Dosing & Uses
Dosage Forms & Strengths
pen-injector
- 15mcg/dose
- 30mcg/dose
- 45mcg/dose
- 60mcg/dose
- 120mcg/dose
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
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (7)
- insulin aspart
insulin aspart, pramlintide. Mechanism: unspecified interaction mechanism. Contraindicated. Must be administered separately.
- insulin detemir
insulin detemir, pramlintide. Mechanism: unspecified interaction mechanism. Contraindicated. Must be administered separately.
- insulin glargine
insulin glargine, pramlintide. Mechanism: unspecified interaction mechanism. Contraindicated. Must be administered separately.
- insulin glulisine
insulin glulisine, pramlintide. Mechanism: unspecified interaction mechanism. Contraindicated. Must be administered separately.
- insulin lispro
insulin lispro, pramlintide. Mechanism: unspecified interaction mechanism. Contraindicated. Must be administered separately.
- insulin NPH
insulin NPH, pramlintide. Mechanism: unspecified interaction mechanism. Contraindicated. Must be administered separately.
- insulin regular human
insulin regular human, pramlintide. Mechanism: unspecified interaction mechanism. Contraindicated. Must be administered separately.
Serious - Use Alternative (42)
- acarbose
pramlintide, acarbose. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI nutrient absorption.
- aclidinium
pramlintide, aclidinium. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.
- anticholinergic/sedative combos
pramlintide, anticholinergic/sedative combos. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.
- atracurium
pramlintide, atracurium. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.
- atropine
pramlintide, atropine. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.
- atropine IV/IM
pramlintide, atropine IV/IM. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.
- belladonna alkaloids
pramlintide, belladonna alkaloids. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.
- belladonna and opium
pramlintide, belladonna and opium. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.
- cisatracurium
pramlintide, cisatracurium. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.
- cyclizine
pramlintide, cyclizine. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.
- cyclobenzaprine
pramlintide, cyclobenzaprine. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.
- darifenacin
pramlintide, darifenacin. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.
- dicyclomine
pramlintide, dicyclomine. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.
- diphenhydramine
pramlintide, diphenhydramine. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.
- fesoterodine
pramlintide, fesoterodine. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.
- flavoxate
pramlintide, flavoxate. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.
- glycopyrrolate
pramlintide, glycopyrrolate. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.
- glycopyrrolate inhaled
pramlintide, glycopyrrolate inhaled. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.
- henbane
pramlintide, henbane. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.
- homatropine
pramlintide, homatropine. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.
- hyoscyamine
pramlintide, hyoscyamine. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.
- hyoscyamine spray
pramlintide, hyoscyamine spray. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.
- incobotulinumtoxinA
pramlintide, incobotulinumtoxinA. pharmacodynamic synergism. Avoid or Use Alternate Drug. Synergistic inhibition of GI motility.
- ipratropium
pramlintide, ipratropium. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.
- meclizine
pramlintide, meclizine. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.
- methscopolamine
pramlintide, methscopolamine. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.
- miglitol
pramlintide, miglitol. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI nutrient absorption.
- onabotulinumtoxinA
pramlintide, onabotulinumtoxinA. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.
- oxybutynin
pramlintide, oxybutynin. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.
- oxybutynin topical
pramlintide, oxybutynin topical. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.
- oxybutynin transdermal
pramlintide, oxybutynin transdermal. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.
- pancuronium
pramlintide, pancuronium. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.
- pralidoxime
pramlintide, pralidoxime. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.
- propantheline
pramlintide, propantheline. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.
- rapacuronium
pramlintide, rapacuronium. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.
- rocuronium
pramlintide, rocuronium. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.
- scopolamine
pramlintide, scopolamine. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.
- solifenacin
pramlintide, solifenacin. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.
- tiotropium
pramlintide, tiotropium. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.
- tolterodine
pramlintide, tolterodine. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.
- trospium chloride
pramlintide, trospium chloride. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.
- vecuronium
pramlintide, vecuronium. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Synergistic inhibition of GI motility.
Monitor Closely (30)
- albiglutide
albiglutide, pramlintide. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Concurrent use may increase risk of hypoglycemia; monitor glucose levels.
- aripiprazole
aripiprazole, pramlintide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- asenapine
asenapine, pramlintide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- atazanavir
atazanavir decreases effects of pramlintide by Other (see comment). Use Caution/Monitor. Comment: Reports of hyperglycemia due to insulin resistance with protease inhibitors. .
- benztropine
pramlintide, benztropine. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Synergistic inhibition of GI motility.
- darunavir
darunavir decreases effects of pramlintide by Other (see comment). Use Caution/Monitor. Comment: Reports of hyperglycemia due to insulin resistance with protease inhibitors. .
- dulaglutide
dulaglutide, pramlintide. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.
