8 mins read

Overview: Symlin is used along with insulin to help manage blood sugar in people with type 1 or type 2 diabetes. It is injected under the skin before meals. It works by slowing stomach emptying, decreasing the amount of glucose (sugar) made by the liver, and regulating appetite. Common side effects include nausea and vomiting, stomach pain, and reduced appetite. Symlin can sometimes cause very low blood sugar. Make sure you know how to prevent, recognize, and treat low blood sugar while using this medicine.

Uses

What is Symlin used for?

Symlin (pramlintide) is commonly used as an add-on to insulin to help lower blood sugar in people with type 1 diabetes or type 2 diabetes.

Symlin may also be used for other conditions as determined by your health care provider.

How does Symlin work (mechanism of action)?

Symlin acts like a natural hormone in your body called amylin. It works to lower blood sugar levels by slowing stomach emptying, decreasing the amount of glucose (sugar) made by the liver, and regulating appetite.

How is Symlin supplied (dosage forms)?

Brands and other names

  • Symlin
  • SymlinPen

Dosage forms and strengths

  • 1,000 mcg/mL, 1.5 mL pen-injector that gives doses of 15 mcg, 30 mcg, 45 mcg, and 60 mcg
  • 1,000 mcg/mL, 2.7 mL pen-injector that gives doses of 60 mcg and 120 mcg

How should I store Symlin?

Unopened Pen. Symlin should be stored in the refrigerator, between 36 F and 46 F (2 C and 8 C) before using it. Protect from light, and do not freeze. Do not use your pen if it has been frozen.

Opened Pen. Once opened, Symlin can be stored at room temperature or in the refrigerator, between 36 F and 86 F (2 C and 30 C) for up to 30 days. Throw away the pen after 30 days, even if there is still medicine left. 

Do not use unopened or opened Symlin after the expiration date on the carton and prescription label. 

Side Effects

What are the most common side effects of Symlin?

The most common side effects of Symlin are listed below. Tell your health care provider if you have any of these side effects that bother you.

  • Nausea and vomiting
  • Stomach pain
  • Headache
  • Loss of appetite

There may be other side effects of Symlin that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of Symlin?

While less common, the most serious side effects of Symlin are described below, along with what to do if they happen.

Low Blood Sugar (Hypoglycemia). Symlin can cause severely low blood sugar when used with insulin. Low blood sugar can be serious and may lead to death. The risk of low blood sugar is higher in people with type 1 diabetes, but it can also happen in people with type 2 diabetes. You may need to check your blood sugar more often if you have changes to your diet, exercise regimen, or medicines for diabetes. Do not use Symlin, and call your health care provider right away if you have any of the following symptoms of hypoglycemia.

  • Headache
  • Crankiness or anxiety
  • Hunger
  • Dizziness or confusion
  • Blurry vision
  • Slurred speech
  • Sweating
  • Feeling jittery or shakiness
  • Fast heartbeat
  • Seizures

Severe Allergic Reactions. Symlin may cause allergic reactions, which can be serious. Stop using Symlin and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Injection Site Reactions. Symlin may cause redness, bruising, swelling, or itching near where it is injected. These mild reactions usually go away in a few days or weeks. You should change injection sites each time you use Symlin. You should also inject Symlin at least 2 inches away from where you inject insulin. Do not inject Symlin and insulin in the same spot. To help lower the chances of an injection site reaction, let Symlin come to room temperature before injecting it. Call your health care provider if you have an injection site reaction that bothers you or does not go away.

Warnings & Precautions

Who should not use Symlin?

Allergies to Ingredients. People who are allergic to any of the following should not use Symlin.

  • Pramlintide
  • Symlin or SymlinPen
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in Symlin.

Unaware of Low Blood Sugar. Symlin should not be used if you can’t tell if your blood sugar is low or you do not have symptoms of low blood sugar. This is called hypoglycemia unawareness. 

Slowed Stomach Emptying. Symlin should not be used if you have slowed stomach emptying, which is called gastroparesis.

What should I know about Symlin before using it?

Do not use Symlin unless it has been prescribed to you by a health care provider. Use it as prescribed. 

This medicine is injected under the skin (subcutaneously). Read and follow the instructions and make sure that you or a caregiver understands how to properly prepare and use Symlin. If you have any questions, talk to your health care provider. 

