Generic Name: pramlintide (PRAM lin tide)Brand Names: Symlin, SymlinPen 120, SymlinPen 60
Pramlintide is a man-made form of a hormone that occurs naturally in the body. Pramlintide 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. Pramlintide also lowers the amount of glucose (sugar) your liver produces. Lastly, pramlintide triggers the feeling of fullness after meals to help control your appetite and decrease how much food you eat.
Pramlintide is used together with insulin to treat type 1 or type 2 diabetes.
Pramlintide may also be used for other purposes not listed in this medication guide.
Do not mix pramlintide and insulin together in the same syringe.
You will need to use a lower dose of insulin than you used before you started using pramlintide. Your doctor will determine your correct dose. Do not change your doses or medication schedule without your doctor's advice.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 pramlintide. Wait until your next meal.
If you stop using pramlintide for a short time, you may need to restart the medication at a lower dose. Follow your doctor's instructions.Take care not to let your blood sugar get too low, causing hypoglycemia. Severe hypoglycemia may occur within 3 hours after your pramlintide injection. Carry a piece of hard candy or glucose tablets with you in case you have low blood sugar. Also be sure your family and close friends know how to help you in an emergency.
If you have certain conditions, you may not be able to use this medication. Before using pramlintide, tell your doctor if you have:
a history of delayed gastric emptying;
if you have trouble recognizing when your blood sugar is low;
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;
Use pramlintide 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. Follow the directions on your prescription. You may not be able to keep using pramlintide if you do not follow the dosing instructions.
Pramlintide is given as an injection under your 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 pramlintide 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.
To keep your blood sugar from getting too low, you will need to use a lower dose of insulin than you used before you started using pramlintide. Your doctor will determine the correct insulin dose based on the type of diabetes you have.Pramlintide is usually given just before each major meal. Follow your doctor's instructions. If you skip a meal, do not take your dose of pramlintide. Wait until your next meal. Pramlintide should be at room temperature when you inject it.
Use a different place on your stomach or thigh each time you give yourself an injection. Inject your insulin in a separate skin area. Do not inject insulin or pramlintide into the same place two times in a row. Do not use the medication if it has changed colors or has any particles in it. Call your doctor for a new prescription.
Use each 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. Do not change your doses or medication schedule without your doctor's advice. You may need to check with your doctor on a weekly basis until your correct dose has been determined. You will need to check your blood sugar at home on a regular basis. You may also need other blood tests at your doctor's office. Do not miss any appointments.
Take care not to let your blood sugar get too low, causing hypoglycemia. Severe hypoglycemia may occur within 3 hours after your pramlintide injection. Symptoms of low blood sugar may include headache, hunger, sweating, tremor, irritability, or trouble concentrating. Carry a piece of hard candy or glucose tablets with you in case you have low blood sugar. Also 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.
If you stop using pramlintide for a short time, you may need to restart the medication at a lower dose. Follow your doctor's instructions.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 pramlintide, 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.
Take the missed dose as soon as you remember, but only if you are getting ready to eat a meal. If it is almost time for your next dose, wait until then to take the medicine and skip the missed dose. Do not take extra medicine to make up the missed dose.
severe nausea that lasts for 3 to 7 days; or
more frequent high blood sugar levels.
Less serious side effects may include:
runny or stuffy nose, sore throat, cough;
diarrhea, nausea, vomiting, loss of appetite;
headache, dizziness, tired feeling; or
This is not a complete list of 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.
The following drugs can interact with pramlintide. Tell your doctor if you are using any of these:
acarbose (Precose) or miglitol (Glyset);
atropine (Atreza, Sal-Tropine), belladonna (Donnatal, and others), benztropine (Cogentin), dimenhydrinate (Dramamine), methscopolamine (Pamine), or scopolamine (Transderm-Scop);
bronchodilators such as ipratropium (Atrovent) or tiotropium (Spiriva);
bladder or urinary medications such as darifenacin (Enablex), flavoxate (Urispas), oxybutynin (Ditropan, Oxytrol), tolterodine (Detrol), or solifenacin (Vesicare); or
irritable bowel medications such as dicyclomine (Bentyl), hyoscyamine (Anaspaz, Cystospaz, Levsin, and others), or propantheline (Pro-Banthine).
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);
cholesterol-lowering medication such as fenofibrate (Lofibra, Fenoglide, TriCor, Lipofen) or gemfibrozil (Lopid); or
an ACE inhibitor such as benazepril (Lotensin), fosinopril (Monopril), enalapril (Vasotec), lisinopril (Prinivil, Zestril), quinapril (Accupril), ramipril (Altace), and others.
You may be more likely to have hyperglycemia (high blood sugar) if you are using pramlintide with other drugs that raise blood sugar. Drugs that can raise blood sugar include:
diuretics (water pills);
steroids (prednisone and others);
phenothiazines (Compazine and others);
thyroid medicine (Synthroid and others);
birth control pills and other hormones;
seizure medicines (Dilantin and others); and
diet pills or medicines to treat asthma, colds or allergies.
You may be more likely to have hypoglycemia (low blood sugar) if you are using pramlintide with other drugs that lower blood sugar. Drugs that can lower blood sugar include:
some nonsteroidal anti-inflammatory drugs (NSAIDs);
aspirin or other salicylates (including Pepto-Bismol);
sulfa drugs (Bactrim, Gantanol, Gantrisin, Septra, SMX-TMP, and others);
a monoamine oxidase inhibitor (MAOI); or
beta-blockers (Tenormin and others).
These lists are not complete and there may be other drugs that can interact with pramlintide. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.