Symlin
® (
pramlintide acetate) is a prescription medication licensed to treat both type 1 and
type 2 diabetes (also known as non-
insulin-dependent
diabetes or adult-onset diabetes). The medication is intended for use in people who take insulin before meals. Even though it is an injectable
diabetes medication, it is not a form of insulin and cannot be used as a replacement for insulin.
Symlin is made by Amylin Pharmaceuticals, Inc.
Symlin works by mimicking the actions of amylin in the body.
Amylin is a hormone that is made and secreted, along with insulin, by the
pancreas. In people without diabetes, the level of amylin (and insulin) increases in response to higher blood sugar levels after meals. When the pancreas becomes damaged as a result of type 1 or type 2 diabetes, it can no longer produce enough insulin and amylin.
The amylin actions that Symlin mimics include:
- Slowing down the emptying of food from the stomach, which slows down the increase in blood sugar after meals
- Decreasing the amount of glucose (sugar) that the liver produces
- Working in the brain to help people feel fuller sooner, resulting in a decrease in appetite and food intake.
Several studies have looked at the effects of Symlin for
type 2 diabetes, particularly with regards to hemoglobin A1c, weight, and
insulin dose.
Hemoglobin A1c
Hemoglobin A1c (HbA1c) is a test used to measure long-term blood sugar control. For people without
diabetes, HbA1c results are usually less than 6 percent, while people with diabetes usually have higher results. In one study of people with type 2 diabetes, people taking Symlin (in combination with insulin) lowered their HbA1c results by 0.57 percent, on average, while people taking insulin alone decreased their HbA1c results by only 0.17 percent. Similar results were seen in people who had
type 1 diabetes.
Studies have shown that the higher the HbA1c, the greater the chance of developing long-term problems related to diabetes. This includes problems such as:
By getting blood sugar levels under control with Symlin, it may be possible to decrease the chances of developing these diabetes-related complications.
Weight
In one study, people taking Symlin and insulin lost 3.3 pounds, on average (over six months), while people taking insulin alone gained about half a pound, on average. Similar results were seen in people with type 1 and type 2 diabetes.
Insulin Dose
Symlin has been shown to reduce the amount of insulin a person needs to take. In one study in people with type 2 diabetes, people taking the drug were able to reduce their doses of both meal-time insulin and long-acting insulin, while people taking insulin alone needed to increase both meal-time and long-acting insulin doses.
When and How to Take Symlin
General considerations for when and how to take Symlin include the following:
- The medication comes in an injectable form. It comes in vials or in pens (injection devices). It is given just under the skin of the thigh or abdomen (stomach).
- The medication should be injected right before every major meal. A major meal must have at least 250 calories or 30 grams of carbohydrates.
- Do not mix Symlin and insulin, as they are not compatible. They must be given as separate injections. Separate the insulin and Symlin injection sites by at least two inches on your body.
- Unopened vials must be refrigerated. Once a vial is opened, it can be stored at room temperature. If you keep the medication in the refrigerator, allow it to warm up to room temperature before injecting.
- For Symlin to work properly, it must be injected as prescribed. The medication will not work if you stop using it.
The dose of Symlin your healthcare provider recommends will vary, depending on a number of factors, including:
- Whether you have type 1 or type 2 diabetes
- Other medical conditions you may have
- Other medications you are currently taking.
As is always the case, do not adjust your dose unless your healthcare provider specifically instructs you to do so.
As with any medicine, side effects are possible with Symlin. However, not everyone who takes it will experience side effects. In fact, most people tolerate the medication quite well. If side effects do occur, in most cases, they are minor and either require no treatment or can be easily treated by you or your healthcare provider. Serious side effects are less common.
The most common side effects include:
- Nausea
- Headaches
- Low blood sugar (hypoglycemia) (see Symlin and Blood Sugar)
- A decrease in appetite and food intake
- Vomiting
- Abdominal pain (stomach pain).
(Click Symlin Side Effects to learn more, including some of the more serious side effects you should report to your healthcare provider.)
What Should I Tell My Healthcare Provider?
You should talk with your healthcare provider prior to taking Symlin if you have:
- Hypoglycemia unawareness (meaning that 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:
Tell your healthcare provider about all of the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements.
What If I Take an Overdose?
People who take too much Symlin may have overdose symptoms that could include:
- Severe nausea
- Vomiting
- Diarrhea
- Dizziness.
If you happen to take too much, seek immediate medical attention.
How Should Symlin Be Stored?
Unopened vials and pens should be stored in the refrigerator. Symlin should not be frozen, and you should not use any vials or pens that have been frozen. Once you have opened a vial or used a pen, it can be stored in the refrigerator or at room temperature (up to 86°F). If your room temperature is above 86°F, you should store Symlin in the refrigerator. Once you use a vial or a pen, you must throw it away after 30 days (four weeks), whether it was stored in the refrigerator or not.
Keep this and all medications out of the reach of children.
What Should I Do If I Miss a Dose?
If you do not take Symlin as scheduled, skip your missed dose and continue with your regular schedule. If you skip a meal, you should also skip that dose.
Symlin is available in 5-mL vials containing Symlin 600 mcg per mL. The medication also comes in pen form, available in the following strengths:
- SymlinPen 60 (which can inject doses of 15, 30, 45, and 60 mcg of Symlin)
- SymlinPen 120 (which can inject doses of 60 or 120 mg of Symlin).
You will need to purchase pen needles, which do not come with the pens. Make sure your healthcare provider gives you a prescription for pen needles.
Currently, there is no generic form of Symlin available
(see Generic Symlin).
