Amylin
The hormone released with insulin that clumps into fibrils, so the drugs are all redesigns of it
Amylin is packaged in the same granules as insulin and released with it, slowing stomach emptying and suppressing glucagon. Human amylin aggregates into the fibrils found in the pancreas in type 2 diabetes, which is why the medicines are engineered analogues rather than the hormone.
What is it?
Amylin, also called islet amyloid polypeptide, is made by the same beta cells as insulin and co-released with it. It slows stomach emptying, suppresses glucagon after meals and promotes fullness, which complements what insulin does.
The hormone itself cannot be a drug. Human amylin aggregates readily into amyloid fibrils, the deposits found in the islets of people with type 2 diabetes, so every medicine in this family is a redesign. Pramlintide, the approved one, substitutes three prolines to stop aggregation; cagrilintide was made by attaching a fatty acid to extend its action.
Pramlintide shows what replacing the hormone does on its own: in a year-long trial of 651 people with type 1 diabetes, mealtime doses added to insulin lowered HbA1c by about 0.3 points and weight by 0.4 kg, with nausea as the main cost. Infused, it also triggered migraine-like attacks in 41% of people with migraine, apparently through an amylin receptor.
The current interest is in combination. Amycretin joins amylin and GLP-1 activity in one molecule, and in an early trial produced weight loss at the top of the range reported for this class, at the cost of the gut side effects that come with it. Long-acting analogues now have their own data: weekly petrelintide cut weight 7.9% to 9.8% at 28 weeks against 1.7% on placebo, cagrilintide about 6% in pooled trials, and a GLP-1 and amylin molecule, zenagamtide, lowered HbA1c by up to 1.7 points by injection and 1.4 by mouth.
We found no human half-life figure for amylin itself in the sources read. The best comparison is pramlintide, whose reported elimination half-life is 30 to 50 minutes, which is why it is dosed with every main meal.
Mechanism of Action
Amylin is a hormone co-secreted with insulin by pancreatic beta cells; it acts on amylin receptors to complement insulin after meals.
Fullness
Amylin promotes fullness and reduces food intake, the basis of the newer weight-loss analogues.
Slower stomach emptying
It slows gastric emptying and nutrient absorption, flattening the rise in glucose after meals.
Glucagon suppression
It suppresses glucagon after meals, a signal missing in insulin-treated diabetes.
Published Research
These are the studies and reviews read from their PubMed abstracts: one early trial of a combined analogue, one tissue study, the molecule's development report and two reviews.
Amycretin, amylin plus GLP-1 in one molecule
In a randomised placebo-controlled phase 1b/2a study, 125 adults with overweight or obesity received weekly subcutaneous amycretin or placebo. Weight change was −24.3% against −1.1% at 60 mg by week 36, and −16.2% against +2.3% at 5 mg by week 28. Gut side effects were the most common, mostly mild to moderate, and many participants withdrew, mostly for reasons unrelated to side effects.
Less amylin staining in insulinoma
In surgical specimens from six patients with insulinoma and six matched controls, amylin staining and the share of amylin-positive beta cells tended to be lower in the insulinoma patients, a difference that did not reach significance (p = 0.17).
Pramlintide with insulin for a year
In 651 people with type 1 diabetes, mealtime pramlintide 60 µg three or four times daily added to insulin lowered HbA1c by 0.29 and 0.34 points over 52 weeks against 0.04 on placebo, with 0.4 kg weight loss against a 0.8 kg gain; transient nausea was the commonest side effect.
Pramlintide can trigger migraine
In a crossover study, 41% of people with migraine had a migraine-like attack after a pramlintide infusion against 56% after CGRP; receptor studies pointed to an amylin receptor rather than the CGRP receptor.
ZUPREME 1: petrelintide
In 485 adults with obesity, weekly petrelintide at 1 to 9 mg cut body weight 7.9% to 9.8% at 28 weeks against 1.7% on placebo, and up to 10.7% by week 42; nausea affected 20% against 6%, while vomiting and diarrhoea were no more common than on placebo.
Weekly zenagamtide in type 2 diabetes
In 262 adults with type 2 diabetes, a once-weekly single molecule acting on GLP-1 and amylin receptors lowered HbA1c by 0.9 to 1.7 points at 36 weeks depending on dose; most adverse events were gastrointestinal.
Oral zenagamtide
In 186 adults with type 2 diabetes, the once-daily oral version lowered HbA1c by 0.9 to 1.4 points at 36 weeks; gastrointestinal events rose with dose, from 26% to 47% against 23% on placebo.
