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Pramlintide

moderate risk

Also: Symlin · Pramlintide acetate

Strong Evidence FDA Approved

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).

Molecular Weight
3949.4 Da
Formula
C171H267N51O53S2
Common Dosing
60–120 mcg SC with each major meal
Category
therapeutic
Last Reviewed
2025-01-15

Reported Benefits

Post-meal glucose control (T1D/T2D)

Strong Evidence 67 studies

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

PubMed →

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.

Regulatory Status

FDA Approved

FDA 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

Type 1 diabetesType 2 diabetesPost-meal glucose control

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Disclaimer: This information is for educational and research purposes only. Not medical advice. Consult a qualified healthcare provider before using any compound.