Generic Name: pramlintide (PRAM lin tide)
Brand Names: Symlin, SymlinPen 120, SymlinPen 60
What is Symlin?
Symlin (pramlintide) is a man-made form of a hormone that occurs naturally in the body. Symlin lowers blood sugar in three ways. It slows the rate that food moves from your stomach to your intestines, which keeps your blood sugar from rising too fast. Symlin also lowers the amount of glucose (sugar) your liver produces. Lastly, it triggers the feeling of fullness after meals to help control your appetite and decrease how much food you eat.
Symlin is used together with insulin to treat type 1 or type 2 diabetes.
Symlin may also be used for other purposes not listed in this medication guide.
Important information about Symlin
Do not mix Symlin and insulin together in the same syringe.
You will need to use a lower dose of insulin than you used before you started using Symlin. Your doctor will determine your correct dose.
Call your doctor if you have severe nausea that lasts for several days. This may be a sign that your dose is too high. If you skip a meal, do not take your dose of Symlin. Wait until your next meal.
If you stop using Symlin for a short time, you may need to restart the medication at a lower dose. Do not change your doses or medication schedule without your doctor's advice.
Take care not to let your blood sugar get too low, causing hypoglycemia. Severe hypoglycemia may occur within 3 hours after your Symlin injection. Carry hard candy or glucose tablets with you in case you have low blood sugar. Be sure your family and close friends know how to help you in an emergency.
Before using Symlin
Do not use Symlin if you are allergic to pramlintide or metacresol. Do not use if you have a digestive condition called "delayed gastric emptying," or if you cannot recognize symptoms of low blood sugar.
If you have any of these other conditions, you may need a Symlin dose adjustment or special tests:
a history of delayed gastric emptying;
if you are unable to check your blood sugars regularly up to several times daily;
if you have had severe hypoglycemia more than once in the past 6 months;
FDA pregnancy category C. It is not known whether Symlin will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.. It is not known whether pramlintide passes into breast milk or if it could harm a nursing baby. Do not use Symlin without telling your doctor if you are breast-feeding a baby. Symlin should not be used in children.
See also: Symlin pregnancy and breastfeeding warnings (in more detail)
How should I use Symlin?
Use Symlin exactly as it was prescribed for you. Do not use the medication in larger or smaller amounts, or use it for longer than recommended by your doctor. You may not be able to keep using Symlin if you do not follow the dosing instructions.
Symlin is injected under the skin, at the same time as your insulin injection but in a separate syringe or injector pen. Do not self-inject this medicine if you do not fully understand how to give the injection and properly dispose of used needles and syringes. Do not mix Symlin and insulin together in the same syringe.
Use only the syringe or injection pen recommended by your doctor. Ask your pharmacist about which needles to buy for proper use of the syringe or injection pen.
Symlin is usually given just before each major meal. Follow your doctor's instructions. If you skip a meal, do not take your dose of Symlin. Wait until your next meal. Symlin should be at room temperature when you inject it.
Use a different place on your stomach or thigh each time you give the injection. Inject your insulin in a separate skin area. Do not inject insulin or Symlin into the same place two times in a row. Do not use the medication if it has changed colors or has particles in it. Call your doctor for a new prescription.
Use a disposable needle only one time. Throw away used needles in a puncture-proof container (ask your pharmacist where you can get one and how to dispose of it). Keep this container out of the reach of children and pets.
Call your doctor if you have severe nausea that lasts for several days. This may be a sign that your dose is too high.
If you stop using Symlin for a short time, you may need to restart the medication at a lower dose. Follow your doctor's instructions.
You will need to use a lower dose of insulin than you used before you started using Symlin. Your doctor will determine the correct insulin dose based on the type of diabetes you have.
Do not change your doses or medication schedule without your doctor's advice. Your blood sugar will need to be checked often, and you may need other blood tests at your doctor's office. Visit your doctor regularly.
