Generic Name: pramlintide, Injectable Solution

Generic Name:

pramlintide, Injectable Solution

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SECTION 1 of 5

Highlights for pramlintide

Injectable Solution
1

Pramlintide is an injectable medicine used to control high blood sugar caused by type 1 and type 2 diabetes.

2

Pramlintide is given to adults who are also taking insulin at mealtimes.

3

Your dose depends on if you have type 1 or type 2 diabetes.

4

You should inject each dose of pramlintide right before starting a meal.

5

Common side effects include nausea, vomiting, decreased appetite, stomach pain, headache, and injection site reactions (redness, swelling, itching).

IMPORTANT INFORMATION

FDA Warning

This drug has a Black Box Warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients to potentially dangerous effects.

Low Blood Sugar Warning: Pramlintide can cause severe low blood sugar (hypoglycemia). This risk is higher if you have type 1 diabetes. Severe low blood sugar usually happens within 3 hours after your dose. Use caution when driving a vehicle, using machinery, or doing similar activities that require alertness. If you get low blood sugar while doing these activities, you could get hurt.

Risk of slow stomach emptying

You shouldn’t take pramlintide if you have slowed emptying of your stomach (gastroparesis). You also shouldn’t take it if you take drugs that affect the emptying of your stomach or how nutrients are absorbed. Pramlintide slows the emptying of your stomach and can cause side effects in your stomach. This can make your condition worse.

Drug Features

Pramlintide is a prescription drug. It’s available as a prefilled pen for injection. This drug is self-injectable.

Pramlintide is used as part of a combination therapy with rapid- or short-acting insulin that’s taken with meals.

Why It's Used

Pramlintide is an injectable medicine used to control high blood sugar caused by type 1 or type 2 diabetes. This drug is used when your mealtime insulin doesn’t control your blood sugar well enough.

More Details

How It Works

Pramlintide belongs to a class of drugs called amylin analogs. A class of drugs refers to medications that work similarly. They have a similar chemical structure and are often used to treat similar conditions.

More Details

Why It's Used

Pramlintide is an injectable medicine used to control high blood sugar caused by type 1 or type 2 diabetes. This drug is used when your mealtime insulin doesn’t control your blood sugar well enough.

It’s important to test your blood sugar as often as directed and keep up with your doctor visits while you take this drug.  

How It Works

Pramlintide belongs to a class of drugs called amylin analogs. A class of drugs refers to medications that work similarly. They have a similar chemical structure and are often used to treat similar conditions. 

Normally after you eat, the hormones insulin and amylin are released from your pancreas into your blood. In diabetes, your pancreas makes less or no insulin and amylin after you eat. Amylin slows down how fast food is released from your stomach to the small intestine (gastric emptying). It does this without changing how nutrients are absorbed.

Amylin and insulin also decrease how much glucagon (a hormone that raises blood sugar) your body releases. If you have diabetes, your body might not make insulin and amylin, or might not respond to it in the normal way. Amylin also helps you feel full (satiety), which makes you eat less. All of these actions help improve your blood sugar levels.

SECTION 2 of 5

pramlintide Side Effects

Injectable Solution

Most Common Side Effects

The most common side effects that occur with pramlintide include:

  • nausea

  • vomiting

  • decreased appetite

  • stomach pain

  • headache

  • injection site reactions, such as redness, swelling, and itching

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious Side Effects

If you experience any of these serious side effects, call your doctor right away. If your symptoms are potentially life threatening, or if you think you’re experiencing a medical emergency, call 9-1-1.

