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The FDA's Center for Drug Evaluation and Research has raised concerns about peptide purity, sterility, and potency in compounded products 29

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Key structural features include N14E and V17R substitutions (helix stabilisation), 25P/28P/29P proline substitutions (suppression of beta-sheet propensity and amyloid fibril formation, the primary instability mode of native human amylin), a C-terminal proline-to-tyrosine substitution (P37Y) for calcitonin-receptor activity, and N-terminal C20 fatty-diacid acylation via a gamma-Glu linker