Symlin

Generic name: pramlintide acetateBrand names: Symlin

Why is Symlin prescribed?

Symlin is an injectable antidiabetes medication prescribed to improve blood sugar control in adults with type 1 and type 2 diabetes whose mealtime insulin alone does not adequately control their blood sugar levels. Symlin is always prescribed in addition to insulin or insulin and an oral diabetes medication.

Insulin helps cells absorb sugar from the bloodstream. Diabetes occurs when the body does not produce enough insulin or cannot effectively utilize insulin, resulting in high levels of unused sugar in the blood (hyperglycemia). After eating a meal, sugar rapidly enters the bloodstream and raises the level of blood sugar. Symlin slows the passing of food from the stomach, while also suppressing additional sugar output from the liver. In addition, Symlin decreases the appetite, which can help with weight control.

Most important fact about Symlin

Symlin used together with insulin can increase your risk of experiencing severe low blood sugar levels (hypoglycemia), especially in type 1 diabetes. This condition will appear within 3 hours of taking a Symlin injection and can impair your ability to think clearly, drive a car, operate heavy machinery, or engage in any hazardous activities where there is danger of injury to yourself or others.

How should you take Symlin?

Take Symlin exactly as prescribed by your doctor. Symlin is always injected at mealtimes. Always inject Symlin in a different area than your insulin, either in the thigh or abdomen; never mix them together. You must test your blood sugar levels before and after each meal, and at bedtime. You doctor may change your usual dose of insulin when you begin treatment and will explain how to further adjust your dose of Symlin based on your response after meals.

  • If you miss a dose...Skip the one you missed and return to your regular schedule. Do not take two doses at once or increase your next dose.
  • Storage instructions...Store unopened vials of Symlin in the refrigerator away from light. Symlin that has been frozen or heated must be thrown away.

Store opened (in-use) vials of Symlin for up to 28 days in the refrigerator or at room temperature (77 degrees or less). Throw away any unused Symlin after 28 days.

What side effects may occur?

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 to continue using Symlin.

  • Side effects may include:Abdominal pain, allergic reaction, dizziness, fatigue, headache, loss of appetite, nausea, muscle pain, severe low blood sugar, and vomiting.

Why should Symlin not be prescribed?

Do not use Symlin if you are allergic to it or any of its ingredients. You should not use Symlin if your stomach does not empty properly or if you must take medicines that help empty your stomach or bowels.

You will not be able to use Symlin if you cannot recognize the warning signs of low blood sugar. Low blood sugar can cause symptoms of headache, hunger, irritability, sweating, tremor, difficulty concentrating, and can lead to more severe conditions including seizure, loss of consciousness, and coma.

Special warnings about Symlin

Symlin is not for everyone and should only be prescribed by a doctor who knows your condition well. You must stay in close contact with a health care professional who is skilled in diabetes education and management while you are taking Symlin. If you have trouble keeping up with your insulin and blood sugar testing schedules, if blood tests show you have an uncontrolled blood sugar average, or if you have frequent episodes of extremely low blood sugar (hypoglycemia), you may not be able to use Symlin.

Symlin is prescribed in addition to a plan that includes insulin and very specific dietary and exercise guidelines, and careful blood sugar monitoring. Failure to follow these guidelines or to take all of your medications as prescribed may result in serious and potentially life-threatening complications. Symlin cannot be used as a substitute for your insulin and other oral antidiabetes medications.

Possible food and drug interactions when taking Symlin

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

Certain medicines can mask low blood sugar or increase the blood sugar lowering effects of Symlin. Your doctor may make a dosage adjustment and closely monitor your condition if you are taking the following:

Blood pressure medicationClonidineDisopyramideFibratesFluoxetineGuanethidineMAO inhibitorsPentoxifyllinePropoxypheneReserpineSalicylates (drugs used to relieve pain and reduce fever)Sulfonamide antibiotics

Special information if you are pregnant or breastfeeding

The effects of Symlin during pregnancy have not been adequately studied. If you are pregnant or plan to become pregnant, notify your doctor before taking Symlin. Only your doctor can determine if the benefits of Symlin outweigh the risks to your unborn child.

Symlin may appear in breast milk and could affect your nursing infant. Your doctor may have you stop breastfeeding if Symlin is necessary to your health.

Recommended dosage for Symlin

ADULTS

Treatment with Symlin requires an insulin dose reduction in both type 1 and type 2 diabetes. After careful monitoring of your response, an individualized dosage of both Symlin and insulin will be specified by your doctor. If you experience persistent and significant nausea, treatment with Symlin may be discontinued.

Type 1 DiabetesThe usual starting dose is 15 micrograms (mcg) injected into the thigh or abdomen immediately before meals 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 DiabetesThe usual starting dose is 60 mcg injected into the thigh or abdomen immediately before meals 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.

Overdosage

If you suspect an overdose, seek emergency treatment immediately.

  • Symptoms of overdose may include:Diarrhea, dizziness, severe low blood sugar, severe nausea, and vomiting.
  • Symlin Prescribing Information (FDA)
  • Symlin Advanced Consumer (Micromedex) - Includes Dosage Information
  • Symlin Vial MedFacts Consumer Leaflet (Wolters Kluwer)
  • Symlin Consumer Overview
  • Pramlintide MedFacts Consumer Leaflet (Wolters Kluwer)