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Peptide — Selective Amylin Receptor Agonist

Eloralintide Phase II

LY3841136  |  once-weekly selective amylin receptor agonist  |  fatty-acid-acylated amylin analog  |  Eli Lilly and Company
Class
Selective amylin receptor (AMY1R) agonist
Engineering
Amylin analog acylated with C20 fatty diacid
Half-life
Once-weekly SubQ
Route
Subcutaneous injection
FDA Status
Investigational — Phase 3 enrollment initiated late 2025
Phase 2 Weight Loss
Up to ~20% at 48 weeks (9 mg)
Receptor Selectivity
AMY1R 12× over CTR
Pivotal Phase 2
NCT06230523 (Lancet 2025)
Developer
Eli Lilly and Company
Cost & Access
Research-only (investigational)
TL;DR

Lilly's selective amylin agonist. 20% weight loss in Phase 2. No GLP-1 receptor in sight.
What is it? Lilly's once-weekly selective amylin receptor agonist (LY3841136). An amylin analog acylated with a C20 fatty diacid. Engineered for AMY1R with 12× selectivity over the calcitonin receptor.
What does it do? Activates amylin receptors in the area postrema, hypothalamus, and nucleus tractus solitarius. Cuts caloric intake, slows gastric emptying, and suppresses postprandial glucagon. Doesn't touch GLP-1, so it layers cleanly on incretin therapy.
Does the evidence hold up? Phase 1 MAD (NCT05295940) cut weight up to 11% at 12 weeks. Phase 2 (Billings, Lancet 2025, NCT06230523) showed 20% weight loss at 9 mg vs 0.4% placebo in 263 adults. Phase 3 enrollment began end of 2025.
Who uses it? Nobody outside clinical trials. Not yet in gray-market distribution.
Bottom line? The amylin answer to the GLP-1 race. If Phase 3 holds, a non-incretin lane opens.

What It Is

Eloralintide (development code LY3841136) is an investigational once-weekly subcutaneous amylin receptor agonist being developed by Eli Lilly and Company for chronic weight management. Chemically, it is a synthetic analog of human amylin — the 37-amino-acid peptide hormone co-secreted with insulin from pancreatic beta cells in response to nutrient intake — conjugated to a C20 fatty diacid that binds reversibly to serum albumin to extend plasma half-life. The engineering objective was a long-acting amylin analog with sufficient receptor selectivity to drive the satiety and body-weight effects of the amylin pathway while limiting the receptor cross-reactivity that contributes to gastrointestinal tolerability burden in non-selective agonists (notably cagrilintide).

Endogenous amylin, together with insulin, regulates postprandial glucose via three established mechanisms: slowing gastric emptying, suppressing postprandial glucagon secretion, and promoting satiety through central receptors in the area postrema and hypothalamus. Native amylin has a plasma half-life of approximately 10 minutes, making it impractical as a therapeutic. Pramlintide (Symlin®), the first amylin analog in clinical use, addressed the aggregation problem of native amylin but retained the short half-life and requires 3× daily injection at mealtime. Cagrilintide (Novo Nordisk) extended amylin therapy to once-weekly dosing using a C20 fatty diacid conjugation strategy similar to eloralintide's, and is currently paired with semaglutide as CagriSema in Phase 3 trials. Eloralintide is Lilly's answer to Novo's CagriSema — a long-acting amylin analog intended to be paired with tirzepatide in the most important head-to-head combination in the 2026 obesity pipeline.

The key differentiator Lilly emphasizes is receptor selectivity. Amylin acts at a family of related receptors formed by the calcitonin receptor (CTR) complexed with receptor activity-modifying proteins (RAMPs): AMY1R (CTR + RAMP1), AMY2R (CTR + RAMP2), and AMY3R (CTR + RAMP3), plus CTR alone. Different amylin analogs engage these receptors with different selectivity profiles, and the weight-loss and GI-tolerability effects are thought to be differentially distributed across AMY1R vs CTR / AMY3R engagement. Eloralintide was engineered to activate AMY1R approximately 12-times more potently than CTR, with reduced AMY3R activity (Briere et al., ScienceDirect 2025). This selectivity is Lilly's central commercial thesis: strong efficacy through AMY1R-mediated satiety with reduced nausea and fatigue through avoidance of broader CTR/AMY3R activation.

