Pramlintide

Generic Name: pramlintide (PRAM-lin-tide)
Brand Name: Symlin Pen

Pramlintide is used along with insulin. It may increase the risk of severe low blood sugar caused by insulin. The risk may be higher in patients with type 1 diabetes. If this occurs, it is seen within 3 hours after an injection of pramlintide. Use caution if you will be driving or performing other possibly unsafe tasks. Be sure you understand how to use pramlintide and how to recognize low blood sugar. Discuss any questions or concerns with your health care provider.


Pramlintide is used for:

Treating diabetes in certain patients who also use insulin.

Pramlintide is an amylin analog. It works by slowing down food digestion. This prevents blood sugar from rising as quickly after you eat. It may also help you feel full faster.

Do NOT use pramlintide if:

  • you are allergic to any ingredient in pramlintide, including metacresol
  • you have a condition that causes your stomach to empty very slowly (gastroparesis)
  • you cannot tell when your blood sugar is low
  • you take an alpha glucosidase inhibitor (eg, acarbose) or an anticholinergic (eg, scopolamine, hyoscyamine)

Contact your doctor or health care provider right away if any of these apply to you.

Slideshow: Flashback: FDA Drug Approvals 2013

Before using pramlintide:

Some medical conditions may interact with pramlintide. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have vision or coordination problems, or a history of stomach or bowel problems
  • if you have had severe low blood sugar within the past 6 months, have diabetic nerve disease (eg, peripheral neuropathy), or have high hemoglobin A1c
  • if you have trouble using your insulin therapy or monitoring your blood sugar levels
  • if you are on dialysis
  • if you take medicine that helps food move through your stomach more quickly

Some MEDICINES MAY INTERACT with pramlintide. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Beta blockers (eg, propranolol), clonidine, guanethidine, or reserpine because they may hide the symptoms of low blood sugar
  • Angiotensin-converting enzyme (ACE) inhibitors (eg, enalapril), disopyramide, fibrates (eg, clofibrate), fluoxetine, monoamine oxidase inhibitors (MAOIs) (eg, phenelzine), pentoxifylline, propoxyphene, salicylates (eg, aspirin), sulfonamide antibiotics (eg, sulfamethoxazole), or sulfonylureas (eg, glipizide) because the risk of low blood sugar may be increased
  • Alpha glucosidase inhibitors (eg, acarbose) or anticholinergics (eg, scopolamine, hyoscyamine) because they may increase the risk of pramlintide's side effects

This may not be a complete list of all interactions that may occur. Ask your health care provider if pramlintide may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use pramlintide:

Use pramlintide as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Pramlintide comes with an extra patient information sheet called a Medication Guide. It also comes with a "Patient Instructions for Use" sheet. Read these information sheets carefully before you use pramlintide. Read them again each time you get pramlintide refilled.
  • Use pramlintide immediately before major meals, as directed by your health care provider.
  • A health care provider will teach you how to use pramlintide. Be sure you understand how to use it. Follow the procedures you are taught when you use a dose. Contact your health care provider if you have any questions.
  • Be sure you understand how to use the pen-injector. Be sure to check the dosing window before each injection to make sure you receive the correct amount of medicine. Ask your doctor or other health care provider any questions that you may have about pramlintide or about using the pen-injector.
  • Do not use pramlintide if it contains particles, is cloudy or discolored, or if the container is cracked or damaged.
  • Pramlintide is given as an injection under the skin, usually in the stomach area or upper thigh. Do not inject pramlintide into the arm, because it may not absorb properly. Rotate injection sites so you do not use the same site repeatedly.
  • Do not transfer medicine from the pen-injector into a syringe. This may cause you to receive too much medicine per dose and may increase your risk of serious side effects.
  • Do not mix pramlintide with insulin or inject it in the same area as insulin. Inject pramlintide at least 2 inches away from where you inject your insulin.
  • If you store pramlintide in the refrigerator, allow it to warm to room temperature before you inject a dose. This may decrease the chance of a reaction at the injection site.
  • Pramlintide may affect the way other medicines are absorbed into your body. Some medicines may need to be taken at least 1 hour before or 2 hours after using pramlintide. Talk with your doctor or pharmacist about how you should take any other medicines with pramlintide.
  • Do not share pen or cartridge devices with another person. Sharing these devices may pass infections from one person to another. This includes infections you may not know you have.
  • Keep this product, as well as syringes and needles, out of the reach of children and pets. Do not reuse needles, syringes, or other materials. Ask your health care provider how to dispose of these materials after use. Follow all local rules for disposal.
  • Continue to use pramlintide even if you feel well. Do not miss any doses.
  • If you miss a dose of pramlintide, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once.

Ask your health care provider any questions you may have about how to use pramlintide.

