Peptide reference
Pramlintide
Symlin ·SymlinPen ·AC137
What cited sources report about pramlintide
Pramlintide is a synthetic 37-amino-acid analog of human amylin (islet amyloid polypeptide) — a peptide hormone co-secreted with insulin from pancreatic beta cells. The pramlintide sequence substitutes proline residues at positions 25, 28, and 29 to prevent the amyloid-aggregation behaviour of the native human peptide, while preserving the single intramolecular disulfide bond. Pramlintide is marketed as Symlin and is the only amylin analog approved for human use; it received FDA approval on 16 March 2005. The drug is FDA-approved but is not authorised in the European Union; it has not been nominated to the FDA Pharmacy Compounding Advisory Committee. The summaries below report what individual cited sources state.
FDA Drug Label — Symlin (revised December 18, 2019)
The DailyMed structured product label for Symlin (AstraZeneca) indicates the product as an adjunctive mealtime treatment in patients with type 1 or type 2 diabetes who use mealtime insulin therapy and have not achieved desired glucose control on optimal insulin therapy alone. The label describes the mechanism as slowed gastric emptying, suppression of glucagon secretion, and centrally mediated effects on food intake. Symlin carries a boxed warning for severe insulin-induced hypoglycemia, which has been reported within three hours of co-administration with insulin.
SYMLIN is indicated as an adjunctive treatment in patients with type 1 or type 2 diabetes who use mealtime insulin therapy and who have failed to achieve desired glucose control despite optimal insulin therapy.
Walker et al. (2025) — Nature Reviews Endocrinology
A 2025 review from the University of Auckland and the University of Manchester traced amylin pharmacology from the identification of human amylin as a glucoregulatory peptide hormone through the FDA approval of pramlintide in 2005 and into a recent generation of long-acting amylin analogs (including cagrilintide) in late-stage clinical development. The authors observed that amylin-based molecules are being explored as alternatives to GLP-1 receptor agonists, with renewed interest driven in part by concerns about lean-body-mass loss with GLP-1 monotherapy.
Advances in peptide chemistry have reinvigorated the amylin field by enabling the manufacture of effective new amylin-based molecules.
PubChem CID 70691388 — National Center for Biotechnology Information
The PubChem compound record for pramlintide lists molecular formula C171H267N51O53S2, consistent with a 37-amino-acid synthetic analog of human amylin carrying proline substitutions at positions 25, 28, and 29 and retaining the intramolecular disulfide bond between cysteine-2 and cysteine-7.
Coverage notes
Pramlintide remains a niche therapy in U.S. practice — used as a mealtime adjunct in selected patients with type 1 or insulin-requiring type 2 diabetes — and was never approved in the European Union. The amylin pathway is currently undergoing renewed pharmaceutical interest, with cagrilintide (a long-acting amylin analog) and the cagrilintide/semaglutide co-formulation CagriSema in late-stage clinical development for obesity, as discussed in Walker et al. (2025).