Reviewed & approved by Dr. Nova Reyes · Last checked 2026-10-25. ← Back to Evidence Library

Amycretin (Zenagamtide): what the evidence says

Legend: HUMAN data · ANIMAL / LAB data · UNKNOWN · UNVERIFIED: not yet confirmed against a primary source

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What is it?

Amycretin (also called zenagamtide in 2026 clinical trial publications ^{R3, R4}; primary WHO INN register entry UNVERIFIED) is a single lab-made peptide that switches on the GLP-1 receptor and the amylin and calcitonin receptors. ^R3 GLP-1 drugs lower appetite and blood sugar. Amylin is a hormone released with insulin that also increases fullness. Novo Nordisk combines the same two actions in CagriSema as two separate drugs; amycretin puts them in one molecule. ^R1 Unknown Whether one molecule works better than two separate drugs has not been tested head-to-head.

Does it help weight loss?

All results below are from trials funded by Novo Nordisk, run at a single research center in Texas.

• Human Injection (phase 1b/2a): 125 adults with overweight or obesity. Weight change ranged from −9.7% on the lowest maintenance level to −24.3% on the highest, vs −1.1% to +2.3% on placebo (a dummy treatment). ^R1
• Caution Many people withdrew from the injection trial, often for reasons the authors said were not side effects. Numbers based on those who stayed may overstate the effect. ^R1
• Human Tablet (phase 1): 144 adults; the main goal was safety. The trial was short and weight change was only an exploratory result. ^R2
• Unknown How amycretin compares with semaglutide or tirzepatide. A phase 3 head-to-head trial vs semaglutide is part of the AMAZE program. ^R7

Does it help type 2 diabetes?

• Human Injection (phase 2): in 262 adults with type 2 diabetes on metformin, HbA1c (average blood sugar) fell 0.9 to 1.7 points across six study groups; the difference vs placebo ranged from 0.77 to 1.56 points. ^R3
• Human Tablet (phase 2): in 186 adults, HbA1c fell 0.9 to 1.4 points across three study groups; the difference vs placebo ranged from 0.5 to 1.09 points. ^R4 An erratum to this paper has been published.
• Caution These results use the "efficacy estimand," which counts only time on treatment without rescue medicines, which can make results look better than real-world use. ^{R3, R4}

Is it safe?

What the trials reported:

• Caution Stomach side effects were the most common; most were mild to moderate. ^{R1, R2, R3, R4} In the tablet diabetes trial, stomach events affected 26% to 47% of people on amycretin vs 23% on placebo. ^R4 In the tablet phase 1 trial, 49% of all side-effect events were stomach-related. ^R2
• Caution Serious side effects: 8% of people in the injection diabetes trial (including some on placebo) and 4% of people on amycretin in the tablet diabetes trial. No deaths were reported in any of these trials. ^{R2, R3, R4}
• Caution Kidney disease: a separate study looked at how the body handles amycretin in people with reduced kidney function. ^R5 Unknown What this means for safe use.
• Caution GLP-1 class risks: Amycretin acts on the GLP-1 receptor, so the risks known for that drug class (pancreatitis, gallbladder disease, rodent thyroid tumors, low blood sugar with insulin or sulfonylureas, older blood-sugar-lowering pills) are reasonable to expect; see the semaglutide page. Unknown The abstracts we reviewed do not report rates of these events.
• Unknown Heart safety: no heart-outcome results. ^R7
• Unknown Long-term safety and rare harms are unknown.

Compounded and gray-market Amycretin: extra risks

• Caution Unregulated "research" vials and tablets. Gray-market sales of amycretin have been reported in the medical press, and any product sold online has unknown identity, strength, purity and sterility. ^R6
• Caution Don't stack with other GLP-1 drugs. Taking Amycretin with semaglutide, tirzepatide, retatrutide or similar drugs means two drugs acting on the same receptor, which no trial on this page tested. Unknown
• Caution Measuring mistakes. FDA has reported people hospitalized after drawing up too much from multi-injection GLP-1 vials. The same syringe-marking problem applies here. See the section on measuring mistakes on our semaglutide page.

What we don't know

• Unknown What is actually in a given gray-market vial or tablet ^R6
• Unknown Phase 3 results ^R7
• Unknown Whether weight loss holds up in larger trials with fewer dropouts
• Unknown Whether amycretin is safe for the heart, or helps heart failure ^R7
• Unknown Long-term effects of acting on calcitonin receptors

Is it legal?

Not FDA-approved; no Drugs@FDA record was found (openFDA search, Oct 24, 2026). We found no announced filing for approval. EU, Japan, China: UNVERIFIED not checked against EMA, PMDA or NMPA. WADA: not named on the 2026 Prohibited List; S0 bans at all times any unapproved substance in development that no other section covers, which describes Amycretin ^R8. WADA has not ruled on Amycretin by name. As of Oct 24, 2026.

What's in the vial?

