Metabolic & Weight Management

Pramlintide

Pramlintide is human amylin with three of its amino acids swapped for proline, a small edit to the pancreatic hormone released with insulin at every meal to slow the stomach, suppress the post-meal glucagon rise and signal fullness. Approved as Symlin in 2005, it is injected alongside mealtime insulin in type 1 and type 2 diabetes, and its label carries a boxed warning for severe insulin-induced hypoglycaemia. The randomised evidence is long-running: a 52-week placebo-controlled trial in 656 people with type 2 diabetes, where HbA1c fell 0.62 percentage points, and a one-year trial in type 1 diabetes. A separate 16-week obesity programme reached 3.7 percent placebo-corrected weight loss and was never taken to registration.

Last updated 12 August 2026

Studied forPostprandial glucose control · Reduced caloric intake · Insulin adjunct research · Body weight research

Evidence on fileFDA-approved · 2 randomised human trials

Strongest sourceAmylin replacement with pramlintide as an adjunct to insulin therapy improves long-term glycaemic and weight… (randomised human trial)

Mechanism

Binds amylin receptors, which are the calcitonin receptor (CTR) in complex with a receptor activity-modifying protein (RAMP1, RAMP2 or RAMP3, giving AMY1, AMY2 and AMY3). Agonism at those receptors slows gastric emptying, suppresses the postprandial glucagon rise, and increases satiety signalling in the area postrema. Which of the three subtypes carries which effect is not established on file.

Regulatory status

Approved by the FDA. Marketed as SYMLIN, SYMLINPEN. Earliest approval 2005-03-16. Application NDA021332.

An approval grades as rung 1 on this site, because 21 CFR 314.126 requires adequate and well-controlled human investigations and one cannot be granted without them. It covers specific indications and doses, though, and does not transfer to other uses of the same molecule.

Reported effects

What sources associate with this compound. Reported categories, not outcomes we have graded — each would need its own citation and rung.

Postprandial glucose control
Reduced caloric intake
Insulin adjunct research
Body weight research

Figures

Every figure below is replotted by this site from values published in the cited paper's text or tables — the numbers are the study's, the drawing is ours, and the evidence rung on each image is the rung of its source.

Weight change at week 52 on pramlintide — type 2 diabetes — Week 52, Mean body-weight change at week 52 (kg) by treatment — Data: Hollander et al. 2003, Diabetes Care (pramlintide added to insulin, 52 weeks) · n=656 insulin-treated adults with type 2 diabetes randomised to pramlintide 60 µg t.d.s., 90 µg b.d., 120 µg b.d. or placebo. Only the 120 µg b.d. arm is plotted, because it is the only arm whose weight change is published numerically. In the same arm HbA1c fell 0.68 and 0.62 percentage points at weeks 26 and 52, and 46% vs 28% reached HbA1c below 8%.

Dosing on file unverified

120 mcg, 2x/day (diabetes)

Carried from a source that labels it unverified, and reproduced with that label attached. A record of what is reported, not a recommendation. No citation on this page establishes it.

Half-life, storage & sport

Elimination half-life: 48 minutes (human, SC) — study. SYMLINPEN FDA prescribing information, section 12.3.

The half-life on file is 48 min, measured subcutaneously. On the schedule this record states — twice daily — each dose has fallen to under 0.1% of its own peak by the time the next is given. Nothing accumulates, and there is no loading phase to run.

Dosed twice daily over 2 d, each dose normalised to the first peak.

The rise is not modelled and the axis is not a blood level. No absorption rate constant and no volume of distribution are on file, so each dose appears at full height the instant it is given, and the axis is percent of this compound's own peak.

Literature on file 3

human RCT
Amylin replacement with pramlintide as an adjunct to insulin therapy improves long-term glycaemic and weight control in Type 1 diabetes mellitus: a 1-year, randomized controlled trial (Diabetic Medicine 2004, cited 262x) graded on: names a randomised controlled trial — “randomized controlled”
human RCT
Pramlintide as an Adjunct to Insulin Therapy Improves Long-Term Glycemic and Weight Control in Patients With Type 2 Diabetes (Diabetes Care 2003, cited 260x) graded on: names a randomised controlled trial — the indexed publication type — “Randomized Controlled”
human RCT
FDA approval NDA021332 graded on: an FDA approval (NDA021332), which requires adequate and well-controlled human investigations — “NDA021332”

Identity

Space-filling 3D model of Pramlintide, carbon grey, nitrogen blue, oxygen red — Built from the SMILES on this record — the atoms and bonds are exact. The shape is **one computed low-energy pose**, not a measured structure: a flexible peptide in solution has no single conformation, and where the SMILES leaves a stereocentre undefined the pose commits to one arbitrarily. The skeletal formula below claims connectivity and nothing more, which is what we actually know.

2D chemical structure of Pramlintide — Built from the SMILES on this record — the atoms and bonds are exact. The shape is **one computed low-energy pose**, not a measured structure: a flexible peptide in solution has no single conformation, and where the SMILES leaves a stereocentre undefined the pose commits to one arbitrarily. The skeletal formula below claims connectivity and nothing more, which is what we actually know.

