Pramlintide
Aliases: Symlin
Last verified: 2026-09-23
The short version
An amylin analogue — approved as an insulin adjunct in type 1 and 2 diabetes; reduces appetite and postprandial glucose.
Identity & type
- Molecular type
- analog
- Origin
- An amylin analogue — approved as an insulin adjunct in type 1 and 2 diabetes; reduces appetite and postprandial glucose.
Mechanism of action
Amylin receptor agonism → satiety, slowed gastric emptying, glucagon suppression.
Dosing & routes
Official / clinical context
Approved drug — indications, dosing and warnings are defined by the official label. 15–120 mcg SC before meals.
Regulator-approved labeling and published study designs — never a recommendation.
Community-reported practice
15–120 mcg SC before meals. Symlin: in diabetics reduces post-meal glucose spikes and food intake; nausea common early, requires careful insulin titration.
Unverified self-reports. Not medical advice. Not endorsement.
Expected effects (community)
Symlin: in diabetics reduces post-meal glucose spikes and food intake; nausea common early, requires careful insulin titration.
Protocol — official vs community
Official / label
Symlin, adjunct to mealtime insulin in type 1 and type 2 diabetes. Type 1: start 15 mcg SC immediately before each major meal (≥250 kcal or ≥30 g carbohydrate); type 2: start 60 mcg SC before each major meal.
- 01Type 1: 15 mcg before meals → 30 mcg → 60 mcg, in steps of ≥3 days
- 02Type 2: 60 mcg before meals → 120 mcg if needed and tolerated
Duration: Chronic adjunct while on insulin therapy. Pre-meal insulin (including fixed-mix) must be reduced ~50% at initiation to prevent hypoglycemia.
An amylin analogue. Never mix in the same syringe as insulin. Nausea is the dominant early side effect and the usual reason for stopping.
Community (anecdotal)
Rare off-label use for appetite suppression at or below the labeled 15–120 mcg pre-meal doses, sometimes without insulin — removing the labeled indication while keeping the nausea risk.
- Cycle:
- Weeks; most abandon it quickly.
- Break:
- None defined.
A footnote in the community compared with GLP-1s; cagrilintide research has absorbed whatever interest amylin pharmacology had for weight loss.
Human evidence
Proven adjunct; modern amylin analogues (cagrilintide) are successors.
Preclinical evidence
The preclinical phase was completed and submitted to regulators as part of registration; pharmacology and toxicology details are part of the official label.
Known risks
- Nausea, hypoglycemia with insulin (reduce insulin).characterized
Teal: characterized in clinical/labeling contexts. Amber: theoretical or reported outside controlled settings.
Unknowns & evidence gaps
- Real-world data outside controlled trials