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Precautions and Warnings With Pramlintide

There are several precautions and warnings with pramlintide to be aware of, such as those concerning the risk of experiencing low blood sugar levels when taking the drug with other medications. Other precautions and warnings to be aware of with pramlintide involve the risks associated with taking the drug during pregnancy. People with diabetic gastroparesis or hypoglycemia unawareness should not take pramlintide.

Pramlintide: What Should I Tell My Healthcare Provider?

Before taking pramlintide acetate (Symlin®), let your healthcare provider know if you have:
  • Hypoglycemia unawareness (meaning that you do not have any symptoms when you have very low blood sugar)
  • Diabetic gastroparesis (a slowing 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.

Some Precautions and Warnings With Pramlintide

Some pramlintide warnings and precautions to be aware of include the following:
  • You and your healthcare provider should carefully consider whether pramlintide is right for you. Pramlintide 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 (inability to sense the symptoms of low blood sugar)
o Diabetic gastroparesis, a slowing of the digestive tract due to diabetes
o Digestive problems that require you to take medication to stimulate your digestive tract. 
  • By itself, pramlintide does not cause low blood sugar (hypoglycemia). However, combining pramlintide with insulin increases the risk of low blood sugar (see Symlin and Blood Sugar). To avoid dangerously low blood sugar levels, you will need to reduce your insulin dose when starting pramlintide (see Pramlintide Dosage) and will need to test your blood sugar often. Taking pramlintide with other medications, including some medications for conditions other than diabetes, can increase your risk of low blood sugar levels. 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. Low blood sugar is most likely to occur within three hours of a pramlintide injection. Low blood sugar can impair your ability to think clearly or to operate a vehicle or heavy machinery.
  • Never mix pramlintide with any type of insulin. Pramlintide needs to be administered as a separate injection.
  • Pramlintide can cause allergic reactions. Usually, these reactions are not severe and involve only the area around the injection. However, severe allergic reactions are possible.
  • Pramlintide is considered a pregnancy Category C medication. This means that pramlintide may not be safe for use in pregnant women, although the full risks of taking pramlintide while pregnant are not known. Talk to your healthcare provider before taking pramlintide during pregnancy (see Symlin and Pregnancy).
  • It is not known if pramlintide passes through breast milk. Therefore, if you are breastfeeding or plan to start, be sure to discuss this with your healthcare provider.
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