Pramlintide Injection

What is this medication?

PRAMLINTIDE (PRAM lin tide) treats diabetes. It works by reducing the amount of sugar released into the blood. It also slows down your digestion, which decreases your blood sugar (glucose). Changes to diet and exercise are often combined with this medication.

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

COMMON BRAND NAME(S): Symlin, SymlinPen

What should I tell my care team before I take this medication?

They need to know if you have any of these conditions:

• Hemoglobin A1C value above 9
• Low blood sugar episodes
• Problems checking blood sugar
• Problems taking diabetes medication
• Stomach problems like gastroparesis
• Trouble being able to tell when blood sugar is low
• An unusual or allergic reaction to pramlintide, metacresol, other medications, foods, dyes, or preservatives
• Pregnant or trying to get pregnant
• Breast-feeding

How should I use this medication?

This medication is for injection under the skin. You will be taught how to prepare and give this medication. Use exactly as directed. Do not mix this medication with insulin in the same syringe. Take this medication immediately before meals. Take your medication at regular intervals. Do not take your medication more often than directed.

Always check the appearance of this medication before using it. Do not use it if it is cloudy or has solid particles in it.

It is important that you put your used needles and injector-pens in a special sharps container. Do not put them in a trash can. If you do not have a sharps container, call your pharmacist or care team to get one.

A special MedGuide will be given to you by the pharmacist with each prescription and refill. Be sure to read this information carefully each time.

This medication comes with INSTRUCTIONS FOR USE. Ask your pharmacist for directions on how to use this medication. Read the information carefully. Talk to your pharmacist or care team if you have questions.

Talk to your care team about the use of this medication in children. Special care may be needed.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.

NOTE: This medicine is only for you. Do not share this medicine with others.

What if I miss a dose?

It is important not to miss a dose. Your care team should discuss a plan for missed doses with you. If you do miss a dose, follow their plan. Do not take double doses.

What may interact with this medication?

• Acetaminophen
• Alosetron
• Atropine
• Birth control pills
• Certain medications for bladder problems like oxybutynin
• Certain medications for stomach problems like dicyclomine, hyoscyamine
• Certain medications for travel sickness like scopolamine
• Eluxadoline
• Other medications for diabetes like acarbose, miglitol

Many medications may cause changes in blood sugar, these include:

• Alcohol-containing beverages
• Antiviral medications for HIV or AIDS
• Aspirin and aspirin-like medications
• Certain medications for blood pressure, heart disease, irregular heart beat
• Chromium
• Diuretics
• Female hormones, such as estrogens or progestins, birth control pills
• Fenofibrate
• Gemfibrozil
• Isoniazid
• Lanreotide
• Male hormones or anabolic steroids
• MAOIs like Carbex, Eldepryl, Marplan, Nardil, and Parnate
• Medications for weight loss
• Medications for allergies, asthma, cold, or cough
• Medications for depression, anxiety, or psychotic disturbances
• Niacin
• Nicotine
• NSAIDs, medications for pain and inflammation, like ibuprofen or naproxen
• Octreotide
• Pasireotide
• Pentamidine
• Phenytoin
• Probenecid
• Quinolone antibiotics such as ciprofloxacin, levofloxacin, ofloxacin
• Some herbal dietary supplements
• Steroid medications such as prednisone or cortisone
• Sulfamethoxazole; trimethoprim
• Thyroid hormones

Some medications can hide the warning symptoms of low blood sugar (hypoglycemia). You may need to monitor your blood sugar more closely if you are taking one of these medications. These include:

• Beta-blockers, often used for high blood pressure or heart problems (examples include atenolol, metoprolol, propranolol)
• Clonidine
• Guanethidine
• Reserpine

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

What should I watch for while using this medication?

Visit your care team for regular checks on your progress.

A test called the HbA1C (A1C) will be monitored. This is a simple blood test. It measures your blood sugar control over the last 2 to 3 months. You will receive this test every 3 to 6 months.

Learn how to check your blood sugar. Learn the symptoms of low and high blood sugar and how to manage them.

Always carry a quick-source of sugar with you in case you have symptoms of low blood sugar. Examples include hard sugar candy or glucose tablets. Make sure others know that you can choke if you eat or drink when you develop serious symptoms of low blood sugar, such as seizures or unconsciousness. They must get medical help at once.

Tell your care team if you have high blood sugar. You might need to change the dose of your medication. If you are sick or exercising more than usual, you might need to change the dose of your medication.

Do not skip meals. Ask your care team if you should avoid alcohol. Many nonprescription cough and cold products contain sugar or alcohol. These can affect blood sugar.

Pens should never be shared. Even if the needle is changed, sharing may result in passing of viruses like hepatitis or HIV.

Wear a medical ID bracelet or chain, and carry a card that describes your disease and details of your medication and dosage times.

What side effects may I notice from receiving this medication?

Side effects that you should report to your care team as soon as possible:

• Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat

Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):

• Headache
• Loss of appetite
• Nausea
• Pain, redness, or irritation at injection site
• Stomach pain
• Vomiting

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Where should I keep my medication?

Keep out of the reach of children and pets.

Store unopened injector-pens in the refrigerator between 2 to 8 degrees C (36 to 46 degrees F). Do not freeze. Throw away any unused medication after the expiration date.

Store opened injector-pens (pens currently in use) in the refrigerator or at room temperature of not greater than 30 degrees C (86 degrees F) for up to 30 days. Do not freeze. Keeping this medication at room temperature decreases the amount of pain during injection. Throw away any opened pens of this medication 30 days after opening.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.