As of April 2026, eloralintide has completed Phase 1 and Phase 2 monotherapy trials in obesity, has additional Phase 2 programs testing combination with tirzepatide in T2D-plus-obesity populations (NCT06603571) and in monotherapy in obesity without diabetes (NCT06297616, NCT06916091), and began Phase 3 enrollment at the end of 2025 per Lilly's November 2025 Phase 2 topline announcement. It is not available outside clinical trials and is not present in the research-peptide gray market.

Mechanism of Action

Eloralintide's mechanism follows the amylin-pathway template but is distinguished by its engineered receptor-selectivity profile and pharmacokinetic properties.

What the Research Shows

Eloralintide's evidence base as of April 2026 spans preclinical characterization, Phase 1 proof-of-concept, and a pivotal 48-week Phase 2 published in The Lancet in late 2025.

Research Context — A Strong Phase 2, Not Yet a Phase 3

Eloralintide's Phase 2 weight-loss result (up to 20% at 48 weeks) is one of the most compelling amylin-class data sets published to date. The improved GI tolerability relative to cagrilintide — if it holds — is a clinically meaningful differentiation. But a single Phase 2 is not a Phase 3; enrollment size, trial duration, and broader patient population in Phase 3 can change the safety and efficacy picture. The 6 mg fixed-dose nausea rate (64%) also illustrates that eloralintide is not a nausea-free drug — titration matters. Watch for Phase 3 topline in 2027 timeframe.

Human Data

All currently published eloralintide human data comes from Lilly's clinical-trial program. There is no off-label or gray-market human experience.

Dosing from the Literature

Doses below summarize what has appeared in the Phase 1 and Phase 2 programs. No approved dose exists. Phase 3 protocols will finalize the labeled starting, titration, and maintenance doses.

Dose / ScheduleSourceOutcomeNotes
0.04–12 mg single doseNCT05295940 Part A (Phase 1 SAD)PK dose-proportionalSafety and PK characterization. No efficacy endpoint.
Multiple ascending, 12 weeksPhase 1 MADUp to ~11% weight lossFavorable GI tolerability vs class.
1 mg weekly × 48 weeksNCT06230523−9% weight (Lancet 2025)Low-end dose; low nausea (11%).
3 mg weekly × 48 weeksNCT06230523−12% weightLow nausea (13%).
6 mg weekly × 48 weeksNCT06230523−18% weightHigh nausea rate (64%) with direct 6 mg start.
9 mg weekly × 48 weeksNCT06230523−20% weightHighest efficacy. Nausea 33% (after gradual exposure).
6→9 mg escalationNCT06230523−20% weightMatches 9 mg direct for efficacy. Nausea 54%.
3→9 mg escalationNCT06230523−16% weightBest tolerability of high-dose arms. Nausea 25%, fatigue 21%.
Dosing Disclaimer

Eloralintide is investigational. No approved dose exists. The Phase 3 labeled-dose regimen will be determined by Lilly's Phase 3 protocols and FDA labeling discussions. Current Phase 2 data strongly suggest that slower titration (3→9 mg) provides similar weight loss to direct higher-dose starts with substantially better tolerability. Anyone seeing eloralintide sold outside a registered clinical trial should assume the product is counterfeit; accept no "research chemical" source of this molecule.

Reconstitution & Storage

Trial-supplied eloralintide has been provided as a pre-formulated solution; no investigator or subject reconstitution has been described in the published literature. Commercial presentation (if approved) is likely to follow Lilly's pre-filled pen / multi-dose pen platform established for tirzepatide.

Form (anticipated)ConcentrationStorageNotes
Trial solution (SubQ)Per trial protocol2–8°C refrigeratedProtocol-specific handling; not publicly published.
Commercial pen (anticipated)Dose-strength-specific2–8°C refrigerated long-termProjected to follow Lilly tirzepatide-pen handling.
Room temperature window (anticipated)Limited-time (<30°C)Consistent with Lilly's other fatty-acid-acylated peptides.

→ Use the Kalios Dosing Calculator for weekly SubQ scheduling

Side Effects & Risks

Important

Eloralintide is Phase 2 and not FDA-approved. Expect amylin-class GI effects. Combining it with tirzepatide is untested in humans. This is a doctor conversation.