  • allergic reaction. Symptoms may include:

    • trouble breathing
    • swelling of your face, lips, tongue, or throat
  • low blood sugar. Symptoms may include:

    • intense hunger
    • nervousness
    • shakiness
    • sweating, chills, and clamminess
    • dizziness
    • fast heart rate
    • lightheadedness
    • sleepiness
    • confusion
    • blurred vision
    • headache
    • depression
    • irritability
    • crying spells
    • nightmares and crying out in your sleep

    If you don’t treat low blood sugar, you can have a seizure, pass out, and possibly develop brain damage. Low blood sugar can even be fatal. If you pass out because of a low sugar reaction or cannot swallow, someone will have to give an injection of glucagon to treat the low sugar reaction. You may need to go to the emergency room.

  • inflammation of your pancreas. Symptoms may include:

    • sudden stomach pain that travels to your back
    • swollen or tender stomach
    • nausea or vomiting
Pharmacist's Advice
Healthline Pharmacist Editorial Team

This drug will decrease your blood sugar levels. Pramlintide can cause your blood sugar level to drop too low (hypoglycemia). If you have a low blood sugar reaction, you need to treat it.

  • For mild hypoglycemia (55–70 mg/dL), treatment is 15–20 grams of glucose (a type of sugar). You need to eat or drink one of the following:
    • 3–4 glucose tablets
    • a tube of glucose gel
    • ½ cup of juice or regular, non-diet soda
    • 1 cup of nonfat or 1% cow’s milk
    • 1 tablespoon of sugar, honey, or corn syrup
    • 8–10 pieces of hard candy, such as lifesavers
  • Test your blood sugar 15 minutes after you treat the low sugar reaction. If your blood sugar is still low, then repeat the above treatment.

Once your blood sugar level is back in the normal range, eat a small snack if your next planned meal or snack is more than 1 hour later.

Pramlintide doesn’t cause drowsiness. 

This drug may cause nausea 1–2 hours after eating meals.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
SECTION 3 of 5

pramlintide May Interact with Other Medications

Injectable Solution

Pramlintide can interact with other medications, herbs, or vitamins you might be taking. That’s why your doctor should manage all of your medications carefully. If you’re curious about how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Note: You can reduce your chances of drug interactions by having all of your prescriptions filled at the same pharmacy. That way, a pharmacist can check for possible drug interactions.

Food Interactions

You shouldn’t skip meals when you take pramlintide. If you have injected a dose, you must eat to prevent a low blood sugar reaction.

You should also make sure that you’re eating full meals. You shouldn’t take this drug if your meal will be under 250 calories or 30 grams of carbohydrates.

Alcohol Interaction

You shouldn’t drink alcohol when taking insulin and pramlintide. It may increase your risk of low blood sugar and make it harder to spot the symptoms of low blood sugar.

Medications That Might Interact with This Drug

Medicines that affect stomach emptying
  • anticholinergic agents, such as:
    • atropine
  • alpha-glucosidase inhibitors, such as:
    • acarbose
    • miglitol
  • metoclopramide

Pramlintide slows down stomach emptying and shouldn’t be taken with these drugs.

Diabetes drugs
  • sulfonylureas, such as:
    • chlorpropamide
    • glimepiride
    • glipizide
    • glyburide
  • glitinides, such as:
    • repaglinide
    • nateglinide

Taking these drugs with pramlintide may raise your risk of low blood sugar (hypoglycemia). You should know how to treat a low blood sugar reaction. Use caution when taking these drugs together.

Medicines to treat high blood pressure or heart failure
  • angiotensin-converting enzymes (ACE) inhibitors, such as:
    • benazepril
    • captopril
    • enalapril
    • fosinopril
    • lisinopril
    • quinapril
    • ramipril

Taking these drugs with pramlintide may raise your risk of low blood sugar (hypoglycemia). You should know how to treat a low blood sugar reaction. Use caution when taking these drugs together.

Medicine to treat heart rate problems (antiarrhythmic)
  • disopyramide

Taking this drug with pramlintide may raise your risk of low blood sugar (hypoglycemia). You should know how to treat a low blood sugar reaction. Use caution when taking these drugs together.