Molecular weight: 3949
Molecular formula: C171H267N51O53S2
CAS number: 151126-32-8
PubChem CID: 70691388; 16132446 (acetate)
UniProt: P10997 (Target)
ChEMBL: CHEMBL3833353
InChI key: TZIRZGBAFTZREM-MKAGXXMWSA-N
Sequence: KCNTATCATQRLANFLVHSSNNFGPILPPTNVGSNTY
SMILES: CC[C@H](C)[C@@H](C(=O)N[C@@H](CC(C)C)C(=O)N1CCC[C@H]1C(=O)N2CCC[C@H]2C(=O)N[C@@H]([C@@H](C)O)C(=O)N[C@@H](CC(=O)N)C(=O)N[C@@H](C(C)C)C(=O)NCC(=O)N[C@@H](CO)C(=O)N[C@@H](CC(=O)N)C(=O)N[C@@H]([C@@H](C)O)C(=O)N[C@@H](CC3=CC=C(C=C3)O)C(=O)N)NC(=O)[C@@H]4CCCN4C(=O)CNC(=O)[C@H](CC5=CC=CC=C5)NC(=O)[C@H](CC(=O)N)NC(=O)[C@H](CC(=O)N)NC(=O)[C@H](CO)NC(=O)[C@H](CO)NC(=O)[C@H](CC6=CNC=N6)NC(=O)[C@H](C(C)C)NC(=O)[C@H](CC(C)C)NC(=O)[C@H](CC7=CC=CC=C7)NC(=O)[C@H](CC(=O)N)NC(=O)[C@H](C)NC(=O)[C@H](CC(C)C)NC(=O)[C@H](CCCNC(=N)N)NC(=O)[C@H](CCC(=O)N)NC(=O)[C@H]([C@@H](C)O)NC(=O)[C@H](C)NC(=O)[C@@H]8CSSC[C@@H](C(=O)N[C@H](C(=O)N[C@H](C(=O)N[C@H](C(=O)N[C@H](C(=O)N8)[C@@H](C)O)C)[C@@H](C)O)CC(=O)N)NC(=O)[C@H](CCCCN)N
InChI: InChI=1S/C171H267N51O53S2/c1-21-81(12)130(163(268)207-110(56-78(6)7)169(274)222-53-33-42-118(222)170(275)221-52-32-41-117(221)160(265)219-135(89(20)230)167(272)206-109(66-125(180)238)151(256)212-128(79(8)9)161(266)186-68-126(239)192-111(70-223)154(259)203-107(64-123(178)236)152(257)218-134(88(19)229)166(271)195-98(136(181)241)57-92-43-45-94(231)46-44-92)214-159(264)116-40-31-51-220(116)127(240)69-187-141(246)101(58-90-34-24-22-25-35-90)199-148(253)105(62-121(176)234)201-149(254)106(63-122(177)235)202-155(260)112(71-224)209-156(261)113(72-225)208-146(251)103(60-93-67-184-75-188-93)205-162(267)129(80(10)11)213-150(255)100(55-77(4)5)198-145(250)102(59-91-36-26-23-27-37-91)200-147(252)104(61-120(175)233)196-137(242)82(13)189-144(249)99(54-76(2)3)197-142(247)96(39-30-50-185-171(182)183)193-143(248)97(47-48-119(174)232)194-165(270)132(86(17)227)215-138(243)83(14)190-157(262)114-73-276-277-74-115(210-140(245)95(173)38-28-29-49-172)158(263)204-108(65-124(179)237)153(258)217-131(85(16)226)164(269)191-84(15)139(244)216-133(87(18)228)168(273)211-114/h22-27,34-37,43-46,67,75-89,95-118,128-135,223-231H,21,28-33,38-42,47-66,68-74,172-173H2,1-20H3,(H2,174,232)(H2,175,233)(H2,176,234)(H2,177,235)(H2,178,236)(H2,179,237)(H2,180,238)(H2,181,241)(H,184,188)(H,186,266)(H,187,246)(H,189,249)(H,190,262)(H,191,269)(H,192,239)(H,193,248)(H,194,270)(H,195,271)(H,196,242)(H,197,247)(H,198,250)(H,199,253)(H,200,252)(H,201,254)(H,202,260)(H,203,259)(H,204,263)(H,205,267)(H,206,272)(H,207,268)(H,208,251)(H,209,261)(H,210,245)(H,211,273)(H,212,256)(H,213,255)(H,214,264)(H,215,243)(H,216,244)(H,217,258)(H,218,257)(H,219,265)(H4,182,183,185)/t81-,82-,83-,84-,85+,86+,87+,88+,89+,95-,96-,97-,98-,99-,100-,101-,102-,103-,104-,105-,106-,107-,108-,109-,110-,111-,112-,113-,114-,115-,116-,117-,118-,128-,129-,130-,131-,132-,133-,134-,135-/m0/s1

Notes unverified prose

FDA-approved; FDA-approved (Symlin)

Not on file 0

All 8 tracked fields hold a value on this record: molecular weight and formula, CAS number, PubChem CID, amino-acid sequence, SMILES, InChI and InChI key.

Counted from the record itself, not from what a source said it was missing. 163 of 188 records still have at least one empty.

At a glance

Strongest rung: human RCT
Citations: 3
Regulatory: FDA approved
Route: Subcutaneous
Declared gaps: 0

Running this

GLP-1 and incretin

How the class is run, with the source of every schedule beside it.

Citations by rung

human RCT3

Strongest wins, never an average.