Pramlintide plus GLP-1 in type 1 diabetes
Three case reports describe adults with type 1 diabetes and obesity who lost 14% to 23% of body weight on a GLP-1 drug plus pramlintide, with lower insulin needs.
Lower in polycystic ovary syndrome
Women with polycystic ovary syndrome had lower serum amylin than controls regardless of obesity, along with lower preptin.
Lower in multiple sclerosis
Serum amylin was lower in multiple sclerosis, significantly so in the relapsing-remitting form, but discriminated poorly as a standalone marker.
No clear change in migraine
Serum amylin trended lower in episodic migraine than in controls but the difference was not significant, and levels did not differ between attacks and attack-free periods.
How cagrilintide was built
A development report describing the structure-activity work behind cagrilintide, a lipidated long-acting amylin analogue. It notes that amylin's tendency to form fibrils is what makes the molecule difficult to design around, and that pramlintide needs three daily injections because of its short half-life.
Pharmacology and clinical potential
A review of amylin's physiology and pharmacology: its release with insulin, its effects on stomach emptying, glucagon and satiety, and the clinical prospects for analogues.
Islet amyloid and diabetes
A review of islet amyloid polypeptide and the amyloid deposits found in the islets in type 2 diabetes, and what the aggregation of the human peptide does to beta cells.
Replacement in insulin-treated type 2
A review explains why insulin-treated type 2 diabetes lacks amylin's glucagon suppression and how pramlintide limits post-meal glucose, slows absorption and promotes fullness, and advises reserving it for well-supported patients.
Cagrilintide meta-analysis
Across 4 trials with 5,425 participants, cagrilintide alone cut body weight about 6% against placebo and lowered blood pressure without improving HbA1c; CagriSema also lowered HbA1c and waist size.
Network meta-analysis of amylin drugs
Across 6 trials with 4,642 adults without diabetes, high-dose amycretin, eloralintide and CagriSema ranked above semaglutide 2.4 mg for weight loss, with more nausea, vomiting and constipation; the authors call the data sparse and preliminary.
Anti-doping detection
Lab work mapped the breakdown products of pramlintide, cagrilintide and KBP-066 and validated a method to detect them, with cagrilintide metabolites confirmed in rat plasma, for future doping control.
Dosing Data
Amylin itself is not given. The analogue pramlintide is injected at meals; newer analogues such as petrelintide are tested once weekly.
Educational information, not medical advice. Each dose above is tagged with its source: an approved label, a published human study, animal data, or amounts reported by users. None is a recommendation for you. An unapproved compound has no established safe or effective human dose, and products sold for “research use only” are not made or tested for people. Talk to a doctor before acting on anything on this site, including before you start, stop or change any medicine or dose. Full medical disclaimer.
Side Effects & Contraindications
Reported Side Effects
Amylin itself is not given as a drug; these come from its analogues.
Contraindications & Cautions
Not a medicine.
Legal Status
The hormone is not a drug; its analogues are.
Frequently Asked Questions
?What does amylin do?
It is released with insulin from beta cells and slows stomach emptying, suppresses glucagon after meals and promotes fullness.
?Why is amylin itself not a medicine?
Human amylin aggregates into amyloid fibrils, the deposits found in the islets in type 2 diabetes. Every drug in the family is a redesigned version that resists aggregation.
?What is amycretin?
A single molecule with both amylin and GLP-1 activity. In an early trial of 125 adults it produced 24.3% weight loss at 60 mg by week 36, against 1.1% on placebo.
?How long does amylin last in the blood?
We found no human figure in the sources read. Pramlintide, the approved analogue, has a reported elimination half-life of 30 to 50 minutes.
?How well do amylin analogues work for weight loss?
Weekly petrelintide cut body weight 7.9% to 9.8% at 28 weeks against 1.7% on placebo, and cagrilintide about 6% more than placebo in pooled trials. A network meta-analysis ranked high-dose amycretin, eloralintide and CagriSema above semaglutide 2.4 mg, on sparse data.
?Can amylin drugs cause migraine?
Infused pramlintide triggered migraine-like attacks in 41% of people with migraine in a crossover study, compared with 56% after CGRP, apparently through an amylin receptor.
References
- [pubmed] Dahl K, et al. "Amycretin, a novel, unimolecular GLP-1 and amylin receptor agonist administered subcutaneously: results from a phase 1b/2a randomised controlled study." Lancet, 2025;406(10499):149-162. PMID: 40550231.