Medicines to treat high cholesterol/triglycerides
  • fibrates, such as:
    • gemfibrozil
    • fenofibrate

Taking these drugs with pramlintide may raise your risk of low blood sugar (hypoglycemia). You should know how to treat a low blood sugar reaction. Use caution when taking these drugs together.

Medicines to treat depression
  • monoamine oxidase inhibitors (MAOIs), such as:
    • isocarboxazid
    • phenelzine
    • tranylcypromine

Taking these drugs with pramlintide may raise your risk of low blood sugar (hypoglycemia). You should know how to treat a low blood sugar reaction. Use caution when taking these drugs together.

Medicines to treat pain
  • salicylates, such as aspirin
  • propoxyphene

Taking these drugs with pramlintide may raise your risk of low blood sugar (hypoglycemia). You should know how to treat a low blood sugar reaction. Use caution when taking these drugs together.

Medicine that thins your blood
  • pentoxifylline

Taking this drug with pramlintide may raise your risk of low blood sugar (hypoglycemia). You should know how to treat a low blood sugar reaction. Use caution when taking these drugs together.

Medicines to treat growth hormone problems
  • somatostatin analogs, such as:
    • octreotide
    • pasireotide

Taking these drugs with pramlintide may raise your risk of low blood sugar (hypoglycemia). You should know how to treat a low blood sugar reaction. Use caution when taking these drugs together.

Medicines to treat infections
  • sulfonamide antibiotics, such as:
    • sulfamethoxazole
    • mafenide

Taking these drugs with pramlintide may raise your risk of low blood sugar (hypoglycemia). You should know how to treat a low blood sugar reaction. Use caution when taking these drugs together.

  • antibiotics, such as:
    • amoxicillin
    • clarithromycin
    • levofloxacin

Pramlintide can change how antibiotics are absorbed. This means that they may not work as well. Take these medicines at least 1 hour before pramlintide is injected or 2 hours after the injection.  

Birth control pills (oral contraceptives)

Pramlintide can change how birth control pills are absorbed. This means that they may not work as well. Take these medicines at least 1 hour before pramlintide is injected or 2 hours after the injection.

Medicines to treat pain
  • analgesics, such as:
    • naproxen
    • celecoxib
    • hydrocodone

Pramlintide can change how these drugs are absorbed. This means that they may not work as well. Take these medicines at least 1 hour before pramlintide is injected or 2 hours after the injection.  

Insulin

Pramlintide and insulin can’t be mixed in the same syringe. They should be given as separate injections. Mixing them could change how both medicines work. This could raise your risk of low blood sugar reactions.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

People with delayed stomach emptying

You shouldn’t take pramlintide if you have gastroparesis. Pramlintide slows the emptying of your stomach and can cause side effects in your stomach. This can make your condition worse.

People with low blood sugar (hypoglycemia)

If you have low blood sugar, you shouldn’t take pramlintide with insulin. This combination will further lower your blood sugar. This would be a medical emergency.

People with low blood sugar unawareness

If you’ve had diabetes for a long time and have a history of low blood sugar, you may not have symptoms of low blood sugar when your sugar is low. Pramlintide and insulin can cause low blood sugar. You shouldn’t take these drugs together, because you may not be able to spot the signs of low blood sugar.

 

Pregnant women

Pramlintide is pregnancy category C. That means two things:

  1. Research in animals has shown adverse effects to the fetus when the mother takes the drug.
  2. There haven’t been enough studies done in humans to be certain how the drug might affect the fetus.

Tell your doctor if you’re pregnant or plan to become pregnant. Pramlintide should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Women who are breast-feeding

It isn’t known if pramlintide passes through breast milk. It isn’t known whether pramlintide causes side effects in a breastfeeding child. 

You and your doctor may need to decide if you’ll take pramlintide or breastfeed.

For Seniors

Seniors may be more sensitive to the effects of this drug. Your doctor will monitor you closely while you take pramlintide and insulin for signs of low blood sugar.

