Pramlintide and cagrilintide are both amylin analogs — they mimic the hormone amylin to promote fullness and slow gastric emptying. The difference is era and duration: pramlintide is an FDA-approved, short-acting mealtime injection used alongside insulin; cagrilintide is a long-acting, investigational analog being developed for obesity (notably with semaglutide).
At a glance
| Pramlintide | Cagrilintide | |
|---|---|---|
| Class | Amylin analog (short-acting) | Amylin analog (long-acting) |
| Brand name | Symlin | None (investigational) |
| FDA status | Approved | Investigational |
| Primary use | Mealtime adjunct to insulin (diabetes) | Obesity (in development) |
| Dosing | With meals (multiple times daily) | Once weekly (in trials) |
| Pathway | Amylin (satiety, gastric emptying) | Amylin (satiety, gastric emptying) |
The bottom line
Bottom line: Same hormone system, different generation. Pramlintide is the approved, short-acting amylin analog taken with meals alongside insulin; cagrilintide is a long-acting, weekly investigational analog aimed at obesity (often paired with semaglutide as CagriSema). Only pramlintide is currently approved.
Frequently asked questions
What's the difference between pramlintide and cagrilintide?
Both are amylin analogs that promote fullness, but pramlintide is a short-acting, FDA-approved mealtime injection used with insulin, while cagrilintide is a long-acting, investigational analog being developed for obesity.
Is cagrilintide approved?
No. Cagrilintide is investigational and in clinical development, often studied alongside semaglutide (CagriSema). Pramlintide (Symlin) is the FDA-approved amylin analog.
What does an amylin analog do?
Amylin analogs mimic the hormone amylin to slow gastric emptying and increase fullness, complementing other appetite pathways like GLP-1. Pramlintide is used in diabetes; cagrilintide is being studied for obesity.
References
Combined peer-reviewed sources from both peptide guides. Inclusion is not endorsement.
- Ratner RE, Dickey R, Fineman M, et al. Amylin replacement with pramlintide improves long-term glycaemic and weight control in type 1 diabetes: a 1-year randomized controlled trial. Diabet Med. 2004. Peer-reviewed study
- Ryan GJ, Jobe LJ, Martin R. Pramlintide in the treatment of type 1 and type 2 diabetes mellitus. Clin Ther. 2005. Peer-reviewed study
- McQueen J. Pramlintide acetate. Am J Health Syst Pharm. 2005. Peer-reviewed study
- Kommera SP, Kumar A, Chitkara D, et al. Pramlintide an Adjunct to Insulin Therapy: Challenges and Recent Progress in Delivery. J Pharmacol Exp Ther. 2024. Peer-reviewed study
- Sheehan A, Goldfine A, Bajwa M, et al. Pramlintide for post-bariatric hypoglycaemia. Diabetes Obes Metab. 2022. Peer-reviewed study
- Younk LM, Mikeladze M, Davis SN. Pramlintide and the treatment of diabetes: a review of the data since its introduction. Expert Opin Pharmacother. 2011. Peer-reviewed study
- Lau DCW, Erichsen L, Francisco AM, et al. Once-weekly cagrilintide for weight management in people with overweight and obesity: a phase 2 trial. Lancet. 2021. Journal article
- Enebo LB, Berthelsen KK, Kankam M, et al. Concomitant cagrilintide with semaglutide 2.4 mg for weight management: a randomised, controlled, phase 1b trial. Lancet. 2021. Peer-reviewed study
- Garvey WT, Blüher M, Osorto Contreras CK, et al. Coadministered Cagrilintide and Semaglutide in Adults with Overweight or Obesity. N Engl J Med. 2025. Peer-reviewed study
- Davies MJ, Bajaj HS, Broholm C, et al. Cagrilintide-Semaglutide in Adults with Overweight or Obesity and Type 2 Diabetes. N Engl J Med. 2025. Peer-reviewed study
- Lau DCW, Erichsen L, Francisco AM, et al. Once-weekly cagrilintide for weight management in people with overweight and obesity: a multicentre, randomised, double-blind, placebo-controlled and active-controlled, dose-finding phase 2 trial. Lancet. 2021. Peer-reviewed study
- Frias JP, Deenadayalan S, Erichsen L, et al. Efficacy and safety of co-administered once-weekly cagrilintide 2·4 mg with once-weekly semaglutide 2·4 mg in type 2 diabetes: a multicentre, randomised, double-blind, active-controlled, phase 2 trial. Lancet. 2023. Peer-reviewed study