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Home / Encyclopedia / GLP-1 & Weight / Pramlintide
MONOGRAPH No. 118
EVIDENCE BASEStrong
TYPE
Amylin analogue
MW
3949.5 g/mol
CAS
151126-32-8
EU STATUS
No EU authorisation found · US status unclear
WADA
Not listed
MIN PURITY
≥98% HPLC
⚖ GLP-1 & Weight

Pramlintide — EU research guide.

Pramlintide is a synthetic analogue of amylin, the pancreatic hormone that slows gastric emptying and blunts post-meal glucagon — the same target class as cagrilintide, but first to reach the clinic decades earlier.

Last reviewed:

What is Pramlintide?

Pramlintide mimics amylin, a hormone co-secreted with insulin that beta cells release after meals. It slows gastric emptying, reduces glucagon secretion and increases satiety — complementary to, rather than overlapping with, GLP-1 agonism.

Status and research context

Approved in the US as Symlin for insulin-treated diabetes since 2005, pramlintide is listed as discontinued in some US drug databases but not in others, and no EU marketing authorisation was found. Its mechanism directly informs newer, longer-acting amylin analogues such as cagrilintide and petrelintide, now in Phase 3 obesity trials.

EU legal status

No EU marketing authorisation was found; US market status is reported inconsistently. Research-grade pramlintide is available from RUO peptide suppliers.

⚠ The licensed product carries a boxed warning for severe hypoglycaemia when used with insulin; vendor research vials are not that product.
✓ For the modern, long-acting amylin analogue in active development, PeptideCompare tracks cagrilintide from EU research vendors with COA documentation.
EVIDENCE SUMMARY
STRONG
Add-on to mealtime insulin: small HbA1c effect — According to the US label, three 6-month placebo-controlled trials in type 1 diabetes and two in type 2 diabetes (roughly 120-240 participants per arm) showed HbA1c falling 0.25-0.34 percentage points more than with placebo in type 1 and 0.30-0.34 percentage points more in type 2. The effect is modest and applies only to people already on mealtime insulin.
STRONG
Weight change over one year — In a 52-week, placebo-controlled trial in 656 people with type 2 diabetes on insulin, weight fell by 1.4 kg with pramlintide versus a gain of 0.7 kg with placebo; nausea and headache were the main adverse events. A 1-year type 1 trial (479 participants) reported weight change of -0.4 kg versus +0.8 kg with placebo.
MODERATE
Safety: severe hypoglycaemia with insulin — The US label carries a boxed warning that use with insulin increases the risk of severe hypoglycaemia, particularly in type 1 diabetes. A review of the clinical programme names nausea and hypoglycaemia as the principal adverse events. Approved in the US in 2005; no EU marketing authorisation was found.

Molecular information

Molecular formula
C171H267N51O53S2
Molecular weight
3949.5 g/mol
CAS number
151126-32-8

Pharmacokinetics

Half-life (t½)
≈ 48 min
Source: Symlin US prescribing information (FDA, revised 02/2015), section 12.3: half-life in healthy individuals of approximately 48 minutes; chart uses 0.8 h
This is the half-life of the licensed product measured in healthy people. It says nothing about the stability of any unregulated material sold as pramlintide.

Potency retained over time

Each line is one storage condition: it starts at 100% and falls as potency is lost. Above the dashed 80% line the material is considered reliable — hover for exact values.

Freezer −20 °C
36+ mo
Stable · >95% potency
Fridge 4 °C
4-5 wks
In use · after recon
Room 20 °C
5-6 days
Avoid · increased loss
Warm 37 °C+
<1 day
Critical · rapid degradation

⚠ Modelled per compound from molecular structure — chain length, cyclisation, oxidation- and deamidation-prone residues and light sensitivity. Indicative only, not lab-measured per batch.

Amylin-class compounds across EU suppliers

COA-verified EU vendors · Updated monthly

References

  1. The official US label (revised February 2015): indication as an add-on to mealtime insulin, boxed warning for severe hypoglycaemia, half-life of about 48 minutes in healthy people, storage (refrigerated, not frozen, away from light) and the pooled 6-month trial results. This is the licensed product, not vendor 'research' vials. SYMLIN (pramlintide acetate) injection: US prescribing information. US Food and Drug Administration; revised February 2015. Source
  2. The peer-reviewed 1-year trial in type 2 diabetes: 656 randomised participants on insulin, placebo-controlled. It shows lower HbA1c and weight with pramlintide and nausea as the main side effect; it is manufacturer-linked research and does not cover outcomes such as complications. Hollander PA, Levy P, Fineman MS, Maggs DG, Shen LZ, Strobel SA, Weyer C, Kolterman OG. Pramlintide as an adjunct to insulin therapy improves long-term glycemic and weight control in patients with type 2 diabetes: a 1-year randomized controlled trial. Diabetes Care. 2003;26(3):784-790. DOIPubMed 12610038
  3. The peer-reviewed 1-year trial in type 1 diabetes. The title reports better long-term glycaemic and weight control with pramlintide added to insulin; the size of the effect is small, and the figures in this guide come from a later review of the trial. Ratner RE, Dickey R, Fineman M, Maggs DG, Shen L, Strobel SA, Weyer C, Kolterman OG. 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. Diabet Med. 2004;21(11):1204-1212. DOIPubMed 15498087
  4. A clinical review of type 1 and type 2 trials lasting 4 to 52 weeks. It confirms modest HbA1c reductions and names nausea and hypoglycaemia as the main adverse events; it is a secondary source from the period of approval. Ryan GJ, Jobe LJ, Martin R. Pramlintide in the treatment of type 1 and type 2 diabetes mellitus. Clin Ther. 2005;27(10):1500-1512. DOIPubMed 16330288
  5. A review of amylin physiology and pramlintide. It explains why the molecule was engineered with three proline substitutions (native amylin is unstable in solution) and summarises the 1-year type 1 trial figures; it is a review, not a new trial. Hoogwerf BJ, Doshi KB, Diab D. Pramlintide, the synthetic analogue of amylin: physiology, pathophysiology, and effects on glycemic control, body weight, and selected biomarkers of vascular risk. Vasc Health Risk Manag. 2008;4(2):355-362. Source

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