Real amycretin is only available inside clinical trials. We have not found published lab tests of gray-market Amycretin. Under the Open Peptide Standard, a GLP-1 vial overfilled by more than 20% is a critical fail (draft threshold). See results at /tests/. A passing test covers one batch, tested on one date. It does not mean the compound itself is safe.

What do users report?

Self-report, not evidence.

Unknown TBD. We'll only list this once we can cite a public source.

Study details

These are doses researchers used, not recommendations. All trials funded by Novo Nordisk.

R1, R2 Human: Weight (overweight or obesity, no diabetes)

Study	People	Route	Dose used	Follow-up	Reported	Side effects / dropouts	Citation
Phase 1b/2a (Dahl 2025), single site, NCT06064006	125 (101 amycretin, 24 placebo)	Subcutaneous, once weekly	Escalated from 0.3 mg to maintenance 60, 20, 5 or 1.25 mg	20–36 wk	−24.3% vs −1.1% (60 mg, wk 36); −22.0% vs +1.9% (20 mg, wk 36); −16.2% vs +2.3% (5 mg, wk 28); −9.7% vs +2.0% (1.25 mg, wk 20)	Mostly GI, mild to moderate; many withdrawals, largely not AE-related	PMID 40550231
Phase 1 (Gasiorek 2025), single site	144	Oral, single and once-daily multiple doses	Single 1–25 mg; daily 3–12 mg for 10 days; escalation to 50 mg or 2 × 50 mg daily for 12 wk	Up to day 105	Exploratory weight change only	364 TEAEs in 62%; 49% of events GI; all mild/moderate; no deaths	PMID 40550229

R3, R4 Human: Type 2 diabetes (on metformin ± SGLT2 inhibitor)

Study	People	Route	Dose used	Follow-up	Reported	Side effects / dropouts	Citation
Phase 2 (Mora 2026), 83 sites, NCT06542874	262 (225 vs 37 placebo)	Subcutaneous, once weekly	Start 0.2 mg, escalate every 4 weeks to 0.4, 1.5, 5, 10, 20 or 40 mg	36 wk	HbA1c −0.9% (0.4 mg; ETD −0.77) to −1.7% (40 mg; ETD −1.56)	Mostly GI; serious AEs 21/261 (8%) incl. 3 placebo; no deaths	PMID 42532080
Phase 2 (Mora 2026), oral, NCT06542874	186 (156 vs 30 placebo)	Oral, once daily	Escalate every 4 weeks to 6, 25 or 50 mg	36 wk	HbA1c −0.9% (ETD −0.5), −1.3% (ETD −0.99), −1.4% (ETD −1.09)	GI 26%–47% vs 23%; serious AEs 7/186 (4%, all in zenagamtide arms) vs 0 on placebo; no deaths; erratum published	PMID 42532079

R5, R6 Other

• R5 Oldenburg 2026, pharmacokinetics in renal impairment. PMID 42443140
• R6 Rubin 2026, JAMA medical news on gray-market amycretin. PMID 42853576

R7 Ongoing trials (as of Oct 24, 2026)

ClinicalTrials.gov: AMAZE 1 NCT07339423; AMAZE 2 NCT07533175; HF-POLARIS, heart failure NCT07567001. Other AMAZE trials (3, 4, 5, 6, 8 vs semaglutide, 10, 12) are listed on ClinicalTrials.gov. No phase 3 results posted. FDA: no Drugs@FDA record (openFDA query, Oct 24, 2026). EMA, PMDA, NMPA: UNVERIFIED not checked.

Full reference list (all PMIDs verified on PubMed, Oct 24, 2026)

1. Dahl K, et al. Lancet. 2025;406(10499):149-162. doi:10.1016/S0140-6736(25)01185-7. PMID 40550231
2. Gasiorek A, et al. Lancet. 2025;406(10499):135-148. doi:10.1016/S0140-6736(25)01176-6. PMID 40550229
3. Mora P, et al. Lancet. 2026;408(10555):621-635. doi:10.1016/S0140-6736(26)01248-1. PMID 42532080
4. Mora P, et al. Lancet. 2026;408(10555):607-620. doi:10.1016/S0140-6736(26)01247-X. PMID 42532079
5. Oldenburg LIK, et al. Diabetes Obes Metab. 2026;28(10):8946-8954. doi:10.1111/dom.71096. PMID 42443140
6. Rubin R. JAMA. 2026. doi:10.1001/jama.2026.20514. PMID 42853576
7. ClinicalTrials.gov. NCT07339423, NCT07533175, NCT07567001.
8. WADA. World Anti-Doping Code International Standard: Prohibited List 2026 (in force Jan 1, 2026). https://www.wada-ama.org/sites/default/files/2025-09/2026list_en_final_clean_september_2025.pdf (text read Oct 24, 2026)

Disclaimer

This page is for education and harm reduction. It is not medical advice and not a recommendation to use Amycretin. Please talk to a clinician you trust before making medical decisions, seek care right away for severe stomach pain or repeated vomiting, and report problems to FDA MedWatch (https://www.fda.gov/safety/medwatch).

Approved for Adam Greene by Dr. Nova Reyes, 2026-10-25.