- fosamprenavir
fosamprenavir decreases effects of pramlintide by Other (see comment). Use Caution/Monitor. Comment: Reports of hyperglycemia due to insulin resistance with protease inhibitors. .
- iloperidone
iloperidone, pramlintide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- indinavir
indinavir decreases effects of pramlintide by Other (see comment). Use Caution/Monitor. Comment: Reports of hyperglycemia due to insulin resistance with protease inhibitors. .
- insulin degludec
pramlintide, insulin degludec. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Pramlintide is indicated to be used in combination with insulin; however, pamlintide increases risk of insulin-induced hypoglycemia; reduce prandial insulin dose when initiating pramlintide.
- insulin degludec/insulin aspart
pramlintide, insulin degludec/insulin aspart. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Pramlintide is indicated to be used in combination with insulin; however, pamlintide increases risk of insulin-induced hypoglycemia; reduce prandial insulin dose when initiating pramlintide.
- insulin inhaled
pramlintide, insulin inhaled. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Pramlintide is indicated to be used in combination with insulin; however, pamlintide increases risk of insulin-induced hypoglycemia; reduce prandial insulin dose when initiating pramlintide.
- liraglutide
liraglutide, pramlintide. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Concurrent use may increase risk of hypoglycemia; monitor glucose levels.
- lonapegsomatropin
lonapegsomatropin decreases effects of pramlintide by Other (see comment). Modify Therapy/Monitor Closely. Comment: Closely monitor blood glucose when treated with antidiabetic agents. Lonapegsomatropin may decrease insulin sensitivity, particularly at higher doses. Patients with diabetes mellitus may require adjustment of their doses of insulin and/or other antihyperglycemic agents.
lonapegsomatropin decreases effects of pramlintide by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Growth hormone (GH) analogs may decrease insulin sensitivity, particularly at higher doses. Antidiabetic agents may require dose adjustment after initiating growth hormone. - lopinavir
lopinavir decreases effects of pramlintide by Other (see comment). Use Caution/Monitor. Comment: Reports of hyperglycemia due to insulin resistance with protease inhibitors. .
- lurasidone
lurasidone, pramlintide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- nelfinavir
nelfinavir decreases effects of pramlintide by Other (see comment). Use Caution/Monitor. Comment: Reports of hyperglycemia due to insulin resistance with protease inhibitors. .
- olanzapine
olanzapine, pramlintide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- paliperidone
paliperidone, pramlintide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- quetiapine
quetiapine, pramlintide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- risperidone
risperidone, pramlintide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
- ritonavir
ritonavir decreases effects of pramlintide by Other (see comment). Use Caution/Monitor. Comment: Reports of hyperglycemia due to insulin resistance with protease inhibitors. .
- saquinavir
saquinavir decreases effects of pramlintide by Other (see comment). Use Caution/Monitor. Comment: Reports of hyperglycemia due to insulin resistance with protease inhibitors. .
- somapacitan
somapacitan decreases effects of pramlintide by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Growth hormone (GH) analogs may decrease insulin sensitivity, particularly at higher doses. Antidiabetic agents may require dose adjustment after initiating growth hormone.
- somatrogon
somatrogon decreases effects of pramlintide by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Growth hormone (GH) analogs may decrease insulin sensitivity, particularly at higher doses. Antidiabetic agents may require dose adjustment after initiating growth hormone.
- somatropin
somatropin decreases effects of pramlintide by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Growth hormone (GH) analogs may decrease insulin sensitivity, particularly at higher doses. Antidiabetic agents may require dose adjustment after initiating growth hormone.
- tipranavir
tipranavir decreases effects of pramlintide by Other (see comment). Use Caution/Monitor. Comment: Reports of hyperglycemia due to insulin resistance with protease inhibitors. .
- trihexyphenidyl
pramlintide, trihexyphenidyl. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Synergistic inhibition of GI motility.
- ziprasidone
ziprasidone, pramlintide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.
