Amylin Analogs (Symlin)

Reviewed by: HU Medical Review Board | Last reviewed: August 2023

Amylin analogs are a class of drugs approved to treat people with type 1 and type 2 diabetes. The drugs work by mimicking a natural body hormone called amylin. Amylin works to help reduce blood sugar when insulin alone does not control blood sugar enough.1

Amylin analogs are injected before meals.2

How do amylin analogs work?

Amylin is a hormone that your pancreas makes, along with insulin. The levels of amylin and insulin rise and fall together in response to your mealtimes. These hormones work together to remove glucose (sugar) from your blood.1

In people with diabetes, the pancreas may not produce enough insulin or the body cannot properly use the insulin. Some people with diabetes also do not make enough amylin. Together, this can cause too much sugar to build up in the bloodstream.1

Amylin analogs are manufactured (synthetic) versions of the natural hormone amylin. They mimic the effect of amylin produced by the body. They can help some people with T2D by:1,2

  • Slowing down the process of food leaving the stomach (gastric emptying)
  • Increasing feelings of fullness
  • Decreasing the release of another pancreatic hormone (glucagon) after eating

These effects can help some people with diabetes control blood sugar levels better. The effects also can help lower body weight, even though amylin analogs are not prescribed for weight loss.2


One amylin analog used in T2D is called Symlin® (pramlintide). It is available in 2 forms:1

  • SymlinPen 60
  • SymlinPen 120

SymlinPen 60 is used for doses of up to 60 mcg. This is more commonly used for people with type 1 diabetes. SymlinPen120 is used for doses of up to 120 mcg. This is more commonly used for people with T2D.3

What are the possible side effects?

Side effects can vary depending on the specific amylin analog you are taking. They usually go away within a few weeks. Slowly increasing the dose can help reduce the risk of side effects. The most common side effects of amylin analogs include:1,3

  • Nausea
  • Vomiting
  • Reduced appetite
  • Stomach pain
  • Headache

Symlin has a boxed warning, the strictest warning from the US Food and Drug Administration (FDA). It has this warning because using it increases the risk of severe hypoglycemia (very low blood sugar). This risk is highest in people with type 1 diabetes. If a serious reaction occurs, it usually happens within 3 hours after a Symlin injection.1

These are not all the possible side effects of amylin analogs. Talk to your doctor about what to expect when taking amylin analogs. You should also call your doctor if you have any changes that concern you when taking amylin analogs.

Other things to know about amylin analogs

Amylin analogs are meant for people with diabetes who are already taking insulin at mealtimes. You will still need to take insulin as prescribed by your doctor. However, you must take insulin and the amylin analog separately and avoid mixing them.2

Take amylin analogs exactly as your doctor prescribes. Symlin is an injectable drug that you can give yourself before meals. You should only take it before meals with at least 250 calories or 30 grams of carbohydrates, or as prescribed by your doctor.2

Before you start taking an amylin analog, tell your doctor:

  • If you are allergic to any ingredients in amylin analogs
  • If you have any other health conditions (especially gastroparesis)
  • If you are taking anticholinergic drugs
  • If you are taking any other drugs, including:
    • Vitamins
    • Supplements
    • Over-the-counter drugs

For more information, read the full prescribing information of Symlin.

By providing your email address, you are agreeing to our privacy policy.