Side effects in the Phase 2 NCT06230523 trial were dominated by amylin-class GI and metabolic effects, with the magnitude strongly influenced by dose and titration approach.

Bloodwork & Monitoring

No FDA-approved monitoring framework exists yet. Likely monitoring (drawing on trial protocols and amylin-class expectations):

Commonly Stacked With

Tirzepatide (Lilly-developed combination)

The most important combination partner. Phase 2 NCT06603571 is evaluating eloralintide alone or combined with tirzepatide in adults with obesity + T2D. Mechanistically complementary: tirzepatide engages GIP and GLP-1 receptors; eloralintide selectively engages AMY1R. Anticipated to produce additive or multiplicative weight loss with improved tolerability at lower doses of each. Lilly's commercial answer to Novo's CagriSema (cagrilintide + semaglutide).

Cagrilintide (class alternative)

Novo Nordisk's long-acting amylin analog. Same drug class, broader receptor activity (non-selective). Cagrilintide is the established amylin comparator; eloralintide's preclinical taste-avoidance and Phase 2 tolerability data position it as the selective-receptor challenger in this class.

Semaglutide (potential combination, not Lilly-led)

Mechanistically similar to the CagriSema logic (GLP-1 + amylin). Not part of Lilly's declared combination program with eloralintide but biologically plausible. Lilly will commercially pursue tirzepatide-combo rather than cross-company semaglutide pairing.

Retatrutide (Lilly's tri-agonist)

GLP-1 / GIP / glucagon tri-agonist in Phase 3. The other next-generation Lilly obesity asset. Retatrutide and eloralintide may become complementary Lilly products addressing different patient segments and combination possibilities.

Standard obesity-care lifestyle interventions

Intensive behavioral therapy (dietary counseling, physical activity, behavioral modification) was the background in the eloralintide Phase 2. Drug effects are layered on top of lifestyle support, not a substitute for it.

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Regulatory Status

Current Status — April 2026

Eloralintide is investigational. It has no FDA, EMA, or other major-regulator approval. The compound has completed Phase 1 and the pivotal 48-week Phase 2 monotherapy obesity trial (NCT06230523; Billings et al., Lancet 2025). Lilly announced November 6, 2025 that Phase 3 enrollment in obesity monotherapy would begin by year-end 2025. Phase 2 combination work with tirzepatide (NCT06603571) is ongoing.

Eloralintide is not on the FDA Category 2 Bulk Drug Substances list and not part of HHS Secretary Robert F. Kennedy Jr.'s February 2026 reclassification announcement. As an investigational NDA-track biologic developed by Eli Lilly, it exists entirely within the conventional pharmaceutical regulatory framework.

WADA: Not specifically named on the WADA Prohibited List as of the 2026 edition. Amylin-class compounds do not fall cleanly into S-class categories; tested athletes in weight-category sports should consult their federation. This is hypothetical for eloralintide in 2026 given the lack of availability outside trials.

Cost & Access

Eloralintide is available only through Lilly-sponsored clinical trials. It is not sold as a research chemical, not available through compounding pharmacies, and not available through any international pharmacy import channel. Clinical-trial participation is the only legitimate access route — see ClinicalTrials.gov for open Phase 2/3 studies (NCT06230523 completed; active programs include NCT06297616, NCT06603571, NCT06916091, NCT06345066, NCT06916065, plus upcoming Phase 3 registrations).

Following approval (anticipated no sooner than 2027–2028 pending Phase 3 timelines), eloralintide is likely to be priced in line with the other Lilly obesity biologics and dispensed through specialty pharmacy channels on prescription. Commercial-coverage and access patterns will evolve with labeling.

Any product being marketed as "eloralintide" outside Lilly's clinical-trial network as of April 2026 is counterfeit. Accept no research-chemical or gray-market source for this molecule — both the legal and the clinical risk are unambiguous.

Estimated pricing as of April 2026. Actual costs vary by provider, location, and prescription status. Kalios does not sell compounds.

Related Compounds

People researching Eloralintide often also look at these:

Synthetic amylin analogue (Symlin). Post-prandial glucose and satiety modulator.

Fixed-dose combination of cagrilintide + semaglutide. Amylin + GLP-1 obesity protocol.

