Symlin Injection: Uses, Dosage, Side Effects, Precautions and Alternates

Quick overview

Symlin Injection (pramlintide acetate) is an amylin analog given by injection along with mealtime insulin to help adults with type 1 or type 2 diabetes manage their blood sugar, especially after meals. It is used when blood sugar goals have not been reached despite the best insulin treatment. Symlin works like the natural hormone amylin, slowing stomach emptying, reducing liver sugar release, and helping you feel full.

What is Symlin Injection

Symlin is a man-made version of a hormone called amylin that your body normally makes. It is given by injection along with insulin to help people with type 1 or type 2 diabetes control their blood sugar, especially after meals.

Symlin Injection uses

• Used along with mealtime insulin in adults with type 1 diabetes who have not reached their blood sugar goals despite the best insulin treatment.
• Used along with mealtime insulin in adults with type 2 diabetes who have not reached their blood sugar goals despite the best insulin treatment.

Benefits of Symlin Injection

• Lowers blood sugar spikes that happen after meals.
• May lower the amount of mealtime insulin you need.
• Can reduce swings in blood sugar levels throughout the day.
• May reduce food intake and support modest weight loss.

How Symlin Injection works

Symlin works like the natural hormone amylin. It slows how fast food leaves the stomach, reduces the amount of sugar the liver releases into the blood, and helps you feel full so you eat less.

Symlin Injection dosage

Inject Symlin under the skin of the stomach area or thigh right before a major meal; do not inject into the arm because absorption is less predictable. A major meal should have a minimum amount of calories or carbohydrate content for the dose to be given.

Never mix Symlin and insulin together in the same syringe; always give them as two separate injections at sites more than 2 inches apart. Let the pen come to room temperature before injecting to help reduce injection site reactions. Rotate injection sites so the same spot is not used repeatedly. Use a new needle for every injection and never share your pen or needles with another person.

If you skip a meal, skip that dose of Symlin and take your usual dose at your next meal; do not double up. When starting Symlin, your mealtime insulin dose will need to be reduced, and your doctor will guide you on adjusting it over time.

Check the liquid before injecting; it should be clear and colorless, with no cloudiness, color, or particles. Take other oral medicines either well before or a couple of hours after your Symlin injection if those medicines need to act quickly, since Symlin slows stomach emptying. Avoid driving or doing activities that need alertness until you know how Symlin affects you, especially regarding low blood sugar risk.

Available forms and strengths

• 1.5 mL SymlinPen 60 disposable multidose pen-injector (1000 mcg/mL) for 15, 30, 45, and 60 mcg doses
• 2.7 mL SymlinPen 120 disposable multidose pen-injector (1000 mcg/mL) for 60 and 120 mcg doses

Side effects of Symlin Injection

Common

• Nausea
• Vomiting
• Decreased appetite (anorexia)
• Headache
• Stomach/abdominal pain
• Fatigue
• Dizziness
• Injection site reactions such as redness, bruising, swelling, or itching

Serious

• Severe low blood sugar (hypoglycemia), which can be life-threatening, especially in people with type 1 diabetes
• Serious allergic reactions, including swelling of the face, lips, mouth, tongue, or throat, trouble breathing, or widespread hives
• Pancreatitis (inflammation of the pancreas)

Warnings and precautions

• Using Symlin together with insulin raises the risk of severe low blood sugar, especially in people with type 1 diabetes. This usually happens within 3 hours of the injection and can be dangerous if it occurs while driving or using machinery.
• Never mix Symlin and insulin together in the same syringe or injection, as this can change how both medicines work and lead to poor blood sugar control or low blood sugar.
• Never share your Symlin pen with another person, even if you change the needle, because this can spread infections between people.
• Symlin should not be used by people who cannot recognize the symptoms of low blood sugar, since this increases the danger of a severe, unnoticed episode.
• Symlin slows stomach emptying, so it should not be used by people taking other medicines that also affect how the stomach empties food.
• Symlin should not be used by people with confirmed gastroparesis, a condition where the stomach empties too slowly.
• It is not known whether Symlin is safe for an unborn baby. Tell your doctor if you are pregnant or planning to become pregnant so you can decide together how best to manage your blood sugar.
• It is not known whether Symlin passes into breast milk. Talk with your doctor about the best way to feed your baby if you are using Symlin.
• Symlin dosing does not need to change for people with mild, moderate, or severe kidney impairment, but it has not been studied in people with kidney failure requiring dialysis.
• Symlin has not been studied in people with liver problems.
• Drinking alcohol can raise your risk of severe low blood sugar while using Symlin.
• Do not drive, operate machinery, or do other activities that require alertness until you know how Symlin affects you, because severe low blood sugar can cause serious injury.

Storage

• Keep unopened Symlin in the refrigerator between 36°F to 46°F (2°C to 8°C), until you are ready to use it.
• Do not freeze. Do not use Symlin if it has been frozen.
• Keep unopened Symlin out of the light.
• Keep Symlin either in the refrigerator or at room temperature between 36°F to 86°F (2°C to 30°C) for up to 30 days once opened.
• Throw away used Symlin after 30 days of use, even if the pen still has medicine in it.
• Do not use Symlin (opened or unopened) after the expiration (EXP) date printed on the carton and the label.
• Keep Symlin and all medicines out of the reach of children.
• Put used needles and pens in an FDA-cleared sharps disposal container right away after use; do not throw loose needles in household trash.

When to see a doctor

• Get emergency help right away if you notice signs of a serious allergic reaction, such as hives, trouble breathing, or swelling of your face, lips, tongue, or throat.
• Call your doctor right away if you have severe nausea that does not go away, as this could mean your dose is too high.
• Call your doctor if you have severe low blood sugar or if low blood sugar is happening more often than usual.
• Watch for symptoms of severe low blood sugar such as headache, dizziness, drowsiness, vision changes, hunger, weakness, sweating, confusion, irritability, a fast heartbeat, or feeling jittery, and get help if these occur.
• If you think you have taken too much Symlin, get medical help right away since overdose can cause severe nausea, vomiting, diarrhea, dizziness, and other symptoms.

Alternatives

• Insulin adjustment