Minor (0)
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
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
Confirmed gastroparesis
Hypoglycemia unawareness
Cautions
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 to injection or 2 hr after injection if rapid onset or threshold concentration of concomitant medication is a critical determinant of its effectiveness (such as with analgesics, antibiotics, and oral contraceptives)
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
Hypoglycemia
- 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, particularly in patients with type 1 diabetes
- If severe hypoglycemia occurs with therapy, it is usually seen within first 2-3 hr following injection
- If severe hypoglycemia occurs while operating a motor vehicle, heavy machinery, or while engaging in other high-risk activities, serious injuries or death may occur
- When introducing therapy, appropriate precautions need to be taken to avoid increasing risk for severe hypoglycemia; these precautions include frequent monitoring of pre- and post-meal glucose combined with initial 50% reduction in doses of mealtime insulin
- Early warning symptoms of hypoglycemia may be different or less pronounced under certain conditions, such as longstanding diabetes; diabetic neuropathy; use of medications such as beta-blockers, clonidine, guanethidine, or reserpine; or intensified glycemic control
- Addition of any anti-diabetic medication, such as this one, to an existing regimen of one or more anti-diabetic medications (eg, sulfonylurea), or other medications that can increase risk of hypoglycemia may necessitate further insulin dose adjustments and particularly close monitoring of blood glucose
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
Pregnancy & Lactation
Pregnancy
Available data from a small number of reports in manufacturer’s safety database on use in pregnant women are not sufficient to determine a drug-associated risk for major birth defects, miscarriage, or other adverse maternal or fetal outcomes; there are risks to mother and fetus associated with poorly controlled diabetes in pregnancy
Ex-vivo studies using term perfused human, rabbit, and rat placentas indicate that drug has low potential to cross maternal/fetal placental barrier
Poorly controlled diabetes in pregnancy increases maternal risk for diabetic ketoacidosis, preeclampsia, spontaneous abortions, preterm delivery, and delivery complications; poorly controlled diabetes increases fetal risk for major birth defects, stillbirth, and macrosomia related morbidity
Animal data
- In animal reproduction studies, congenital abnormalities were observed in fetuses of pregnant rats but not in fetuses of pregnant rabbits exposed during organogenesis to drug at 10 times clinical dose of 360 mcg/day, based on exposure
Lactation
There is no data on presence in human milk, effects on breastfed infant, or on milk production; developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for drug and any potential adverse effects on breastfed child from drug or from underlying maternal condition
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.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%
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| SymlinPen 60 subcutaneous - | 1,500 mcg/1.5 mL injection |  | |
| SymlinPen 120 subcutaneous - | 2,700 mcg/2.7 mL injection |  |
Copyright © 2010 First DataBank, Inc.
Patient Handout
pramlintide subcutaneous
PRAMLINTIDE INJECTOR - INJECTION
(PRAM-lin-tide)
COMMON BRAND NAME(S): Symlinpen
WARNING: Pramlintide may increase the risk of very low blood sugar when used with insulin, particularly in patients with type 1 diabetes. This reaction is most likely to occur within 3 hours after an injection. Your doctor may decrease your insulin dose when you start pramlintide. Low blood sugar makes it hard to think clearly, drive a car, use heavy machinery, or safely participate in other activities that include a risk of hurting yourself or others. (See also Side Effects and Precautions sections.)
USES: Pramlintide is used with mealtime insulin and a proper diet and exercise program to control high blood sugar in people with type 1 and type 2 diabetes. It is used when patients who are already using insulin need better blood sugar control. Controlling high blood sugar helps prevent kidney damage, blindness, nerve problems, loss of limbs, and sexual function problems. Proper control of diabetes may also lessen your risk of a heart attack or stroke.Pramlintide acts like a certain natural substance called amyrin, which lowers blood sugar. This drug works by slowing the movement of food through your stomach. It also decreases your appetite and the amount of sugar your liver makes. Pramlintide does not replace insulin, but it may lower the amount of insulin you need.This medication should not be used by people who are unable to tell when they have symptoms of low blood sugar (such as children).
HOW TO USE: Read the Medication Guide provided by your pharmacist before you start using pramlintide and each time you get a refill. If you have any questions, consult your doctor or pharmacist.Inject this medication under the skin of the thigh or abdomen just before each main meal. Do not use pramlintide if your blood sugar is too low, if you are planning to eat a small meal (less than 250 calories or 30 grams of carbohydrate), or if you are skipping a meal.The liquid in the pre-filled injector is stronger than the liquid in the vial. Make sure you are using the correct product. Do not switch between products unless directed by your doctor.Make sure you learn from your health care professional how to measure your dose and inject this drug. Always use a new needle for each injection. Consult your doctor or pharmacist if you have any questions. If you are storing this drug in the refrigerator, remove it and allow it to come to room temperature before injecting. Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid. Before injecting each dose, clean the injection site with rubbing alcohol. It is important to change the location of the injection site daily to avoid problems under the skin. Never mix pramlintide and insulin in the same syringe or at the same injection site. Inject pramlintide in an area that is at least 2 inches (5 centimeters) away from your insulin injection site.Your dosage is based on your medical condition, use of other medications, and response to treatment. To reduce the risk of nausea, your doctor may direct you to start at a low dose of pramlintide and gradually increase the dose. Your doctor may also direct you to lower your insulin dose and to check you blood sugar more often. Do not change your dosage without consulting your doctor. Use this medication regularly in order to get the most benefit from it.Do not share your pen device with another person, even if the needle is changed. You may give other people a serious infection, or get a serious infection from them. Learn how to store and discard medical supplies safely.