Symlin should be given right before each meal that has at least 250 calories or at least 30 grams of carbohydrates.

Symlin is not a replacement for insulin. However, you may need to use less insulin while using Symlin. Follow your health care provider’s instructions on how much of each medicine to use, how often to check your blood sugar, and how to change your dose. Tell your health care provider if you have nausea or low blood sugar while using Symlin. Ask your health care provider how to prevent, recognize, and treat low blood sugar.

Do not mix Symlin and insulin in one syringe. They must be given as separate injections at different injection sites. 

Your health care provider will monitor you closely while you are using Symlin. Keep all appointments, including for blood tests. 

Do not share Symlin with other people, even if they have the same condition as you. It may harm them. Use a new needle for each injection, and do not share needles or pens with other people. This could increase your risk of getting a serious infection. Throw away needles and used pens in a sharps container. 

Keep Symlin out of the reach of children. When storing this medicine in a refrigerator, take special precautions to keep it away from children who also use the refrigerator.

Symlin can cause low blood sugar, which can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how Symlin affects you. 

What should I tell my health care provider before using Symlin?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if Symlin is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your health care provider if you have any of the following.

  • Hypoglycemia unawareness (when you are unaware of low blood sugar) or a history of frequent episodes of low blood sugar or very low blood sugar
  • Slowed stomach emptying, also called gastroparesis
  • Trouble using insulin or checking your blood sugar as directed by your health care provider
  • Trouble with your vision or using your hands

Planned Surgery. Tell your health care provider if you have a planned surgery or procedure. These may affect your blood sugar levels and the amount of Symlin or insulin you need.

Illness. Tell your health care provider if you are ill. This may affect your blood sugar levels and the amount of Symlin or insulin you need.

Other Medicines and Supplements. Symlin may interact with other medicines and supplements. Before using Symlin, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. It is not known if or how Symlin could affect pregnancy or harm a fetus. Tell your health care provider if you are pregnant or plan to become pregnant.

Breastfeeding. It is not known if Symlin passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will let you know if you should use Symlin while breastfeeding.

How can I get more information about Symlin?

For more information about Symlin, you can call the drugmaker at 800-236-9933.

Interactions

Does Symlin interact with foods or drinks?

There are no known interactions between Symlin and foods or drinks.

Avoid drinking alcohol while using Symlin. Alcohol can increase your risk of having severely low blood sugar. 

Does Symlin interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before using Symlin.

  • Insulin or any other medicine for diabetes, including acarbose, miglitol, or a sulfonylurea, such as glimepiride, glipizide, or glyburide
  • An anticholinergic medicine, which includes antihistamines and medicines commonly used for overactive bladder, Parkinson’s disease, or stomach problems
  • A birth control pill
  • Any type of antibiotic, which is a medicine used to treat certain infections
  • Any medicine used to treat pain
  • An angiotensin-converting enzyme (ACE) inhibitor, such as enalapril or lisinopril, which is a medicine for high blood pressure, heart failure, and certain kidney problems
  • A fibrate, such as fenofibrate (Tricor), fenofibric acid (Fibricor, Trilipix), or gemfibrozil (Lopid), which is a medicine for high cholesterol
  • A monoamine oxidase inhibitor (MAOI), which is a medicine usually used for depression or Parkinson’s disease
  • Fluoxetine (Prozac and others), which is a selective serotonin reuptake inhibitor (SSRI) commonly used for depression and other mental health conditions
  • A salicylate, such as diflunisal or salsalate, which is a medicine used for arthritis
  • Disopyramide (Norpace, Norpace CR), which is a medicine used to treat certain abnormal heart rhythms
  • Pentoxifylline, which is a medicine used for intermittent claudication
  • A somatostatin analog, such as octreotide (Sandostatin and others)

Symlin may affect the absorption of some medicines that you take by mouth. You may need to take certain medicines by mouth at least one hour before or two hours after using Symlin. Tell your health care provider about all medicines that you take or have recently taken. Your health care provider can give you advice on the best time to take your medicines.

This may not be a complete list of medicines that can interact with Symlin. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much Symlin?

If you or someone else has used too much Symlin, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of Symlin?

If you miss a dose, skip the missed dose and use the next dose at your next meal. Do not use double or extra doses.