Initiating and Titrating SYMLIN1

When starting SYMLIN, initially decrease patient’s mealtime insulin* doses by 50% to reduce the risk of hypoglycemia. Monitor blood glucose levels frequently (pre- and post-meals, and at bedtime), particularly when initiating SYMLIN or increasing the SYMLIN dose, and adjust insulin doses accordingly to optimize glycemic control.

*Mealtime insulin = preprandial, rapid-acting, short-acting, fixed-mixed insulins (eg, 70/30).

Initiating and Titrating SYMLINInitiating and Titrating SYMLINInitiating and Titrating SYMLINInitiating and Titrating SYMLIN
  • SYMLIN injection should be administered subcutaneously immediately prior to each major meal (≥250 kcal or containing ≥30 g of carbohydrate)
  • SYMLIN should only be used in patients who can fully understand and adhere to proper insulin adjustments and glucose monitoring
  • SYMLIN should be at room temperature before injecting to reduce potential injection site reactions
Discontinuation of therapy

If SYMLIN therapy is discontinued for any reason (eg, surgery or illness), the same initiation protocol should be followed when SYMLIN therapy is re-instituted. SYMLIN therapy should be discontinued if there is:

  • Recurrent unexplained hypoglycemia that requires medical assistance
  • Persistent clinically significant nausea
  • Noncompliance with self-monitoring of blood glucose concentrations
  • Noncompliance with insulin dose adjustments
  • Noncompliance with scheduled healthcare provider contacts or recommended clinic visits
 

SYMLIN Administration: Adjusts to Patients’ Major Mealtimes1

SymlinPen 60SymlinPen 60

Single Patient Use Only

  • SYMLIN injection should be administered subcutaneously immediately prior to each major meal (≥250 kcal or containing ≥30 g of carbohydrate)
  • Each SYMLIN dose should be administered subcutaneously into the abdomen or thigh (administration into the arm is not recommended because of variable absorption)
  • Injection sites should be rotated and should be distinct from the site chosen for any concomitant insulin injection
  • If a SYMLIN dose is missed, wait until the next scheduled dose and administer the usual amount
 

SYMLIN and Insulin

When starting SYMLIN, initially decrease patient’s mealtime insulin* dose by 50% to reduce the risk of hypoglycemia. Monitor blood glucose levels frequently (pre- and post-meals, and at bedtime), particularly when initiating SYMLIN or increasing the SYMLIN dose, and adjust insulin doses accordingly to optimize glycemic control.

*Mealtime insulin = preprandial, rapid-acting, short-acting, fixed-mixed insulins (eg, 70/30).

  • SYMLIN and insulin should always be administered as separate injections
  • SYMLIN should not be mixed with any type of insulin
  • Insulin and SYMLIN dose adjustments should be made only as directed by a healthcare professional skilled in the use of insulin
  • After the initial 50% reduction in mealtime insulin dose, individualize insulin dose adjustments based on glycemic control and tolerability (eg, if nausea occurs it may affect the dose of insulin required). An increased frequency of mild to moderate hypoglycemia should be viewed as a warning sign of increased risk for severe hypoglycemia
  • Please see below for additional warnings on severe hypoglycemia
 

Storage and Disposal Information

SymlinPen Pen-Injectors not in use
  • Unused SymlinPen Pen-Injectors should be stored in the refrigerator until ready for use (2°C to 8°C; 36°F to 46°F), and protected from light
  • Do not freeze. SymlinPen should not be used if it has been frozen
  • SymlinPen should not be used after the expiration (EXP) date printed on the carton and the label
SymlinPen Pen-Injectors in use
  • After first use, refrigerate or keep SymlinPen Pen-Injectors at a temperature (30°C, ≤86°F) for 30 days
  • SymlinPen should be used within 30 days, whether or not refrigerated
  • Instruct patients to dispose of their SymlinPen after 30 days of use, even if the pen still contains SYMLIN