Pramlintide

Summary

Pramlintide belongs to the drug class of amylin mimetics and is clinically used to treat both type 1 and type 2 diabetes.

Pramlintide works in the body by slowing gastric emptying and decreasing glucagon release.

While pramlintide usually does not cause hypoglycemia when taken on its own, patients may be at an increased risk of hypoglycemia if they take pramlintide in combination with insulin. Other side effects include skin reactions at the injection site, as well as nausea and vomiting. Pramlintide blocks the absorption of oral medications, so oral meds should generally be taken at least 1 hour before, or 2 hours after pramlintide.

Pramlintide is administered via a subcutaneous injection, and should be administered with meals.

Key Points

• Pramlintide (Symlin)
  • Drug Class
    • Amylin mimetics
      • Also called amylin analogs
      • Pramlintide is a synthetic form of amylin, a hormone made naturally in the pancreas that helps regulate blood glucose levels
  • Mechanism
    • Slows gastric emptying
      • Decreases the rate at which food gets passed through the stomach into the intestines
      • Causes the patient to feel full longer, helping them to eat less
    • Decreases glucagon release
      • The hormone glucagon raises blood glucose levels, so by decreasing glucagon release, pramlintide helps lower blood glucose levels
    • Reduces after meal (postprandial) glucose levels
      • Pramlintide minimizes the fluctuation of blood glucose levels after meals
  • Clinical Use
    • Treats Diabetes Mellitus (DM)
      • Treats both type 1 and type 2
  • Side Effects
    • Causes nausea/vomiting
      • Generally goes away with time
      • Can be minimized by starting with a low dose of pramlintide and titrating up over time
    • May cause skin reaction at injection site
      • Pramlintide is administered via subcutaneous injection
    • Insulin increases risk for hypoglycemia
      • When given alone, pramlintide is unlikely to cause hypoglycemia. However, when combined with insulin the risk for hypoglycemia increases.
      • Patients who take pramlintide and insulin should be aware of the symptoms of hypoglycemia.
    • Blocks the absorption of oral medications
      • Because pramlintide delays gastric emptying, oral medications take longer to reach the intestines, meaning it takes much longer for them to be absorbed and start to have an effect
      • Take oral pills 1 hour before or 2 hours after the injection of pramlintide.
  • Administration
    • Take with meals
      • Pramlintide should be administered with every meal
    • Administered via subcutaneous injection