Research use only. This page is education, not medical advice. Neither compound is approved for human use, and nothing here is a recommendation for either.

Short answer: Eloralintide is a selective AMY1 receptor agonist with a roughly 10-fold selectivity margin over AMY3; cagrilintide activates both the amylin and calcitonin receptors. No head-to-head trial exists between them, so published weight-loss figures (eloralintide: up to -20.1% over 48 weeks; cagrilintide: up to -10.8% over 26 weeks) come from separate trials with different durations and populations and should not be read as a direct comparison.

The core difference: receptor selectivity

Eloralintide (LY3841136, Eli Lilly) is a selective amylin receptor agonist, preferentially activating the AMY1 receptor over AMY3 and the calcitonin receptor (EC50 23.9 pM at AMY1 vs. 253.8 pM at AMY3; Briere et al., Mol Metab. 2025;102:102271). Cagrilintide (Novo Nordisk) is a long-acting amylin analog that activates both amylin and calcitonin receptors, making it non-selective by comparison. No head-to-head clinical trial between the two compounds has been published, so any cross-drug comparison below is based on separate trials run in different populations, not a direct comparison.

Trial design and duration

Reported weight-loss results

In Lilly’s Phase 2 trial, efficacy-estimand mean weight reduction across eloralintide’s active-dose arms ranged from 9.5% to 20.1%, versus 0.4% on placebo, over 48 weeks. In the published cagrilintide Phase 2 trial, all tested doses (0.3mg to 4.5mg) produced greater weight reduction than placebo, ranging from 6.0% to 10.8% versus 3.0% for placebo, over 26 weeks; the highest cagrilintide dose also outperformed liraglutide 3.0mg (10.8% vs. 9.0%), though a published commentary on that trial noted the liraglutide comparison wasn’t adjusted for multiple comparisons.

Because the two trials differ in duration, dosing schedule, and patient population, these numbers should not be read as a direct head-to-head comparison. A longer eloralintide trial duration (48 vs. 26 weeks) likely contributes to at least part of the difference in reported percentages.

Half-life and dosing interval

Eloralintide’s reported terminal half-life after a single dose is 12.9 to 15.3 days, roughly double cagrilintide’s. Despite that longer half-life, every published eloralintide trial has still used once-weekly dosing — no registered study has tested a longer interval, so a longer half-life has not translated into a less-frequent dosing schedule in practice for either compound.

Safety signals reported so far

Eloralintide’s Phase 2 trial reported mild to moderate nausea (11%–64% by arm) and fatigue (0%–46%) as the most common adverse events, with about 10% of participants stopping treatment because of one. Amylin-class compounds as a group are generally associated with gastrointestinal side effects, similar to the GLP-1 class, though the specific tolerability profile of each compound depends on its individual trial data rather than its drug class alone. A separate preclinical study in obese rats found eloralintide preserved more lean mass than cagrilintide at comparable doses, a signal not yet confirmed in human body-composition data for either drug.

Where each compound stands today

Neither eloralintide nor cagrilintide is FDA-approved. Cagrilintide has reached later-stage development (including combination study with semaglutide), while eloralintide has moved into Phase 3-stage studies following its Phase 2 readout, including an obstructive sleep apnea trial (NCT07369011), a knee osteoarthritis pain study, and a pharmacokinetic study (NCT07701083), with five ENLIGHTEN-branded Phase 3 obesity trials estimating primary completion between January and June 2028. Neither compound is available for purchase or human use outside of registered clinical trials.

Sources

All sources read and verified October 2026.

• Billings LK, et al. Eloralintide Phase 2. The Lancet 2025. ClinicalTrials.gov NCT06230523.
• Briere DA, et al. Molecular Metabolism 2025. PMC12640043.
• ClinicalTrials.gov, eloralintide (LY3841136) records: search.