Peptide Comparison
PramlintidevsSemaglutide
Synthetic amylin analog for comprehensive postprandial glucose control with insulin therapy
The revolutionary once-weekly GLP-1 medication that helps your body feel full faster and longer, leading to significant weight loss while also protecting your heart—FDA approved and backed by some of the largest clinical trials in obesity medicine history.
At a Glance
Quick
comparison
Dose Range
Pramlintide
15 mcg–120 mcg mcg
Semaglutide
0.25–2.4 mg
Frequency
Pramlintide
Once daily
Semaglutide
Once weekly
Administration
Pramlintide
subcutaneous injection
Semaglutide
Subcutaneous injection
Cycle Length
Pramlintide
Ongoing/indefinite
Semaglutide
Ongoing/indefinite
Onset Speed
Pramlintide
Moderate (1-2 weeks)
Semaglutide
Moderate (1-2 weeks)
Evidence Level
Pramlintide
Strong human trials (Phase 3 or FDA approved)
Semaglutide
Strong human trials (Phase 3 or FDA approved)
Efficacy
Benefit
ratings
Blood Sugar Control
Weight Management
Metabolic Health
Weight Loss
Appetite Control
Heart Protection
Technical Data
Compound
specifications
Pramlintide
Molecular Formula
C171H267N51O53S2
Molecular Weight
3,949 Da
Half-Life
~48 minutes
Bioavailability
30-40% subcutaneous bioavailability
CAS Number
196078-30-5
Semaglutide
Molecular Formula
C187H291N45O59
Molecular Weight
4113.58 g/mol
Half-Life
Approximately 7 days (168 hours)
Bioavailability
89% (subcutaneous); 0.4-1% (oral, with absorption enhancer)
CAS Number
910463-68-2
Protocols
Dosing
tiers
Pramlintide
Semaglutide
Applications
Best
suited for
Pramlintide
Improving postprandial glucose control in insulin-treated diabetes
Pramlintide is particularly well-suited for individuals focused on improving postprandial glucose control in insulin-treated diabetes. Research and clinical experience suggest meaningful benefits in this area when used as part of a comprehensive treatment approach.
Reducing insulin dose requirements while maintaining glycemic control
Pramlintide is particularly well-suited for individuals focused on reducing insulin dose requirements while maintaining glycemic control. Research and clinical experience suggest meaningful benefits in this area when used as part of a comprehensive treatment approach.
Supporting weight management in insulin-treated T1DM and T2DM patients
Pramlintide is particularly well-suited for individuals focused on supporting weight management in insulin-treated t1dm and t2dm patients. Research and clinical experience suggest meaningful benefits in this area when used as part of a comprehensive treatment approach.
Addressing amylin deficiency in insulin-dependent diabetes
Pramlintide is particularly well-suited for individuals focused on addressing amylin deficiency in insulin-dependent diabetes. Research and clinical experience suggest meaningful benefits in this area when used as part of a comprehensive treatment approach.
Semaglutide
People with Obesity Seeking Significant Weight Loss
If your BMI is 30 or higher (or 27+ with weight-related health conditions), semaglutide is currently one of the most effective non-surgical weight loss options available. Clinical trials show average weight loss of 15% of body weight—that's 30+ pounds for someone starting at 200 pounds.
Those Who've Struggled with Diet and Exercise Alone
Semaglutide works by changing the biological signals that drive hunger and cravings. If you've tried to lose weight through willpower alone and found yourself constantly battling hunger, this medication addresses that underlying biology rather than just telling you to eat less.
People with Type 2 Diabetes Needing Better Control
Originally developed for diabetes, semaglutide excellently controls blood sugar while also promoting weight loss—addressing two major health concerns simultaneously. It can often allow people to reduce or eliminate other diabetes medications.
Individuals at High Cardiovascular Risk
The SELECT trial proved that semaglutide reduces heart attacks, strokes, and cardiovascular death by 20% in people with obesity and existing heart disease—even without diabetes. It's one of the few weight loss medications proven to improve hard cardiovascular outcomes.
Safety Profile
Side
effects
Pramlintide
Common
- Nausea
- Reduced Appetite / Anorexia
- Headache
Uncommon
- Abdominal Pain and Vomiting
- Injection Site Reactions
Serious
- Severe Hypoglycemia (BLACK BOX WARNING)
Semaglutide
Common
- Nausea
- Constipation or Diarrhea
- Decreased Appetite
- Vomiting
Uncommon
- Gallbladder Problems
- Hair Loss (Telogen Effluvium)
Serious
- Pancreatitis
- Thyroid Tumors (Theoretical Risk)
Research Status
Safety
& evidence
Pramlintide
Evidence Level
Strong human trials (Phase 3 or FDA approved)
FDA Status
FDA approved for this use
Safety Overview
FDA-approved pramlintide demonstrates good tolerability in insulin-treated diabetes with well-characterized safety profile from >20 years clinical use. Gastrointestinal side effects (nausea) occur in 30-50% of initiators but typically resolve within 1-3 weeks. Hypoglycemia risk, especially when combined with insulin, requires dose coordination and patient education. Pancreatic side effects theoretically possible but not documented in clinical trials. Pregnancy category C requires careful consideration.
Contraindications
- xConfirmed gastroparesis requiring treatment
- xHypoglycemia unawareness (inability to recognize hypoglycemic symptoms)
- xKnown hypersensitivity to pramlintide or metacresol
- xPediatric patients (safety not established in children)
Semaglutide
Evidence Level
Strong human trials (Phase 3 or FDA approved)
FDA Status
FDA approved for this use
Safety Overview
Semaglutide has been studied in over 20,000 participants across multiple large clinical trials, making it one of the most thoroughly researched weight loss medications available. The FDA approved it after rigorous review of safety data. While GI side effects are common (especially early on), serious side effects are rare. The SELECT trial showed it actually reduces cardiovascular events, adding a safety benefit beyond just weight loss.
Contraindications
- xPersonal or family history of medullary thyroid carcinoma (MTC)
- xMultiple Endocrine Neoplasia syndrome type 2 (MEN2)
- xHistory of serious allergic reaction to semaglutide
- xCurrent or recent pancreatitis
- xPregnancy or planning to become pregnant
Decision Guide
Which is
right for you?
Choose Pramlintide if...
- Improving postprandial glucose control in insulin-treated diabetes
- Reducing insulin dose requirements while maintaining glycemic control
- Supporting weight management in insulin-treated T1DM and T2DM patients
- Addressing amylin deficiency in insulin-dependent diabetes
Choose Semaglutide if...
- Significant weight loss
- Long-term weight management
- Cardiovascular risk reduction
- Blood sugar control