Pramlintide
moderate riskAlso: Symlin · Pramlintide acetate
Pramlintide (Symlin) is the first FDA-approved amylin analog. An adjunct to insulin therapy in T1D and T2D, it reduces post-meal glucose excursions, promotes satiety, and modestly reduces body weight. Predecessor to next-generation amylin analogs (cagrilintide, davalintide).
Reported Benefits
Post-meal glucose control (T1D/T2D)
FDA-approved; Phase III RCTs show HbA1c reduction and post-prandial glucose improvement as insulin adjunct.
Mechanism of Action
Amylin receptor agonist; suppresses post-meal glucagon; slows gastric emptying; promotes satiety via CNS amylin receptors; reduces post-prandial glucose excursions.
Key Clinical Studies
Ratner et al. (2005)
Phase III RCT · n=651
Significant HbA1c reduction and weight loss vs. placebo as insulin adjunct in T1D
Amylin Class Progenitor
Pramlintide proved amylin receptor agonism is a viable drug class. Its limitations (twice-to-thrice daily dosing, nausea burden, insulin dose reduction requirement) drove development of longer-acting analogs like cagrilintide.
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Regulatory Status
FDA ApprovedFDA approved as Symlin (T1D and T2D adjunct)
Safety Profile
Side Effects
- •Nausea (~30%)
- •Vomiting
- •Hypoglycemia (with insulin — requires dose reduction)
- •Injection site reactions
Contraindications
- •Hypoglycemia unawareness
- •Gastroparesis
- •Pregnancy
Drug Interactions
- •Insulin (reduce mealtime dose 50% when starting)
Primary Uses
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