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pramlintide (Rx)Brand and Other Names:Symlin, SymlinPen 120, more...SymlinPen 60

 
 
 

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

injectable solution

  • 0.6mg/mL

pen-injector

  • 15mcg/dose
  • 30mcg/dose
  • 45mcg/dose
  • 60mcg/dose
  • 120mcg/dose
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Type 1 Diabetes

Initial: 15 mcg SC immediately prior to major meals

Increase by 15 mcg q3Days (if not significant nausea occur)

Reduce postprandial short-acting insulin dose by 50%

Maintenance: 30-60 mcg SC

Type 2 Diabetes

Initial: 60 mcg SC immediately prior to major meals

After 3-7 days increase to 120 mcg prior to meals (if not significant nausea occurs)

Reduce postprandial short-acting insulin dose by 50%

Maintenance: 60-120 mcg SC

Renal Impairment

No adjustments necessary

Monitor

Blood glucose AC, PC & HS

Safety and efficacy not established

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Interactions

Interaction Checker

pramlintide and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            >10%

            Nausea

            Headache

            Vomiting

            Anorexia

            Severe hypoglycemia

            Inflicted injury

            1-10%

            Dizziness

            Fatigue

            Abdominal pain

            Pharyngitis

            Cough

            Arthralgia

            Allergic reaction

            Postmarketing Reports

            Injection site reactions

            Pancreatitis

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            Warnings

            Black Box Warnings

            Pramlintide is used with insulin and has been associated with an increased risk of insulin-induced severe hypoglycemia, particularly in patients with type 1 diabetes

            When severe hypoglycemia associated with pramlintide use occurs, it is seen within 3 hours following injection

            If severe hypoglycemia occurs while operating a motor vehicle or heavy machinery, or while engaging in other high-risk activities, serious injuries may occur. Appropriate patient selection, careful patient instruction, and insulin dose adjustments are critical elements for reducing this risk

            Contraindications

            Hypersensitivity

            Gastroparesis

            Hypoglycemia unawareness

            Cautions

            Risk of severe insulin-induced hypoglycemia; pramlintide alone does not cause hypoglycemia; however, since it is indicated to be coadministered with mealtime insulin therapy, and in this setting there is an increased risk of severe hypoglycemia

            Do not mix with insulin - administer the two separately

            Slows gastric emptying, which may delay the absorption of concomitantly administered oral medications; administer the concomitant oral medication at least 1 hr prior or 2 hr after pramlintide

            Slows gastric emptying; not recommended if taking other medications that alter gastrointestinal motility

            Never share pen between patients even if needle is changed

            Erythema, edema, or pruritus at site of injection reported; may be related to other factors, such as irritants in a skin cleansing agent or improper injection technique

            Proper patient selection

            • Proper patient selection is essential to safe and effective use
            • For use only in patients with type 1 or type 2 diabetes using mealtime insulin who fulfill the following criteria:
            • -failed to achieve adequate glycemic control despite individualized insulin management
            • -receiving ongoing care under the guidance of a healthcare professional skilled in the use of insulin and supported by the services of diabetes educator
            • Not for use in patients with ANY of the following criteria:
            • -poor compliance with current insulin regimen
            • -poor compliance with prescribed self blood glucose monitoring
            • -have a HbA1c >9%
            • -recurrent severe hypoglycemia requiring assistance during the past 6 months
            • -presence of hypoglycemia unawareness
            • -confirmed diagnosis of gastroparesis
            • -require the use of drugs that stimulate gastrointestinal motility
            • -pediatric patients
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            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: Unknown whether excreted in breast milk, use caution

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Mechanism of Action

            Synthetic analog of the polypeptide pancreatic hormone amylin, which slows gastric emptying, supresses glucagon, and regulate appetite

            Pharmacokinetics

            Half-Life: 48 min

            Bioavailability: 30-40%

            Metabolism: kidneys

            Excretion: Primarily urine

            Duration: 3 hr

            Protein binding: 60%

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            Images

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            Formulary

            FormularyPatient Discounts

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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