pramlintide
Brand names: Symlin
Symlin is a drug that helps control blood sugar in people with type 1 or type 2 diabetes who also use insulin. It works with insulin to lower blood sugar levels after meals.
Drug Shortage Alert
pramlintide is currently listed as to be discontinued by the FDA. Affected manufacturer: AstraZeneca AB.
View all drug shortages →What it does
Symlin is used to help manage blood sugar levels in adults with type 1 or type 2 diabetes.
Common side effects
Nausea, Vomiting, Loss of appetite
Key warnings
Symlin can cause very low blood sugar, especially if you have type 1 diabetes.
How It Works
Symlin is similar to a natural hormone in your body. It slows down how quickly food leaves your stomach. It also helps to prevent your liver from releasing too much sugar after you eat, and reduces your appetite.
How to Take It
Inject Symlin under your skin right before each major meal. When you start Symlin, your insulin dose will be cut in half. Your doctor will tell you how much Symlin to use and how to adjust your insulin. Wait at least 3 days before changing your Symlin dose to avoid nausea.
Pregnancy & Breastfeeding
It is not known if Symlin will harm your unborn baby. Talk to your doctor if you are pregnant or plan to become pregnant. It is also not known if Symlin passes into breast milk, so discuss breastfeeding with your doctor.
Missed Dose
If you miss a dose of Symlin, skip that dose and take your next dose before your next meal. Do not take two doses at once.
Storage
Keep unused Symlin pens in the refrigerator, away from light, and do not freeze. Once opened, Symlin pens can be kept in the refrigerator or at room temperature (up to 86°F) for 30 days.
Side Effects (from patient reports)
Based on 89 FDA adverse event reports.
Serious Warnings
Symlin can cause very low blood sugar, especially if you have type 1 diabetes. This can happen within 3 hours after a Symlin shot. To avoid this, follow your doctor's instructions carefully and check your blood sugar often. Make sure you know the signs of low blood sugar.
Known Drug Interactions
Drugs That May Increase the Risk of Hypoglycemia Drugs: Antidiabetic agents, ACE inhibitors, angiotensin II receptor blocking agents, disopyramide, fibrates, fluoxetine, monoamine oxidase inhibitors, pentoxifylline, pramlintide, salicylates, somatostatin analog (e.g., octreotide), and sulfonamide antibiotics. • Drugs that may increase the risk of hypoglycemia: antidiabetic agents, ACE inhibitors, angiotensin II receptor blocking agents, disopyramide, fibrates, fluoxetine, monoamine oxidase inhibitors, pentoxifylline, pramlintide, salicylates, somatostatin analog (e.g., octreotide), and sulf...
Mechanism: Both of these medications are used to lower blood sugar, so taking them together increases the chance of your blood sugar falling to a dangerous level.
What to do: Watch for signs of low blood sugar and check your levels often. Your healthcare provider might need to change your insulin dosage.
Drugs That May Increase the Risk of Hypoglycemia Drugs: Antidiabetic agents, ACE inhibitors, angiotensin II receptor blocking agents, disopyramide, fibrates, fluoxetine, monoamine oxidase inhibitors, pentoxifylline, pramlintide, salicylates, somatostatin analogs (e.g., octreotide), and sulfonamide antibiotics Intervention: Dosage reductions and increased frequency of glucose monitoring may be required when XULTOPHY 100/3.6 is coadministered with these drugs.
Mechanism: Both drugs work to lower blood sugar, so taking them at the same time can cause your blood sugar to drop too low.
What to do: You should monitor your blood sugar levels closely and your doctor may need to lower your insulin dose.
Table 6: Clinically Significant Drug Interactions with LEVEMIR Drugs That May Increase the Risk of Hypoglycemia Drugs: Antidiabetic agents, ACE inhibitors, angiotensin II receptor blocking agents, disopyramide, fibrates, fluoxetine, monoamine oxidase inhibitors, pentoxifylline, pramlintide, salicylates, somatostatin analogs (e.g., octreotide), and sulfonamide antibiotics, GLP-1 receptor agonists, DPP-4 inhibitors, SGLT-2 inhibitors.
