Pramlintide (Symlin)

An analogue of amylin, a small peptide hormone that is released into the bloodstream by the β-cells of the pancreas along with insulin, after a meal.

Trade name Symlin

A subcutaneous agent that is an adjunct for diabetes, both type 1 and 2,

Has a bioavailability of 30 to 40%, with protein binding of approximately 60%.

Metabolism via the kidneys.

Half-life of approximately 48 minutes.

Amylin is completely absent in individuals with Type I diabetes.

Reduces hemoglobin A1c and weight loss in insulin-treated patients with type 2 diabetes taking pramlintide as an adjunctive therapy.

By increasing endogenous amylin, it aids in the absorption of glucose by slowing gastric emptying, promoting satiety via hypothalamic receptors, and inhibits inappropriate secretion of glucagon, a catabolic hormone that opposes the effects of insulin and amylin.

Raises the acute first-phase insulin response threshold following a meal.

Approved for use by Type 1 and Type 2 diabetics who use insulin.

An injectable drug that lowers the level of glucose in blood.

It is used for treating type 1 and type 2 diabetes.

A synthetic hormone that resembles human amylin.

Amylin is a hormone that is produced by the pancreas and released into the blood after meals where it helps the body to regulate levels of blood glucose.

Amylin controls blood glucose: It slows the rate at which food is absorbed from the intestine, reduces the production of glucose by the liver by inhibiting the action of glucagon, a hormone produced by the pancreas that stimulates the production of glucose by the liver.

Reduces appetite.

Pramlintide-treated patients achieves lower blood glucose levels and experience weight loss.

Side effects include: nausea,




abdominal pain,

weight loss, and


Nausea decreases with continued administration.

Nausea is less severe when pramlintide is slowly increased to the desired dose.

When used with insulin, especially in patients with type 1 diabetes, severe hypoglycemia may occur.

If severe hypoglycemia occurs, it usually manifests within 3 hours after receiving pramlintide.

Used in combination with insulin in patients with type 1 diabetes who use mealtime insulin and have not achieved adequate glucose control.

Also used in patients with type 2 diabetes who use mealtime insulin and have uncontrolled blood glucose levels despite maximal insulin therapy, with or without sulfonylurea and/or metformin.

Administered subcutaneously prior to major meals.

Patients with type 1 diabetes should start treatment with a dose of 15 mcg that is increased by 15 mcg increments to 30 or 60 mcg as tolerated.

Treatment of type 2 diabetes should start with 60 mcg, the dose increasing to 120 mcg as needed, and insulin doses should be reduced when pramlintide is started.

The drug slows the transit of food through the intestine and, should not be administered with other drugs that slow down the intestine or slow the absorption of food.

May slow the absorption of orally administered drugs.

Orally administered drugs that require rapid absorption should be administered 1 hour before or 2 hours after injections of pramlintide.

Insulin alters the chemical properties of pramlintide, pramlintide and insulin should not be mixed in the same syringe.

Use results in less insulin use, lowers average blood sugar levels, and substantially reduces rise in blood sugar that occurs in diabetics right after eating.

Only drug approved to lower blood sugar in type 1 diabetics since insulin in the early 1920s.

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