- [pubmed] Ishibashi C, et al. "Decreased islet amyloid polypeptide staining in the islets of insulinoma patients." Islets, 2024;16(1):2379650. PMID: 39028826.
- [review] Kruse T, et al. "Development of Cagrilintide, a Long-Acting Amylin Analogue." J Med Chem, 2021;64(15):11183-11194. PMID: 34288673.
- [pubmed] Hay DL, et al. "Amylin: Pharmacology, Physiology, and Clinical Potential." Pharmacol Rev, 2015;67(3):564-600. PMID: 26071095.
- [pubmed] Westermark P, et al. "Islet amyloid polypeptide, islet amyloid, and diabetes mellitus." Physiol Rev, 2011;91(3):795-826. PMID: 21742788.
- [pubmed] Ratner RE, et al. "Amylin replacement with pramlintide as an adjunct to insulin therapy improves long-term glycaemic and weight control in Type 1 diabetes mellitus: a 1-year, randomized controlled trial." Diabet Med, 2004;21(11):1204-12. PMID: 15498087.
- [pubmed] Owen SK. "Amylin replacement therapy in patients with insulin-requiring type 2 diabetes." Diabetes Educ, 2006;32 Suppl 3:105S-110S. PMID: 16751351.
- [pubmed] Ghanizada H, et al. "Amylin Analog Pramlintide Induces Migraine-like Attacks in Patients." Ann Neurol, 2021;89(6):1157-1171. PMID: 33772845.
- [pubmed] Garvey WT, et al. "Petrelintide, a human amylin analogue for the treatment of obesity (ZUPREME 1): a randomised, double-blind, placebo-controlled, phase 2 trial." Lancet Diabetes Endocrinol, 2026. PMID: 42810355.
- [pubmed] Mora P, et al. "Efficacy and safety of once-weekly subcutaneous zenagamtide, a novel unimolecular GLP-1 and amylin receptor agonist, in type 2 diabetes: a multicentre, randomised, parallel, double-blind, placebo-controlled, dose-finding, phase 2 trial." Lancet, 2026;408(10555):621-635. PMID: 42532080.
- [pubmed] Mora P, et al. "Efficacy and safety of once-daily oral zenagamtide, a novel unimolecular GLP-1 and amylin receptor agonist, in adults with type 2 diabetes: a multicentre, randomised, parallel, double-blind, placebo-controlled, dose-finding, phase 2 trial." Lancet, 2026;408(10555):607-620. PMID: 42532079.
- [pubmed] Yaseen M, et al. "Amylin-based obesity therapy: a meta-analysis of Cagrilintide and CagriSema versus placebo." Ann Med Surg (Lond), 2026;88(8):5317-5326. PMID: 42583410.
- [pubmed] Kamrul-Hasan ABM, et al. "Novel Amylin-Based Therapies for Weight Management in Adults With Overweight or Obesity Without Diabetes: A Network Meta-Analysis." Endocrinol Diabetes Metab, 2026;9(3):e70247. PMID: 42175595.
- [pubmed] Wong G, et al. "Combined GLP-1 Receptor Agonist and Amylin Analogue Pharmacotherapy to Treat Obesity Comorbid With Type 1 Diabetes." JCEM Case Rep, 2023;1(2):luad040. PMID: 37908483.
- [pubmed] Nasralddin LM, et al. "Altered serum amylin and preptin levels in women with polycystic ovary syndrome: a comparative analysis based on obesity status." J Endocrinol Invest, 2026;49(10):2825-2843. PMID: 42287528.
- [pubmed] Cinkir U, et al. "Serum amylin levels in patients with multiple sclerosis: A cross-sectional case-control study." Medicine (Baltimore), 2026;105(35):e50425. PMID: 42675707.
- [pubmed] Kocoğlu AI, et al. "Peptides whose levels change during the attack period in episodic migraine: NETRIN-1 and amylin." Front Neurol, 2026;17:1932356. PMID: 42755650.
- [pubmed] Alhalabi H, et al. "In vitro metabolic profiling of weight-loss-inducing amylin receptor agonists in the context of preventive doping research." J Pharm Biomed Anal, 2026;273:117418. PMID: 41702251.
Sources & Citations
Studies were read from their PubMed abstracts; amylin itself has no label. Read October 7, 2026.
Medical Disclaimer: This content is for educational and informational purposes only. It is not medical advice, and nothing here is an instruction to obtain or use any compound. Talk to a licensed clinician about your own situation.