Mechanism: Both drugs lower blood sugar, so taking them together increases the chance of your blood sugar dropping to a dangerous level.
What to do: Your doctor may need to lower your insulin dose, and you should check your blood sugar more often.
7 DRUG INTERACTIONS Table 6 includes clinically significant drug interactions with BASAGLAR Table 6: Clinically Significant Drug Interactions with BASAGLAR Drugs That May Increase the Risk of Hypoglycemia Drugs: Antidiabetic agents, ACE inhibitors, angiotensin II receptor blocking agents, disopyramide, fibrates, fluoxetine, monoamine oxidase inhibitors, pentoxifylline, pramlintide, salicylates, somatostatin analogs (e.g., octreotide), and sulfonamide antibiotics. Drugs that may increase the risk of hypoglycemia: antidiabetic agents, ACE inhibitors, angiotensin II receptor blocking agents, d...
Mechanism: Both medications are used to lower blood sugar, so using them at the same time increases the risk of hypoglycemia.
What to do: Your healthcare provider may need to adjust your insulin dose and you should monitor your blood sugar levels frequently.
7 DRUG INTERACTIONS Table 6: Clinically Significant Drug Interactions with APIDRA Drugs that May Increase the Risk of Hypoglycemia Drugs: Antidiabetic agents, ACE inhibitors, angiotensin II receptor blocking agents, disopyramide, fibrates, fluoxetine, monoamine oxidase inhibitors, pentoxifylline, pramlintide, salicylates, somatostatin analog (e.g., octreotide), and sulfonamide antibiotics.
Mechanism: Pramlintide can increase the risk of low blood sugar when taken with insulin.
What to do: Your doctor may need to adjust your insulin dose and you should check your blood sugar more often.
Common Questions
Can Symlin be mixed with insulin?
What should I do if I feel nauseous after taking Symlin?
Can I share my Symlin pen with others?
Does Symlin cause weight loss?
What if I take other medications?
What should my A1c be before starting Symlin?
Can I use Symlin if I have gastroparesis?
What are the symptoms of low blood sugar?
How often should I check my blood sugar?
Can children use Symlin?
What are the common side effects of pramlintide?
Does pramlintide interact with other medications?
What drug class is pramlintide?
Is pramlintide safe during pregnancy?
Is pramlintide currently in shortage?
Related Medications in Amylin Analog
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bromocriptine
Cycloset
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canagliflozin
Invokana
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colesevelam
Welchol
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What the FDA Data Shows for pramlintide
The FDA label for pramlintide (sold under brand names such as Symlin) classifies it as a prescription-only medication in the Amylin Analog class. Symlin is used to help manage blood sugar levels in adults with type 1 or type 2 diabetes. Official labeling lists 9 commonly reported side effects, including Nausea, Vomiting, Loss of appetite.
Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 89 voluntary reports. The database also lists 13 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated moderate severity. Acquisition-cost data is surveyed weekly by CMS and updated as manufacturers report changes.
Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history, and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.
Data Sources
Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Shortage status: FDA Drug Shortages Database.
FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.
Last updated: December 18, 2019
Read our methodology — how this data is sourced, computed, and verified.
All federal data sources used on this page
- FDA Orange Book — approved drug products with therapeutic equivalence. accessdata.fda.gov/cder/ob
- FDA DailyMed — NIH-hosted drug labeling for FDA-approved meds. dailymed.nlm.nih.gov
- FDA Adverse Event Reporting System (FAERS) — post-marketing safety surveillance. fda.gov/drugs/faers
- NLM RxNorm — standardized clinical drug nomenclature. nlm.nih.gov/research/umls/rxnorm
- CMS Medicare Part B Drug Average Sales Price Files — federal drug pricing data. cms.gov/medicare/part-b-drugs/asp
- FDA Drug Shortages Database — current and resolved drug shortage tracking. accessdata.fda.gov/drugshortages