Weight Management

Pramlintide

Symlin · amylin analog · AC137

Mealtime amylin analog (Symlin), adjunct to insulin. Micrograms before meals, not weekly milligrams. Hypoglycemia risk with insulin. Older cousin of cagrilintide, not a GLP-1.

Not FDA-approved - research chemical
Reviewed by CalcMyPeptide Editorial Team
Last updated: August 2026Evidence: High1 peer-reviewed citation
Typical research dose
15-120 mcg per meal
Frequency
3× daily (before meals)
Half-life
~48 minutes
Common vials
0.6 mg / 1 mg
CAS
151126-32-8
Molecular weight
3949.4 g/mol

Use-case scores

0–10 against the evidence we have, not a gym ranking. Hidden domains do not apply here.

  • Metabolic / weight7.5/10

    FDA-approved adjunct to insulin in T1D/T2D. Ceiling 9 for approval; haircut because weight loss is modest and this is not a weekly obesity peptide.

Compound card

Sequence
Amylin analog (Pro25,28,29)
Class
Mealtime amylin analog (Symlin); adjunct to insulin
Formula
C171H267N51O53S2
Status
Not FDA-approved · research use
Dose it
0.6 mg + 1 mL BAC water → 0.6 mg/mL · 15 mcg ≈ 3 units (U-100)
Open in calculator

How it works

Pramlintide (Symlin®) is a synthetic analog of human amylin - a pancreatic beta-cell hormone co-secreted with insulin that regulates postprandial glucose by three mechanisms: (1) slowing gastric emptying, (2) suppressing postprandial glucagon secretion from pancreatic alpha cells, and (3) promoting satiety via central amylin receptor signaling. While native amylin aggregates (causing the amyloid deposits seen in T2D), pramlintide uses proline substitutions to prevent aggregation. FDA-approved as an adjunct to insulin in both T1D and T2D, producing HbA1c reductions of 0.5-0.7% and modest weight loss (1-2 kg).

Source: FDA Label (Symlin), PMID: 15677783

Research Use Cases

  • ✓T1D / T2D on Insulin: High
  • ✓Postprandial Glucose Spikes: High

Dosing

PhaseDoseFrequencyNotes
T2D Protocol60 mcgBefore each major meal (SC)Reduce pre-meal insulin by 50% when starting to prevent hypoglycemia.
T1D Protocol15 mcg → 30-60 mcgBefore each major meal (SC)Start low at 15 mcg; titrate up over 3-7 days. Insulin dose reduction essential.

Administration

Route / form
Subcutaneous injection (abdomen or thigh, separate syringe from insulin)
Timing
Immediately before each major meal (≥250 kcal or ≥30g carb).
Empty stomach?
No - Food timing is not critical.

Timeline

Immediately
Postprandial glucose slowing begins within 30 minutes of injection.
Months 2-3
HbA1c reduction ~0.5-0.7%. Modest weight loss 1-2 kg.

Who it is for

T1D / T2D on Insulin

High

FDA-approved with both T1D and T2D insulin regimens. Reduces postprandial spikes without extra insulin.

Postprandial Glucose Spikes

High

Direct amylin mechanism slows gastric emptying and suppresses glucagon - complementary to insulin action.

Reconstitution

VialWaterConcentrationExample dose
Pen (Symlin)n/a (prefilled)Device-labeledFollow the pen. Mealtime mcg, not weekly mg. Reduce mealtime insulin as labeled.

Change vial size or water volume? Open the reconstitution calculator.

Safety & Considerations

FDA-approved (Symlin). CRITICAL: Reduce concomitant meal-related insulin by ≥50% to prevent severe hypoglycemia. Do not mix with insulin in same syringe. Nausea is common initially - start low and titrate.

Regulatory & Legal Status

FDA Status (US)
Research Only
WADA Status (2026)
Not Listed

Not currently on the WADA 2026 Prohibited List. Policies may change - verify before competition.

Classification

Research Chemical

US Compounding: Not eligible / not available

⚠️ This information is for educational purposes only and may not reflect the most current regulatory updates. Always verify with official FDA, WADA, and jurisdiction-specific sources before use.

Limits of current evidence

  • Symlin is micrograms before meals with an insulin reduction. That is not a milligram-weekly chart.
  • Do not stack with cagrilintide. Same receptor family.
  • This page does not replace diabetes care.

Verdict

Pramlintide is labeled Symlin, a mealtime amylin shot next to insulin. It is the older cousin of cagrilintide, not a GLP-1. Hypoglycemia risk with insulin is the safety story. Do not treat a research cake as Symlin.

Interactions & Contraindications

FDA-approved (Symlin). CRITICAL: Reduce concomitant meal-related insulin by ≥50% to prevent severe hypoglycemia. Do not mix with insulin in same syringe. Nausea is common initially - start low and titrate.

Frequently Asked Questions

Can pramlintide be mixed with insulin in the same syringe?▼
No - pramlintide and insulin must always be injected separately. Mixing alters the pharmacokinetics of both. Always use a separate insulin syringe or pen for pramlintide.
Why do I need to reduce my insulin when starting pramlintide?▼
Pramlintide slows gastric emptying, delaying carbohydrate absorption. Without reducing meal-related insulin, the insulin peaks before glucose is absorbed, causing dangerous hypoglycemia. Reduce meal insulin by 50% when starting.

References

  1. Edelman SV et al. “"Pramlintide as an adjunct to insulin therapy in T1D and T2D".” Diabetes Technology & Therapeutics (2006). PMID: 16734556

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