SIDE EFFECTS: Nausea, vomiting, tiredness, and upset stomach may occur as your body adjusts to the medication. Nausea can be reduced by starting at a low dose and increasing the dose slowly. Redness, swelling and itching at the injection site may occur and usually go away in a few days. If any of these effects last or get worse, contact your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Though pramlintide does not cause low blood sugar (hypoglycemia) by itself, this effect can occur because it is used with insulin. This may also occur if you do not consume enough calories from food or if you do unusually heavy exercise. Symptoms of low blood sugar include sudden sweating, shaking, fast heartbeat, hunger, blurred vision, dizziness, or tingling hands/feet. It is a good habit to carry glucose tablets or gel to treat low blood sugar. If you don't have these reliable forms of glucose, rapidly raise your blood sugar by eating a quick source of sugar such as table sugar, honey, or candy, or drink fruit juice or non-diet soda. Tell your doctor right away about the reaction and the use of this product. To help prevent low blood sugar, eat meals on a regular schedule, and do not skip meals. Check with your doctor or pharmacist to find out what you should do if you miss a meal.Symptoms of high blood sugar (hyperglycemia) include thirst, increased urination, confusion, drowsiness, flushing, rapid breathing, and fruity breath odor. If these symptoms occur, tell your doctor right away. Your dosage may need to be increased.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Before using pramlintide, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients (such as the preservative metacresol), which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using pramlintide, tell your doctor or pharmacist your medical history, especially of: stomach/intestinal disorders (for example, digestion problems such as gastroparesis), attacks of low blood sugar (hypoglycemia) that required treatment.You may experience blurred vision, dizziness, or drowsiness due to extremely low or high blood sugar. Do not drive, use machinery, or do any activity that requires alertness or clear vision until you are sure you can perform such activities safely. Limit alcoholic beverages because alcohol can affect your blood sugar.It may be harder to control your blood sugar when your body is stressed (such as due to fever, infection, injury, or surgery). Consult your doctor because this may require a change in your treatment plan, medications, or blood sugar testing.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is unknown if pramlintide passes into breast milk. Consult your doctor before breast-feeding.
DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug are: diabetes drugs (including alpha glucosidase inhibitors such as acarbose/miglitol), darifenacin, drugs for high blood pressure that may make it harder to notice symptoms of low blood sugar (such as clonidine, guanethidine), drugs that slow down or speed up movement of food through your stomach (causing constipation or diarrhea; drugs such as atropine, exenatide, metoclopramide), solifenacin.Some other medications may not work as well if used at the same time as pramlintide. Affected products include antibiotics, birth control pills, pain relievers (such as acetaminophen), among others. If you are using any of the those drugs, use them at least 1 hour before or 2 hours after your injection. If you have any questions about when to take your other medications, ask your pharmacist.If you are using a medication that needs to be taken with food, take it with a small meal or snack (less than 250 calories or 30 grams of carbohydrate) at a time when you do not normally inject pramlintide.Beta blocker medications (such as metoprolol, propranolol, glaucoma eye drops such as timolol) may prevent the fast/pounding heartbeat you would usually feel when your blood sugar falls too low (hypoglycemia). Other symptoms of low blood sugar such as dizziness, hunger, or sweating are unaffected by these drugs.Many drugs can affect your blood sugar, making it harder to control. Before you start, stop, or change any medication, talk with your doctor or pharmacist about how the medication may affect your blood sugar. Check your blood sugar regularly as directed and share the results with your doctor. Tell your doctor right away if you have symptoms of high or low blood sugar. (See also Side Effects section.) Your doctor may need to adjust your diabetes medication, exercise program, or diet.
OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: severe nausea, vomiting, diarrhea, flushing, dizziness.
NOTES: Do not share this medication, syringes, or needles with others.Attend a diabetes education program to learn more about how to manage your diabetes with medications, diet, exercise, and regular medical exams.Lab and/or medical tests (such as fasting blood glucose, hemoglobin A1c) should be done while you are using this medication. Keep all medical and lab appointments. Check your blood sugar regularly as directed (usually before and after meals and at bedtime) and share the results with your doctor.
MISSED DOSE: If you miss a dose, skip the missed dose. Use your next dose at the regular time. Do not double the dose to catch up.
STORAGE: Store injectors you are not currently using in the refrigerator. Protect from light. Do not freeze. Discard injectors that have been frozen or overheated. The injector you are currently using can be stored in the refrigerator or at room temperature for up to 30 days as long as the temperature is not higher than 86 degrees F (30 degrees C). Discard the injector 30 days after first use whether or not it has been refrigerated, even if some drug remains in the injector. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
MEDICAL ALERT: Your condition can cause complications in a medical emergency. For information about enrolling in MedicAlert, call 1-888-633-4298 (US) or 1-800-668-1507 (Canada).
Information last revised May 2023. Copyright(c) 2023 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Formulary
Adding plans allows you to compare formulary status to other drugs in the same class.
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.
