Pramlintide vs Setmelanotide
A detailed comparison to help you understand the differences and choose the right peptide for your research goals.
Pramlintide
Pramlintide (Symlin) is a synthetic analog of amylin, FDA-approved as an adjunct to insulin therapy in type 1 and type 2 diabetes. It helps control post-meal blood sugar spikes and promotes modest weight loss.
Full details →Setmelanotide
Setmelanotide (Imcivree) is an FDA-approved MC4R agonist for chronic weight management in patients with obesity due to specific genetic conditions (POMC, PCSK1, or LEPR deficiency).
Full details →Side-by-Side Comparison
| Aspect | Pramlintide | Setmelanotide |
|---|---|---|
| Mechanism | Mimics amylin's effects: slows gastric emptying, suppresses glucagon secretion after meals, and promotes satiety through central mechanisms. Complements insulin therapy. | Selective agonist of melanocortin 4 receptors (MC4R) in the hypothalamus, restoring the satiety signaling pathway that is disrupted in certain genetic obesity syndromes. |
| Typical Dosage | Type 1: Start 15mcg before meals, titrate to 30-60mcg. Type 2: Start 60mcg, may increase to 120mcg. Always with meal containing 30+ grams carbs or 250+ calories. | Adults: Start 2mg daily, titrate based on tolerability up to 3mg daily. Pediatrics (6+): Weight-based dosing starting at 1mg daily. |
| Administration | Subcutaneous injection immediately before major meals. Must reduce mealtime insulin by 50% when starting to prevent hypoglycemia. Never mix with insulin. | Subcutaneous injection once daily. Requires genetic testing to confirm eligible mutations before prescribing. |
| Side Effects | Nausea (very common initially), headache, anorexia, vomiting, and abdominal pain. GI effects typically improve over time. | Injection site reactions, skin hyperpigmentation, spontaneous penile erections, depression, and suicidal ideation (boxed warning). GI effects less common than GLP-1s. |
| Best For |
What They Have in Common
Both Pramlintide and Setmelanotide are commonly used for: