Diabetes Home > Symlin Warnings and Precautions

Symlin warnings and precautions include the risk of low blood sugar when it is taken with insulin, the potential for allergic reactions, and the danger of taking the medication while pregnant. People who have diabetic gastroparesis or hypoglycemia unawareness should not take the drug. Symlin warning and precautions also extend to people who have certain allergies and digestive problems.

Symlin: What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to taking Symlin® (pramlintide acetate) if you have:
  • Hypoglycemia unawareness (you do not have any symptoms when you have very low blood sugar)
  • Diabetic gastroparesis (a slowing down of the digestive tract due to diabetes)
  • Other digestive problems
  • Any allergies, including allergies to foods, dyes, or preservatives.
Also, let your healthcare provider know if you are:
Make sure to tell your healthcare provider about all of the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements.

Specific Symlin Warnings and Precautions

Warnings and precautions to be aware of prior to taking Symlin include the following:
  • You and your healthcare provider should carefully decide if Symlin is right for you. The drug is not considered to be a good choice for children, and it is not the best choice if you have:
o Trouble taking your insulin as prescribed on a regular basis
o Trouble monitoring your blood sugar as prescribed on a regular basis
o Very poor blood sugar control (if you have HbA1c levels greater than 9 percent)
o Recurrent low blood sugar (hypoglycemia) that has required assistance within the past six months
o Hypoglycemia unawareness (you cannot feel the symptoms of low blood sugar)
o Diabetic gastroparesis (a slowing down of the digestive tract due to diabetes)
o Digestive problems that require you to take medication to stimulate your digestive tract.
  • By itself, Symlin does not cause low blood sugar. However, combining it with insulin increases the risk (see Symlin and Blood Sugar). To avoid dangerously low blood sugar levels, you will need to reduce your insulin dose when starting Symlin (see Symlin Dosage) and will need to test your blood sugar often. Taking Symlin with other medications, including some medications for conditions other than diabetes, can increase your risk of low blood sugar as well. If you have diabetes, it is always a good idea to ask your healthcare provider if any medication you are starting or stopping will have an effect on your blood sugar levels.
  • The risk of low blood sugar is higher in people with type 1 diabetes. This is most likely to occur within three hours of a Symlin injection. Low blood sugar can impair your ability to think clearly or to operate a vehicle or heavy machinery.
  • Symlin should never be mixed with any type of insulin. It needs to be given as a separate injection.
  • Symlin can cause allergic reactions. Usually, these reactions are not severe and involve only the area around the injection site. However, severe allergic reactions are possible.
  • Symlin is considered a pregnancy Category C medication. This means that it may not be safe for use in pregnant women, although the full risks of taking the drug during pregnancy are not known. Talk to your healthcare provider before taking the drug if you are pregnant (see Symlin and Pregnancy).
  • It is not known if Symlin passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider.
Written by/reviewed by:
Last reviewed by: Kristi Monson, PharmD;
Last updated/reviewed:
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