Comparison
Pramlintid vs. Setmelanotide
Two peptides side-by-side — identity, evidence base, legal status and known adverse events.
Identity
Category
Metabolic
Metabolic
CAS no.
151126-32-8
920014-72-8
Molecular weight
3949.4 g/mol
1117.32 g/mol
Half-life
no data
11 h
Sequence
no data
Ac-Arg-Cys(1)-D-Ala-His-D-Phe-Arg-Trp-Cys(1)-NH2 (zyklisches Oktapeptid, Disulfidbrücke Cys2–Cys8)Mechanism of action
Pramlintid
Pramlintide mimics the beta-cell hormone amylin, which is co-secreted with insulin. It slows gastric emptying, suppresses postprandial glucagon release and promotes satiety — thereby blunting post-meal blood-glucose spikes.
Setmelanotide
Setmelanotide is an agonist at the melanocortin-4 receptor (MC4R), a central receptor of the hypothalamic melanocortin pathway involved in the control of energy balance, satiety and body weight. In certain genetic defects (e.g. in POMC, PCSK1 or LEPR), the natural activation of MC4R is reduced. Setmelanotide activates MC4R directly, thereby bypassing the upstream defect. This description is mechanistic and neutral and does not constitute a recommendation for use.
Evidence base
Highest evidence
Human RCT
Human RCT
Studies
0
4
of which in humans
0
3
Effects recorded
2
3
Open conflicts
1
1
Documented adverse events
2
3
Legal status
Full entries
Frequently asked questions
- What is the difference between Pramlintid and Setmelanotide?
- Pramlintid is classified as "Metabolic", while Setmelanotide is classified as "Metabolic". Pramlintid: Pramlintide is a synthetic analog of the hormone amylin. It is used as an adjunct to mealtime insulin therapy in type 1 and type 2 diabetes and, among other things, slows gastric emptying. Setmelanotide: Setmelanotide (brand name Imcivree) is a synthetic cyclic octapeptide and an agonist at the melanocortin-4 receptor (MC4R). It was developed and approved as a prescription medicine for chronic weight management in rare genetic forms of obesity within the MC4R signalling pathway (including POMC, PCSK1 and LEPR deficiency as well as Bardet-Biedl syndrome). The following information is provided for informational and educational purposes only. This page contrasts both neutrally and source-based — with no usage or dosing recommendation.
- Which peptide is better supported by science, Pramlintid or Setmelanotide?
- The highest available evidence level is "Human RCT" for Pramlintid and "Human RCT" for Setmelanotide. A higher evidence level means more robust data, but says nothing about suitability for an individual. The full body of evidence is on each peptide's own page.
- What is the legal status of Pramlintid and Setmelanotide in Germany and the United States?
- Germany: Pramlintid — Unapproved, Setmelanotide — Prescription. United States: Pramlintid — Prescription, Setmelanotide — Prescription. These are factual summaries with source and review date on the individual pages.