Take care not to let your blood sugar get too low, causing hypoglycemia. Severe hypoglycemia may occur within 3 hours after your Symlin injection. Symptoms include headache, hunger, sweating, tremor, irritability, or trouble concentrating. Carry hard candy or glucose tablets with you in case you have low blood sugar. Be sure your family and close friends know how to help you in an emergency.
Severe hypoglycemia may cause loss of consciousness, seizures, or death. If you have severe hypoglycemia and cannot eat or drink, use an injection of glucagon. Your doctor can give you a prescription for a glucagon emergency injection kit and tell you how to give the injection. Storing unopened vials or injection pens: Keep in the carton and store in a refrigerator, protected from light. Throw away any insulin not used before the expiration date on the medicine label.
Do not freeze Symlin, and throw away the medication if it has become frozen.
Storing after your first use: You may keep "in-use" vials or injection pens in the refrigerator or at room temperature. Use within 30 days.
What happens if I miss a dose?
Take the missed dose as soon as you remember, but only if you are getting ready to eat a meal. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose may cause diarrhea, vomiting, dizziness, cold sweats, warmth or tingly feeling.
What should I avoid while using Symlin?
Do not remove Symlin from an injector pen and put it in a syringe. You may receive too high a dose. Avoid drinking alcohol. It can lower your blood sugar.
Symlin side effects
Get emergency medical help if you have any of these signs of an allergic reaction to Symlin: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have any of these serious side effects:
severe nausea that lasts for 3 to 7 days; or
more frequent high blood sugar levels.
Less serious Symlin side effects may include:
runny or stuffy nose, sore throat, cough;
nausea, loss of appetite;
headache, tired feeling; or
This is not a complete list of Symlin side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
See also: Symlin side effects (in more detail)
What other drugs will affect Symlin?
The following drugs can interact with Symlin. Tell your doctor if you are using any of these:
acarbose (Precose) or miglitol (Glyset);
propoxyphene (Darvon, Darovcet);
diabetes medications you take by mouth;
atropine (Atreza, Sal-Tropine), dicyclomine (Bentyl), hyoscyamine (Hyomax), oxybutynin (Ditropan, Oxytrol);
an ACE inhibitor such as benazepril (Lotensin), fosinopril (Monopril), enalapril (Vasotec), lisinopril (Prinivil, Zestril), quinapril (Accupril), ramipril (Altace), and others; or
cholesterol-lowering medication such as fenofibrate (Lofibra, Fenoglide, TriCor, Lipofen) or gemfibrozil (Lopid).
Using certain medicines can make it harder for you to tell when you have low blood sugar. Tell your doctor if you use any of the following:
albuterol (Proventil, Ventolin);
clonidine (Catapres); or
a beta-blocker such as atenolol (Tenormin, Tenoretic), carvedilol (Coreg), labetalol (Normodyne, Trandate), metoprolol (Lopressor, Toprol), nadolol (Corgard), propranolol (Inderal, InnoPran), sotalol (Betapace), and others.
You may be more likely to have high or low blood sugar if you are using Symlin with other drugs that raise or lower blood sugar. This includes:
aspirin or other salicylates (including Pepto-Bismol);
birth control pills and other hormones;
diet pills or medicines to treat asthma, colds or allergies;
diuretics (water pills);
a monoamine oxidase inhibitor (MAOI);
phenothiazines (Compazine and others);
steroids (prednisone and others);
seizure medicines (Dilantin and others);
some nonsteroidal anti-inflammatory drugs (NSAIDs); and
sulfa drugs (Bactrim, Gantanol, Gantrisin, Septra, SMX-TMP, and others).
These lists are not complete and other drugs may interact with Symlin. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.
More Symlin resources
Where can I get more information?
- Your pharmacist can provide more information about Symlin.
- Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
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Copyright 1996-2010 Cerner Multum, Inc. Version: 3.02. Revision Date: 03/12/2010 12:46:49 PM.