Pramlintide (Symlin) Dosing Calculator

Dose

15-60 mcg

Frequency

Before major meals (2-3 times daily)

Duration

Ongoing

Route

Subcutaneous

FDA-approved T1D schedule: start at 15 mcg before meals, increase by 15 mcg increments every 3+ days to target of 30-60 mcg; must reduce mealtime insulin by 50%

Dose

60-120 mcg

Frequency

Before major meals (2-3 times daily)

Duration

12-24 weeks

Route

Subcutaneous

Some community members use pramlintide off-label for appetite suppression and weight loss; not an FDA-approved indication for pramlintide alone

Dose

Frequency

Before each major meal (2-3 times daily)

Maintenance dose is 60 mcg before meals. Must be administered as a separate injection from insulin. Mealtime insulin dose reduction is critical to prevent severe hypoglycemia.

Dose

Frequency

Before each major meal (2-3 times daily)

Maintenance dose is 120 mcg before meals. Must be administered as a separate injection from insulin. Monitor for hypoglycemia, especially during the titration period.

How much bacteriostatic water should I add to a 5 mg vial of Pramlintide (Symlin)?

The community standard is 1 mL of bacteriostatic water for a 5 mg Pramlintide (Symlin) vial. That gives a concentration of 2.50 mg/mL, so a 60 mcg dose is 2.4 units on a U-100 insulin syringe. Adding 1 mL instead doubles the concentration to 5.00 mg/mL and halves the draw to 1.2 units. Less water = smaller injection volume but harder to measure precisely.

How many syringe units is a 60 mcg dose of Pramlintide (Symlin)?

On a standard U-100 insulin syringe, a 60 mcg dose of Pramlintide (Symlin) is 2.4 units when the 5 mg vial is reconstituted with 1 mL of bacteriostatic water (2.50 mg/mL). If you use 1 mL of bac water instead, draw 1.2 units (5.00 mg/mL).

What is the standard Pramlintide (Symlin) dose?

Community-reported protocols for Pramlintide (Symlin) typically use 60 mcg–120 mcg once daily via Subcutaneous. 60 mcg is a common starting dose. FDA-approved T2D schedule: start at 60 mcg before meals, increase to 120 mcg if tolerated after 3-7 days; must reduce mealtime insulin by 50% when initiating

How long does a vial of Pramlintide (Symlin) last at 60 mcg once daily?

A 5 mg vial of Pramlintide (Symlin) contains roughly 83 doses at 60 mcg per injection. At once daily dosing, that is approximately 83 days (about 12 weeks) of supply per vial. Reconstituted Pramlintide (Symlin) should generally be used within 28 days when refrigerated.

Where do you inject Pramlintide (Symlin)?

Pramlintide (Symlin) is typically injected subcutaneous. Common sites reported in the literature and by users include: Abdomen, Thigh. Rotate sites with each injection to reduce localized irritation.

Can I use sterile water instead of bacteriostatic water for Pramlintide (Symlin)?

Bacteriostatic water (containing 0.9% benzyl alcohol as a preservative) is strongly preferred for multi-dose vials like Pramlintide (Symlin) because it inhibits microbial growth and lets a single vial be used over multiple weeks. Sterile water has no preservative and should generally be reserved for single-use preparations only.