic equivalents.
Risk: Thin medical screening. Compounded versions are not reviewed by FDA for quality.
Covers: Approved GLP-1 drugs, compounded semaglutide and tirzepatide
Source: GZERO Media, Apr 2026
Clinical trial enrolment
The only lawful way to get an unapproved peptide drug with medical monitoring. ClinicalTrials.gov lists eligibility, sites and phone numbers. Researchers note recruitment is hard when people can buy the drug on the gray market instead of risking placebo.
Risk: Possible placebo assignment, strict eligibility and travel to a study site.
Covers: Investigational peptide drugs still in development
Source: NIH, finding a clinical trial
Routes people use for any peptide in the United States
Compounding pharmacy with prescription
A clinician prescribes and a pharmacy compounds. Twelve peptides left the FDA do-not-compound category in April 2026 and a panel backed six in July, but they are not yet formally eligible. Pharmaceutical-grade ingredient is scarce.
Risk: Legal status is unsettled until FDA rulemaking ends. Pharmacies may use research-grade ingredient.
Covers: BPC-157, TB-500, KPV, MOTS-c, Semax, Epitalon and similar
Source: Frier Levitt, Apr 2026
Med spas and weight-loss clinics
Very common. Secret shoppers called 75 clinics and med spas in two states after shortages ended. 92 percent offered compounded semaglutide and 87 percent tirzepatide, often mixed with B vitamins to look custom.
Risk: Four of 23 suppliers lacked sterile compounding licenses and four had disciplinary records.
Covers: Compounded semaglutide and tirzepatide
Source: American Med Spa Association on JAMA Health Forum study, Jul 2026
Concierge and longevity doctors
Cash-pay physicians build peptide plans for wealthy clients. Reporting from San Francisco says some source from overseas channels, domestic research-use-only sellers or the few compounding pharmacies that will supply clinicians.
Risk: A doctor's involvement does not guarantee a pharmaceutical-grade product.
Covers: BPC-157, thymosin alpha-1, Selank, Semax, CJC-1295, ipamorelin, retatrutide
Source: San Francisco Standard, Sep 2025
Cross-border purchase or import
FDA says importing drugs for personal use is illegal in most cases but it may not object to small personal quantities in limited situations. Reporting also describes people travelling to Mexico for injections.
Risk: Packages can be seized. Product origin and cold-chain handling are hard to check.
Covers: Approved prescription peptides sold abroad
Source: FDA, personal importation
Routes people use for any peptide in the United States
Research-chemical websites
Sites sell vials marked for research or not for human consumption, with no prescription. FDA says some ship direct to consumers with dosing directions, and it has sent warning letters. Retatrutide exists only through this route or trials.
Risk: Unknown identity, strength and sterility. No pharmacist or prescriber involved.
Covers: Retatrutide, semaglutide, tirzepatide, BPC-157 and most unapproved peptides
Source: FDA, unapproved GLP-1 drugs page
Direct orders from Chinese factories
Buyers message factory sales agents and pay by crypto or payment app. A minimum order of about ten vials pushes people to buy in bulk and share. A blockchain analysis found US buyers were the largest source of funds.
Risk: Many of the same vendors list fentanyl precursors. Lab reports sent by sellers cannot be verified.
Covers: GLP-1 copies, melanotan II, BPC-157, TB-500, GHK-Cu, epitalon
Source: TRM Labs, Oct 2026
Chat groups and social sellers
Dealers are found through Telegram, WhatsApp, Discord and influencer discount codes. In a May 2026 survey of 1,000 US users, 14.5 percent bought this way and three quarters asked an AI chatbot for dosing.
Risk: 45 percent of social media buyers in that survey reported an emergency or urgent care visit for a reaction.
Covers: Retatrutide and other research-use-only peptides
Source: The Ethos, May 2026
This describes what people do. It is not advice. The decision is yours.
More contextWhat public figures say, videos and articles and when options run out
What experts and influencers say
Paraphrased from the linked sources.
Said the amylin part of amycretin looks more potent, and noted it is a single molecule while CagriSema combines two medicines in one pen.
Source: BioPharma Dive, 2025-06
Prakhar AgrawalSourceRecommends
Wrote that the move to phase 3 in injectable and oral forms was a big deal and suggested amycretin may be the drug Novo was waiting for.