Daily GLP-1 receptor agonist (Victoza / Saxenda). First-generation GLP-1 with shorter half-life.

Next Steps

Key References

  1. Billings LK, Hansen HH, Dam-Larsen S, et al. Eloralintide, a selective amylin receptor agonist for the treatment of obesity: a 48-week phase 2, multicentre, double-blind, randomised, placebo-controlled trial. Lancet. 2025. PMID: 41207310. (NCT06230523 — pivotal Phase 2; up to 20% weight loss at 9 mg over 48 weeks.)
  2. Eloralintide, a selective, long-acting amylin receptor agonist for treatment of obesity: Phase 1 proof of concept. 2025. PMID: 41559929. (Phase 1 multiple-ascending-dose results; 100 participants, up to ~11% weight loss at 12 weeks.)
  3. Briere DA, Bueno AB, Gimeno RE, et al. Eloralintide (LY3841136), a novel amylin receptor agonist for the treatment of obesity: From discovery to clinical proof of concept. Mol Metab. 2025. PMID: 41109426. (Full translational characterization; AMY1R selectivity, preclinical weight loss, conditioned-taste-avoidance comparison vs cagrilintide.)
  4. Briere DA, Long A, Bullock DM, et al. 849-P: Eloralintide (LY3841136), a Selective Amylin Mimetic, Lowered Body Weight with Improved Quality of Weight Loss and GI Tolerability in Rats Compared with Cagrilintide. Diabetes 2025;74(Suppl 1):849-P. (ADA 2025 scientific sessions preclinical comparison.)
  5. Eli Lilly and Company. Lilly's selective amylin agonist, eloralintide, demonstrated meaningful weight loss and favorable tolerability in a Phase 2 study of adults with obesity or overweight. Press release, November 6, 2025. (Phase 2 topline announcement; Phase 3 enrollment initiation.)
  6. ClinicalTrials.gov NCT05295940 — A Study of LY3841136 in Healthy Participants. (Phase 1 SAD/MAD.)
  7. ClinicalTrials.gov NCT06230523 — A Study of LY3841136 in Adult Participants With Obesity or Overweight. (Pivotal Phase 2.)
  8. ClinicalTrials.gov NCT06603571 — A Study to Investigate Weight Management With LY3841136 and Tirzepatide (LY3298176), Alone or in Combination, in Adult Participants With Obesity or Overweight With Type 2 Diabetes. (Combination Phase 2.)
  9. ClinicalTrials.gov NCT06297616, NCT06916091 — Additional Phase 2 eloralintide monotherapy programs.
  10. Lutz TA. The role of amylin in the control of energy homeostasis. Am J Physiol Regul Integr Comp Physiol. 2010;298(6):R1475-R1484. PMID: 20357017.
  11. Hay DL, Chen S, Lutz TA, Parkes DG, Roth JD. Amylin: Pharmacology, Physiology, and Clinical Potential. Pharmacol Rev. 2015;67(3):564-600. PMID: 26071591.
  12. Boyle CN, Lutz TA, Le Foll C. Amylin — Its role in the homeostatic and hedonic control of eating and recent developments of amylin analogs to treat obesity. Mol Metab. 2018;8:203-210. PMID: 29203236.
  13. Amylin: emergent therapeutic opportunities in overweight, obesity and diabetes mellitus. Nat Rev Endocrinol. 2025;21:482-494. (Modern review of the amylin drug class including eloralintide context.)
  14. Lau DCW, Erichsen L, Francisco AM, et al. Once-weekly cagrilintide for weight management in people with overweight and obesity: a multicentre, randomised, double-blind, placebo-controlled and active-controlled, dose-finding phase 2 trial. Lancet. 2021;398(10317):2160-2172. PMID: 34798049. (Cagrilintide Phase 2 — the class comparator.)
  15. Frias JP, Deenadayalan S, Erichsen L, et al. Efficacy and safety of co-administered once-weekly cagrilintide 2.4 mg with once-weekly semaglutide 2.4 mg in type 2 diabetes: a multicentre, randomised, double-blind, active-controlled, phase 2 trial. Lancet. 2023;402(10403):720-730. PMID: 37515693. (CagriSema Phase 2 — the combination benchmark.)

Last updated: April 2026  |  Profile authored by Kalios Peptides research team