Pramlintide Acetate, Injection

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What are other names for this medicine?

Type of medicine: antihyperglycemic; antidiabetic

Generic and brand names: pramlintide acetate, injection; SYMLIN

What is this medicine used for?

This medicine is given by injection (shots) along with insulin to treat diabetes mellitus. It helps maintain the proper amount of sugar in the blood.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• an allergic reaction to any medicine
• hypoglycemic episodes (low blood sugar)
• gastroparesis (slow stomach emptying)

Females of childbearing age: Tell your healthcare provider if you are pregnant or plan to become pregnant. It is not known whether this medicine will harm an unborn baby. Do not breast-feed while taking this medicine without your healthcare provider's approval.

How do I use it?

This medicine is injected before meals. Talk with your healthcare provider for specific instructions.

Do not mix this medicine with insulin.

Your healthcare provider will adjust your dosage based on your blood sugar levels. Check the label on the medicine for directions about your specific dose. Measure your dosage very carefully to avoid an overdose, which can lead to a coma.

These shots are given in your abdomen or thigh. Follow your healthcare provider's instructions carefully regarding dosage and times of injection. Measure your doses carefully to avoid overdose (which can cause insulin shock). Be sure you know how and when to have these shots and how much medicine to use.

Use sterile, disposable syringes and needles. Use them only once and dispose of them safely, following your healthcare provider's instructions.

Do not use this medicine if the liquid in the vial looks cloudy.

Wash your hands before using this medicine. Warm the medicine to room temperature before you use it. Follow these steps to give yourself the shots:

1. Choose a site on your abdomen around the belly button but not in the belly button, or in the thigh. Each day, choose a different spot for the shot to lessen irritation. Inject this medicine at least 2 inches away from your insulin injection.
2. Use an alcohol swab to clean the skin where you will give yourself the shot.
3. Gently pinch up the skin and insert the needle into the skin at a 45° angle. After you insert the needle completely, release your grasp of the skin.
4. Inject the medicine by gently and steadily pushing down the plunger.
5. After you have given yourself the shot, withdraw the needle and syringe and press the alcohol swab at the spot where the shot was given.
6. Discard the syringe, needle, and drug vial when empty. Use the syringes and needles ONLY ONCE. Throw them away after use. Put used needles in rigid puncture-resistant containers with lids or caps, such as heavy plastic bleach bottles with screw caps. DO NOT throw needles directly into garbage cans or dumpsters.

If you are not sure of how to give yourself the shots, ask your healthcare provider or pharmacist for help.

What if I miss a dose?

Ask your healthcare provider what to do if you miss a dose.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: nausea, vomiting, loss of appetite, diarrhea, flushing, dizziness.

What should I watch out for?

Follow the diet and exercise program prescribed by your healthcare provider. Eat regular meals and do not skip meals, even when you travel or are sick. Your dosage of this medicine is based on your food intake. Also, your must test your blood sugar tested regularly. Follow your healthcare provider's advice exactly.

Alcohol may affect your response to medicine and food. Do not drink alcohol unless your healthcare provider approves.

Low blood sugar (hypoglycemia) can occur if you miss or delay meals, drink too much alcohol, use too much of this medicine or too much insulin, or exercise more than usual. Symptoms of low blood sugar include confusion, shaking, weakness, strong hunger, cold sweats, headache, nausea, vision problems, and feeling faint. Treat the condition quickly by eating or drinking something with sugar in it such as candy, juice, or nondiet soda. Taking glucose tablets or gels (available in drug stores) is another quick way to treat hypoglycemia.

If you need emergency care, surgery, or dental work, tell the healthcare provider or dentist you are taking this medicine. Carry an ID card or a Medic Alert bracelet. If you become unconscious, the ID tells emergency healthcare providers that you are a diabetic and need special care.

This medicine may make you dizzy. Do not drive or operate machinery unless you are fully alert.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat).

Serious (report this to your healthcare provider if these symptoms happen often): Symptoms of hypoglycemia (confusion, shaking, weakness, strong hunger, cold sweats, headache, nausea, vision problems, and feeling faint), constant nausea.

Other: Mild nausea, loss of appetite, vomiting, stomach pain, tiredness, dizziness, indigestion, redness or pain at the spot where an injection has been given, joint pain.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• ACE inhibitors such as benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril), lisinopril (Prinivil, Zestril), perindopril (Aceon), quinapril (Accupril), ramipril (Altace), and trandolapril (Mavik)
• alcohol
• anticholinergic medicines such as atropine sulfate, belladonna, propantheline (Pro-Banthine), benztropine (Cogentin), dicyclomine (Bentyl), l-hyoscyamine (Levsin, Levsinex), amantadine (Symmetrel), procyclidine (Kemadrin), and trihexyphenidyl (Artane)
• beta blockers such as atenolol (Tenormin), carvedilol (Coreg), carteolol, labetalol (Trandate, Normodyne), metoprolol (Lopressor, Toprol XL), pindolol, propranolol (Inderal), sotalol (Betapace), and timolol
• clonidine
• fluoxetine (Prozac)
• guanethidine
• herbal remedies such as garlic and chromium
• MAO inhibitors such as phenelzine (Nardil), tranylcypromine (Parnate), and isocarboxazid (Marplan) (Do not take this medicine and an MAO inhibitor within 14 days of each other.)
• pentoxifylline (Trental)
• oral medicines for diabetes such as acarbose (Precose) and miglitol (Glyset)
• propoxyphene (Darvon)
• reserpine

Many nonprescription products contain sugar, alcohol, or other ingredients that may interfere with this medicine or increase your blood sugar. Check product labels for warnings for diabetics or ask your healthcare provider or pharmacist for advice.

Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Refrigerate unopened bottles but do not freeze them. Take the medicine out of the refrigerator and allow it to warm to room temperature before using it.

This medicine may be stored at room temperature for up to 1 month. Mark the bottle with the date it was opened. Discard it after a month, even if the bottle is not empty.

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This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicines in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.

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