For Children

The safety and effectiveness of pramlintide haven’t been established in people younger than 18 years old.

Special Kid Safety:

Keep your pramlintide pen, pen needles, and all medicines out of the reach of children.

  • Needles are used to inject this drug. Accidental needle sticks can spread infection or cause bleeding.
  • Don’t throw away the used pen with a needle attached directly into the garbage.
  • Place used needles in a puncture-resistant container that can be closed. You may use a sharps container (red biohazard container), a hard plastic container (detergent bottle) or a metal container (empty coffee can). Ask your healthcare provider for instructions on the right way to throw away your used pens and the container. There may be state and local laws about how you should dispose of your used pen and needles.
  • Don’t throw needles directly into the trash. If you must throw the needle container into the trash, label it “don’t recycle”.
  • Keep the needle container out of the reach of children.

Contact with drug

Don’t share pramlintide with anyone else, even if they have the same medical condition and even if the needle on the pen is changed. Sharing a pen can spread infection.

When to call the doctor

Call your doctor if you’re starting or stopping medicines. This way, your doctor or pharmacist can make sure that pramlintide and the other medicines will work well and safely together.

Allergies

Pramlintide can cause a severe allergic reaction. Symptoms include:

  • trouble breathing
  • swelling of your face, lips, tongue, or throat

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal.

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How to Take pramlintide (Dosage)

Injectable Solution

All possible dosages and forms may not be included here. Your dose, form, and how often you take it will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What Are You Taking This Medication For?

Type 1 diabetes
Form: Injectable prefilled pen
Strengths: 1000 mcg/mL as 1.5 or 2.7 mL pens
Adult Dosage (ages 18 years and older)
  • The starting dose of pramlintide is 15 mcg injected under your skin right before each meal.
  • Your dose may be increased to 30 mcg, then 45 mcg, and then 60 mcg. Your doctor will increase your dose based on your blood sugar and how well you’re tolerating the drugs.
  • If you have severe nausea, your dose may be lowered or your doctor may give you a different drug.
  • When starting pramlintide, your doctor will lower your mealtime insulin dose by 50%. This reduces your risk of low blood sugar. Your doctor may increase your insulin dose based on your blood sugar control and how you’re tolerating both drugs. Tell your doctor right away if you have nausea or low blood sugar.
Child Dosage (ages 0-17 years)

This medicine hasn’t been studied in children and shouldn’t be used in people younger than 18 years.

Type 2 diabetes
Form: Injectable prefilled pen
Strengths: 1000 mcg/mL as 1.5 or 2.7 mL pens
Adult Dosage (ages 18 years and older)
  • The starting dose of pramlintide is 60 mcg injected under your skin right before each meal.
  • Your dose may be increased to 120 mcg if you don’t have nausea for at least 3 days.
  • If you have severe nausea, your dose may be lowered.
  • When starting pramlintide, your doctor will lower your mealtime insulin dose by 50%. This reduces your risk of low blood sugar. Your doctor may increase your insulin dose based on your blood sugar control and how you’re tolerating both drugs. Tell your doctor right away if you have nausea or low blood sugar.
Child Dosage (ages 0-17 years)

This medicine hasn’t been studied in children and shouldn’t be used in people younger than 18 years.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Healthline Pharmacist Editorial Team

Pramlintide comes with serious risks if you don’t take it as prescribed.

If You Don’t Take It at All

If you don’t take pramlintide at all or skip doses, your blood sugar levels won’t be controlled. You may get long-term complications from diabetes, such as heart, kidney, eye, or nerve problems.

If You Take Too Much

If you use too much pramlintide, call your healthcare provider or poison control center right away.

If you take more than your prescribed dose, you may get nauseated or vomit, and may not be able to eat the amount of food you usually eat. If you inject more pramlintide than your prescribed dose, pay careful attention to the amount of insulin you use because you may be at more risk for a low blood sugar reaction.

