Symlin

Generic Name: Pramlintide

  • What is Symlin?

    Symlin is an injectable medication used with mealtime insulin to control blood sugar in adults with type 1 or type 2 diabetes. Symlin slows down the movement of food through your stomach, which affects how fast sugar enters your blood after eating. Symlin is always used with insulin to help lower blood sugar during the 3 hours after meals.

  • What is the most important information I should know about Symlin?

    Even when Symlin is carefully added to your mealtime insulin therapy, your blood sugar may drop too low, especially if you have type 1 diabetes. If this low blood sugar (severe hypoglycemia) happens, it is seen within 3 hours after a Symlin injection. Severe low blood sugar makes it hard to think clearly, drive a car, operate heavy machinery, or perform other risky activities where you could hurt yourself or others. Symptoms include headache, hunger, irritability, sweating, tremor, difficulty concentrating, and can lead to more severe conditions including seizures, loss of consciousness, and coma.

  • Who should not take Symlin?

    Do not use Symlin if you cannot tell when your blood sugar is low, have a stomach problem called gastroparesis (when your stomach does not empty as fast as it should), or are allergic to Symlin or any of its ingredients.

  • What should I tell my doctor before I take the first dose of Symlin?

    Tell your doctor about all prescription, over-the-counter, and herbal medications you are taking before beginning treatment with Symlin. Also, talk to your doctor about your complete medical history, especially if you are pregnant, plan to become pregnant, or are breastfeeding.

  • What is the usual dosage?

    The information below is based on the dosage guidelines your doctor uses. Depending on your condition and medical history, your doctor may prescribe a different regimen. Do not change the dosage or stop taking your medication without your doctor's approval.

    When you first start Symlin, your healthcare professional should instruct you to reduce the dose of insulin you take before meals by 50%. Your doctor should direct future insulin changes based on blood sugar testing.

    Type 1 Diabetes

    Adults: The usual starting dose is 15 micrograms (mcg) injected into the thigh or abdomen immediately before meals and at the same time as your insulin. Always inject Symlin in a different site than your insulin. Depending on your response, in time and with close monitoring, your doctor may adjust your dose in steps, up to a maximum of 60 mcg. Only a healthcare professional skilled in the use of Symlin can monitor and recommend dose adjustments.

    Type 2 Diabetes

    Adults: The usual starting dose is 60 mcg injected into the thigh or abdomen immediately before meals and at the same time as your insulin. Always inject Symlin in a different site than your insulin. Depending on your response, in time and with close monitoring, your doctor may adjust your dose up to a maximum of 120 mcg. Only a healthcare professional skilled in the use of Symlin can monitor and recommend dose adjustments.

  • How should I take Symlin?

    You must use Symlin exactly as prescribed. The amount you use will depend on whether you have type 1 or type 2 diabetes.

    Never mix insulin and Symlin. You should use different syringes for each.

    Injecting Symlin is similar to injecting insulin. Inject Symlin under the skin (subcutaneously) of your stomach area or thigh, at a site that is more than 2 inches away from your insulin injection site. Allow Symlin to warm to room temperature before injecting. Use a U-100 insulin syringe (it is best to use the 0.3 mL size) to draw up and inject Symlin. Always use a new syringe and needle for each injection. Do not use Symlin if the liquid in the vial looks cloudy.

    Do not inject Symlin if you skip a meal or if your blood sugar is too low; you plan to eat a meal with <250 calories or 30 grams of carbohydrates; you are sick and cannot eat your usual meal; you are having surgery or a medical test where you cannot eat; or you do not plan to eat.

  • What should I avoid while taking Symlin?

    Do not drive or operate dangerous machinery until you know how Symlin affects your blood sugar. Low blood sugar makes it hard to think clearly, drive a car, operate heavy machinery, or perform other risky activities where you could hurt yourself or others.

    Avoid alcohol. Alcohol may increase the risk of low blood sugar.

  • What are possible food and drug interactions associated with Symlin?

    Symlin may slow the absorption of drugs taken by mouth. Your doctor may have you take your other medicines at least 1 hour before or 2 hours after your Symlin injection.

    If Symlin is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Symlin with acarbose, anticholinergic medications (including atropine), miglitol, or pain medications.

  • What are the possible side effects of Symlin?

    Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking this drug.

    Side effects may include: decreased appetite, dizziness, indigestion, low blood sugar, nausea, stomach pain, tiredness, or injection-site reactions (eg, redness, minor bruising, or pain)

  • Can I receive Symlin if I am pregnant or breastfeeding?

    The effects of Symlin during pregnancy and breastfeeding are unknown. Tell your doctor immediately if you are pregnant, plan to become pregnant, or are breastfeeding.

  • What should I do if I miss a dose of Symlin?

    If you miss or forget a dose of Symlin, wait until the next meal and take your usual dose of Symlin at that meal. Do not take more than your usual dose.

  • How should I store Symlin?

    Store the vials in the refrigerator until you open them. Opened vials and pens can be refrigerated or kept at room temperature for up to 30 days. Any opened vials and pens should be thrown away after 30 days, even if they still have medicine in them. Medication that has been frozen or heated must be thrown away.

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I'm Kristen Dore, PharmD. Welcome to PDR Health!

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