Source: On The Pen Substack, 2025-06
David KnappWebsiteRecommends
Photo source: glp1tribe.com
Said he was very encouraged by phase 2 results in type 2 diabetes and that they support a potential best-in-class profile. Phase 3 trials were planned for 2026.
Source: Healio, 2025-11
Martin Holst LangeWebsiteRecommends
Money: Novo Nordisk executive
Photo source: jcst2d.com
Praised the early trials but wrote that head-to-head outcome studies are needed to show the added amylin action offers real value over GLP-1-only drugs.
Source: Consultant Live, 2025-06
Tricia Tan and Bernard KhooSourceMixed view
Watch and read
Explainers, reporting and podcasts worth your time. Summaries are ours. No sellers.
New drug helps patients lose nearly 25% of body weight in early trials
Melissa Rudy, health reporter
Summarizes Novo's early amycretin results: big weight loss in a small trial, mostly stomach side effects, and an outside specialist urging more long-term data.
Plain-language summary with an independent expert's caution.
Novo Nordisk Scores a Plausible Win with Amycretin
Looks at the phase 2 amycretin data in type 2 diabetes and obesity, and warns that cross-trial comparisons mislead and phase 3 could go sideways.
Measured read that keeps early data in perspective.
When options run out
Uses people turn to when standard treatment has failed.
Type 2 diabetes uncontrolled on metformin
- Who
- Adults whose blood sugar stays high despite metformin, some also on an SGLT2 inhibitor.
- Evidence
- Phase 2, 448 adults, 36 weeks. Weekly injection and daily pill both cut HbA1c and weight versus placebo. Company-run, no long-term data.
- Route
- Novo phase 3 trials
Source: Healio, 2025-11
Pill form for needle-averse patients
- Who
- People with obesity who want strong weight loss without injections.
- Evidence
- Phase 1 only, 144 participants. About 62 percent had side effects, mostly nausea and vomiting, all mild or moderate.
- Route
- Novo phase 3 trials
Source: Consultant Live, 2025-06
Legal last-resort routes
Expanded access (compassionate use)
For a serious or life-threatening condition with no comparable alternative and no trial you can join. Your physician asks the company for the drug, then files with FDA and an ethics board. The company can refuse. Costs are often not insured.
Right to Try
For a life-threatening condition after approved options are exhausted and no trial is open to you. The drug must have finished Phase 1 and be in active development. Your doctor asks the manufacturer directly. FDA does not review requests.
Source: FDA, Right to Try
Trial finders
Search ClinicalTrials.gov by condition or drug name, check eligibility and call the listed site. ResearchMatch is a free NIH-funded registry that lets researchers find you. Discuss risks with your own clinician before enrolling.
Source: NIH, finding a clinical trial
Personal import for serious conditions
FDA may not object when a US citizen imports up to about three months of a drug for a serious condition with no effective US treatment, with written personal-use confirmation and a US doctor's details. It is discretion, not a right.
Source: FDA, personal importation
Patient-specific compounding
When the approved product cannot meet a specific need of an identified patient, a prescriber can order a compounded version from a licensed pharmacy. Lower price alone does not qualify. Ingredients must be pharmaceutical grade.
Questions people ask
What is amycretin?
One peptide that acts on both GLP-1 and amylin receptors, doing the job of both halves of CagriSema. Novo Nordisk has renamed it zenagamtide.
How much weight loss did amycretin give?
Early trials of the weekly injection reported about 22% to 24% loss at 36 weeks. A phase 2 trial in type 2 diabetes reported up to 14.5% at 36 weeks.
Is amycretin a pill or an injection?
Both are being tested. The weekly injection is in several phase 3 trials that began in 2026; Novo planned to start a phase 3 trial of the daily tablet in the third quarter of 2026.
Is amycretin approved?
No. The phase 3 program (AMAZE) began in the first half of 2026, and there is no approved dose.
What are the side effects of amycretin?
Nausea and vomiting, as with other drugs in this class. Longer-term safety is not known.
Your notebook
Taking it? A ten-second daily check-in keeps a record of how you feel, to talk through with your clinician.
Sources
Structure: PubChem