What to Do If You Miss a Dose

If you miss or forget to take a dose, skip that dose. Wait until your next meal and take your usual dose at that meal.

Don’t take more than your usual dose.

How to Tell If the Drug Is Working

You may be able to tell that this drug is working if your blood sugar levels 1–2 hours after you eat (post-prandial) are lower.

Pramlintide is a long-term drug treatment.

Pramlintide should be injected right before each meal

Your meal must have at least 250 calories or 30 grams of carbohydrates.

There are two ways to store your pramlintide pens

Pramlintide pens that haven’t been opened:

  • Refrigerate them at 36–46°F (2–8°C).  
  • Protect the pen from light.
  • Don’t freeze it. Don’t use the pen if it’s been frozen.
  • Don’t use pramlintide (opened or unopened) after the expiration date printed on the carton and label. 

Pramlintide pens that are being used:

  • After its first use, keep the pen refrigerated at 36–46°F (2–8°C) or at room temperature below 86°F (30°C).
  • Use it within 30 days, whether or not it’s refrigerated.
  • After 30 days, throw the pen out, even if there’s still pramlintide left.

Travel

When traveling with your medication:

  • Always carry your medication with you or in your carry-on bag.
  • Don’t worry about airport X-ray machines. They can’t hurt this medication.
  • You may need to show your pharmacy’s label to clearly identify the medication. Keep the original prescription label with you when traveling.
  • This medication needs to be refrigerated. You may need to use an insulated bag with a cold pack to keep it cold when traveling.
  • Don’t leave this medicine in the car, especially when the temperature is hot or freezing.
  • Pen needles need to be used to inject this medicine. Check for special rules about traveling with medicine, pen needles, and pens.

Self-Management

Your healthcare provider will show you how to:

  • inject pramlintide
  • test your blood sugar using a blood glucose monitor
  • recognize and treat high and low blood sugar reactions

You must test your blood sugar as often as your doctor tells you to. This may be before and after every meal and at bedtime, especially when starting pramlintide or increasing your dose.

You will inject pramlintide yourself. Your doctor, nurse, pharmacist, or diabetes educator will show you how to prepare and inject a dose.

Pen needles aren’t included with pramlintide pen injector. Use 29, 30, or 31 gauge disposable pen needles. Ask your healthcare provider which needle gauge and length is best for you.

Clinical Monitoring

To check if your medicine is working your doctor will check the following:

  • blood sugar, before and after meals
  • glycosylated hemoglobin (A1C) levels. This test measures your blood sugar control over the last 2–3 months.

Your doctor may do other tests to check for complications of diabetes:

  • eye exam at least once a year
  • foot exam at least once a year
  • dental exam at least once a year
  • tests for nerve damage
  • cholesterol
  • blood pressure and heart rate

Hidden Costs

In addition to the drug, you’ll also need the following for your injection and testing your blood sugar:

  • sterile alcohol wipes
  • pen needles. Ask your healthcare provider which needle gauge and length is best for you.  
  • container for used needles and pen disposal
  • blood glucose meter
  • lancing device and lancets (a pricking needle used to prick your finger to draw a drop of blood for testing blood sugar)
  • blood sugar test strips

Insurance

Many insurance companies will require a prior authorization before they approve the prescription and pay for pramlintide.

Are There Any Alternatives?

Many insurance companies will require a prior authorization before they approve the prescription and pay for pramlintide.

SECTION 5 of 5

How Much Does pramlintide Cost?

Injectable Solution
We've partnered with GoodRX so you can compare prices and save money on your next prescription. Check out the lowest cash prices below and enter your zip code to find the best deal near you.

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Lowest price for pramlintide

Kroger Pharmacy $678.51
Walgreens $686.08
Target $686.83
These represent the lowest cash prices for pramlintide and may be lower than your insurance.

Find the lowest prices of pramlintide near you

These represent the lowest cash prices for pramlintide and may be lower than your insurance.

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Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on July 29, 2015

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

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