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What the FDA labels say about taking them together

Insulin glulisine and pramlintide

Insulin glulisine's FDA label of November 25, 2025 names pramlintide in its drug interactions section; pramlintide's label does not name insulin glulisine itself but warns about its class (insulin analogs). The insulin glulisine label: “… disopyramide, fibrates, fluoxetine, monoamine oxidase inhibitors, pentoxifylline, pramlintide, salicylates, somatostatin analog (e.g., octreotide), and sulfonamide antibiotics. …”

Check it at the source: the insulin glulisine FDA label on DailyMed (effective November 25, 2025); the pramlintide FDA label on DailyMed (effective December 18, 2019, AstraZeneca Pharmaceuticals LP).

What does the insulin glulisine label say about pramlintide?

Insulin glulisine label, 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. Intervention: Dose adjustment and increased frequency of glucose monitoring may be required when APIDRA is coadministered with these drugs.

Source: FDA drug label (Apidra), sanofi-aventis U.S. LLC, effective November 25, 2025 (SPL set e7af6a7a-8046-4fb4-9979-4ec4230b23aa), via openFDA; the full label on DailyMed

What does the pramlintide label say about insulin glulisine?

Pramlintide's label does not name insulin glulisine itself; it warns about its class (insulin analogs):

Pramlintide label, boxed warning

SEVERE HYPOGLYCEMIA SYMLIN use with insulin increases the risk of severe hypoglycemia, particularly in patients with type 1 diabetes.

Pramlintide label, boxed warning

Appropriate patient selection, careful patient instruction, and insulin dose reduction are critical elements for reducing this risk.

Source: FDA drug label (SymlinPen), AstraZeneca Pharmaceuticals LP, effective December 18, 2019 (SPL set 4aea30ff-eb0d-45c1-b114-3127966328ff), via openFDA; the full label on DailyMed

These are the labels' own sentences. PlainMeds does not grade interactions; a pharmacist or prescriber can say what they mean for one person's medicines.

Both medicines on the record

0Insulin glulisine generic labelers
0Pramlintide generic labelers
Insulin glulisinePramlintide
Labeled forType 2 diabetes, Type 1 diabetesType 2 diabetes, Type 1 diabetes
Boxed warningNoYes
Pharmacy cost (NADAC)$8.16 per mL 100 unit/mL vialn/a
Shortage nowNo current entryA presentation being discontinued

Source: FDA NDC Directory, CMS NADAC of October 7, 2026 and the FDA Drug Shortage Database (FDA files October 8, 2026)

What next?