'''Pramlintide acetate''' (Symlin) is a relatively new adjunct treatment for [[Diabetes mellitus|diabetes]] (both type 1 and 2), developed by [[Amylin Pharmaceuticals]].
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==Pharmacology==
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It is derived from [[amylin]], a [[hormone]] that is released into the [[Blood|bloodstream]], in a similar pattern as [[insulin]], after a meal.<ref name="pmid17619527">{{cite journal |author=Jones MC |title=Therapies for diabetes: pramlintide and exenatide |journal=American family physician |volume=75 |issue=12 |pages=1831–5 |year=2007 |pmid=17619527 |doi=}}</ref> Like insulin, amylin is deficient in individuals with diabetes.
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By substituting for amylin, pramlintide aids in the absorption of [[glucose]] by slowing [[Stomach|gastric emptying]], promoting [[satiety]], and inhibiting inappropriate secretion of [[glucagon]], a catabolic hormone that opposes the effects of insulin and amylin.
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|lookAlike=* A® — B®<ref name="www.ismp.org">{{Cite web | last = | first = | title = http://www.ismp.org | url = http://www.ismp.org | publisher = | date = }}</ref>
==Approval==
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Symlin has been approved for use by the FDA by type 1 and type 2 diabetics who use insulin.<ref name="pmid16330288">{{cite journal |author=Ryan GJ, Jobe LJ, Martin R |title=Pramlintide in the treatment of type 1 and type 2 diabetes mellitus |journal=Clinical therapeutics |volume=27 |issue=10 |pages=1500–12 |year=2005 |pmid=16330288 |doi=10.1016/j.clinthera.2005.10.009}}</ref> Symlin results in weight loss, allows patients to use less insulin, lowers average blood sugar levels, and substantially reduces what otherwise would be a large unhealthy rise in blood sugar that occurs in diabetics right after eating. Symlin is the only drug approved by the FDA to lower blood sugar in type 1 diabetics since insulin's discovery in the early 1920s.
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==Design and structure==
Since native human amylin is highly [[amyloid]]ogenic and potentially toxic, the strategy for designing pramlintide was to substitute residues from rat amylin, which is not amyloidogenic (but would presumably retain clinical activity). Proline residues are known to be structure-breaking residues, so these were directly grafted into the human sequence. The glutamine residue was also substituted with an asparagine, probably because glutamines are generally considered to be amyloid-promoting.
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Black Box Warning
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Overview
Pramlintide is a {{{drugClass}}} that is FDA approved for the {{{indicationType}}} of {{{indication}}}. There is a Black Box Warning for this drug as shown here. Common adverse reactions include .
Adult Indications and Dosage
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Off-Label Use and Dosage (Adult)
Guideline-Supported Use
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There is limited information regarding Off-Label Guideline-Supported Use of Pramlintide in adult patients.
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There is limited information regarding Off-Label Non–Guideline-Supported Use of Pramlintide in adult patients.
Pediatric Indications and Dosage
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There is limited information regarding FDA-Labeled Use of Pramlintide in pediatric patients.
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There is limited information regarding Off-Label Guideline-Supported Use of Pramlintide in pediatric patients.
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There is limited information regarding Off-Label Non–Guideline-Supported Use of Pramlintide in pediatric patients.
Contraindications
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See full prescribing information for complete Boxed Warning.
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Description
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Adverse Reactions
Clinical Trials Experience
There is limited information regarding Clinical Trial Experience of Pramlintide in the drug label.
Body as a Whole
Cardiovascular
Digestive
Endocrine
Hematologic and Lymphatic
Metabolic and Nutritional
Musculoskeletal
Neurologic
Respiratory
Skin and Hypersensitivy Reactions
Special Senses
Urogenital
Miscellaneous
Postmarketing Experience
There is limited information regarding Postmarketing Experience of Pramlintide in the drug label.
