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In adult patients with diabetes not adequately controlled on mealtime insulin

SYMLIN FAQs

Q: What is the most important information I should know about SYMLIN® (pramlintide acetate) injection?

SYMLIN can cause serious side effects, including:

  • severe low blood sugar (hypoglycemia). 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 severe low blood sugar (hypoglycemia) happens, it is seen within 3 hours after a SYMLIN injection. Symptoms of severe low blood sugar and low blood sugar include:
  • lightheadedness
  • dizziness
  • shakiness
  • sweating
  • hunger
  • fast heartbeat
  • trouble concentrating or confusion
  • change in vision
  • headache
  • irritability
  • drowsiness

People who have severely low blood sugar have had injuries while driving their car, operating heavy machinery, or doing other dangerous activities. You and your healthcare provider should talk about a plan to treat low blood sugar. You should have fast-acting sugar (such as hard candy, glucose tablets, juice) or glucagon for injection with you at all times. Call your healthcare provider if you have severe low blood sugar or if you have low blood sugar more often than normal.

You have a higher chance of getting severe low blood sugar if you:

  • do not follow your healthcare provider’s instructions to reduce your insulin use before meals
  • use more SYMLIN or insulin than prescribed by your healthcare provider
  • change your insulin dose without checking your blood sugar
  • eat less food than your usual meal
  • are sick and cannot eat
  • are more active than usual
  • have a low blood sugar level before eating
  • drink alcohol

SYMLIN is used with insulin to lower blood sugar, especially high blood sugar that happens after meals.

SYMLIN is taken at mealtimes. The use of SYMLIN does not replace your daily insulin but may lower the amount of insulin you need, especially before meals.

Do not share your SymlinPen with other people, even if the needle is changed. You may give other people a serious infection, or get a serious infection from them.

Q: What is SYMLIN?

SYMLIN is an injectable prescription medicine used to treat adults with type 1 and type 2 diabetes to control blood sugar. SYMLIN is used when your mealtime insulin dose has not controlled your blood sugar well enough.

It is not known if SYMLIN is safe and effective in children.

Q: What is amylin?

Amylin is a hormone secreted by beta cells located in the pancreas, the same cells that also secrete insulin. Amylin works by:

  • Slowing down how quickly the stomach empties, slowing the appearance of sugar in your blood.
  • Suppressing the release of glucagon, a hormone that triggers the liver to make sugar, when it's not needed.
  • Helping reduce the amount of food you eat by balancing feelings of fullness after meals.*

*SYMLIN is not a weight-loss product. Individual results may vary.

Q: Who should not use SYMLIN?

Do not use SYMLIN if you:

  • are allergic to SYMLIN or any ingredients in SYMLIN. See Medication Guide for a complete list of ingredients in SYMLIN.
  • cannot tell when your blood sugar is low (hypoglycemia unawareness).
  • have a stomach problem called gastroparesis. This is when your stomach does not empty as fast as it should.

Q: Who should use SYMLIN?

SYMLIN should only be used by adults with type 1 and type 2 diabetes who:

  • already use their mealtime insulin as prescribed, but still need better blood sugar control.
  • will follow their healthcare provider’s instructions exactly.
  • will follow up with their healthcare provider often.
  • will test their blood sugar levels frequently, as directed by their healthcare provider.
  • understand how to adjust SYMLIN and insulin doses, as directed by their healthcare provider.

Q: What should I tell my healthcare provider before using SYMLIN?

Before you use SYMLIN, tell your healthcare provider about all of your medical conditions, including if you:

  • are pregnant or plan to become pregnant. It is not known if SYMLIN will harm your unborn baby. You and your healthcare provider should decide how to best control your blood sugar levels during pregnancy.
  • are breastfeeding or plan to breastfeed. It is not known if SYMLIN passes into your breastmilk. You and your healthcare provider should decide about the best way to feed your baby if you are using SYMLIN.

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. SYMLIN slows stomach emptying and can affect medicines that need to pass through the stomach quickly.

Q: How should I use SYMLIN?

  • Read the Instructions for Use and the Medication Guide that come with your SYMLIN for information about the right way to use SYMLIN.
  • Use SYMLIN exactly as your healthcare provider tells you to use it.
  • Your healthcare provider will tell you how much SYMLIN to use and when to use it.
  • Your healthcare provider may change your dose if needed.
  • If you stop taking SYMLIN for any reason, such as surgery or illness, talk to your healthcare provider about how to re-start SYMLIN.
  • To reduce the risk of hypoglycemia, it is important that you plan your meals and physical activity every day while you use SYMLIN. Plan for what you will eat and when you will eat your meals.
  • The amount of SYMLIN you use will depend on whether you have type 1 or type 2 diabetes.
  • The way you inject SYMLIN is similar to the way you inject insulin. Inject SYMLIN under the skin of your stomach area (abdomen) or upper leg (thigh). Inject SYMLIN at a site that is more than 2 inches away from your insulin injection. Do not inject SYMLIN and insulin in the same site.
  • To help reduce the chances of getting a reaction at the injection site, allow SYMLIN to come to room temperature before injecting.
  • Use a new needle for each SYMLIN injection. Do not reuse or share your needles with other people. You may give other people a serious infection, or get a serious infection from them.
  • Never mix SYMLIN and insulin. Insulin can affect SYMLIN when they are mixed together.
  • Do not use SYMLIN if the liquid looks cloudy.
  • If you take more than your prescribed dose of SYMLIN, you may get nauseous or vomit, and may not be able to eat the amount of food you usually eat. If you take more SYMLIN than your prescribed dose, pay careful attention to the amount of insulin you use because you may be at more risk for low blood sugar. Contact your healthcare provider for guidance.
  • 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 of SYMLIN.
  • Do not share your SymlinPen with other people, even if the needle is changed. You may give other people a serious infection, or get a serious infection from them.

Q: 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 of SYMLIN.

Q: What should I avoid while using SYMLIN?

  • See What is the most important information I should know about SYMLIN?
  • Do not drive, operate machinery, or do other dangerous activities until you know how SYMLIN affects you. Talk to your healthcare provider about the activities you should avoid.
  • Alcohol. Drinking alcohol may increase your chances of getting severe low blood sugar.

Q: What are the most common side effects with SYMLIN?

The most common side effects of SYMLIN include:

  • nausea
  • vomiting
  • decreased appetite
  • stomach pain
  • headache

Tell your healthcare provider if you have any side effect that bothers you or that does not go away.

These are not all the possible side effects of SYMLIN. For more information, ask your healthcare provider or pharmacist.

Q: What should I know about SYMLIN and hypoglycemia (low blood sugar) and my insulin dose?

SYMLIN can cause low blood sugar (hypoglycemia). When starting SYMLIN, reduce your dose of insulin before meals as directed by your healthcare provider to reduce the chance of low blood sugar.

You and your healthcare provider should talk about a plan to treat low blood sugar. You should have fast-acting sugar (such as hard candy, glucose tablets, juice) or glucagon for injection with you at all times. Call your healthcare provider if you have low blood sugar more often than normal or if you have severe low blood sugar.

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