Important safety information:

  • Dizziness may occur while you are using pramlintide. This effect may be worse if you take it with alcohol or certain medicines. Use pramlintide with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
  • Do not drink alcohol without discussing it with your doctor. Drinking alcohol may increase the risk of developing low blood sugar.
  • Nausea is a common side effect of pramlintide. Mild nausea is more likely during the first weeks of treatment and usually does not last long. Tell your doctor if nausea continues or is bothersome.
  • Do NOT use pramlintide if your blood sugar is too low, you skip a meal, you plan to eat a meal with fewer than 250 calories or 30 grams of carbohydrates, you are sick and cannot eat your usual meal, you are having surgery or a medical test in which you cannot eat, or you are pregnant or breast-feeding and have not talked to your doctor.
  • Do not use more than your prescribed dose of pramlintide without checking with your doctor. Using more than the prescribed dose may cause nausea and vomiting, and you may not be able to eat the amount of food you usually eat. If you use more of pramlintide than the prescribed dose, pay close attention to the amount of insulin use. You may have greater risk of developing low blood sugar. Contact your doctor or other health care provider for instructions.
  • Tell your doctor or dentist that you take pramlintide before you receive any medical or dental care, emergency care, or surgery.
  • Talk with your health care provider about all of your diabetes medicines and how to use them. Do not start, stop, or change the dose of any diabetes medicine unless your doctor tells you to.
  • If you stop using pramlintide for any reason (eg, surgery, illness), contact your doctor. Follow your doctor's instructions for restarting pramlintide.
  • Pramlintide may increase the risk of severe low blood sugar caused by insulin. Low blood sugar may also occur if you use too much of pramlintide, use too much insulin, skip a meal, or exercise more than usual. Low blood sugar may make you anxious, sweaty, weak, dizzy, drowsy, or faint. It may also make your heart beat faster; make your vision change; give you a headache, chills, or tremors; or make you more hungry. It is a good idea to carry a reliable source of glucose (eg, tablets or gel) to treat low blood sugar. If this is not available, you should eat or drink a quick source of sugar like table sugar, honey, candy, orange juice, or non-diet soda. This will raise your blood sugar level quickly. Tell your doctor right away if this happens. To prevent low blood sugar, eat meals at the same time each day and do not skip meals.
  • Carry an ID card at all times that says you take pramlintide.
  • Monitor your blood sugar levels as directed by your health care provider. Most patients will monitor blood sugar before meals, after meals, and at bedtime. If your blood sugar is often higher or lower than it should be, check with your doctor.
  • Follow the diet and exercise program given to you by your health care provider.
  • Ask your health care provider what you should do if you miss a dose of your insulin.
  • It may be harder to control your blood sugar during times of stress such as fever, infection, injury, or surgery. If any of these occur, talk with your doctor. A change in your medicine may be needed.
  • Lab tests, including fasting blood sugar levels and hemoglobin A1c, may be performed while you use pramlintide. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.
  • Pramlintide should not be used in CHILDREN; safety and effectiveness have not been confirmed.
  • PREGNANCY and BREAST-FEEDING: If you become pregnant while taking pramlintide, contact your doctor. You will need to discuss the benefits and risks of using pramlintide while you are pregnant. It is not known if pramlintide is found in breast milk. If you are or will be breast-feeding while you are using pramlintide, check with your doctor. Discuss any possible risks to your baby.

Possible side effects of pramlintide:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Decreased appetite; indigestion; minor redness, swelling, itching, or pain at the injection site; nausea; stomach pain; tiredness; vomiting.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); seizure; severe of persistent nausea; symptoms of low blood sugar (eg, chills, dizziness, drowsiness, fainting, fast heartbeat, headache, increased hunger, irritability, nervousness, sweating, tremor, trouble concentrating, weakness).

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include diarrhea; dizziness; flushing; severe nausea; vomiting.

Proper storage of pramlintide:

Store new (unused) pen-injectors in the refrigerator, between 36 and 46 degrees F (2 and 8 degrees C). Do not freeze. Store opened (used) pen-injectors in the refrigerator or at room temperature, up to 86 degrees F (30 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Throw away used pen-injectors after 30 days, even if they still contain medicine. Do not use pramlintide if it has been frozen or heated above room temperature, or if it is expired. Keep pramlintide out of the reach of children and away from pets.

General information:

  • If you have any questions about pramlintide, please talk with your doctor, pharmacist, or other health care provider.
  • Pramlintide is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.
  • Check with your pharmacist about how to dispose of unused medicine.

This information should not be used to decide whether or not to take pramlintide or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about pramlintide. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to pramlintide. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using pramlintide.

Issue Date: July 2, 2014
Database Edition 14.3.1.001
Copyright © 2014 Wolters Kluwer Health, Inc.

Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.

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