When This Medicine Should Not Be Used:
This medicine is not right for everyone. Do not use it if you had an allergic reaction to pramlintide. This medicine is not for use by anyone who cannot recognize the signs and symptoms of low blood sugar.

How to Use This Medicine:
Injectable

• Your doctor will prescribe your exact dose and tell you how often it should be given. This medicine is given as a shot under your skin. It is given into your stomach or thigh.
• Do not change the timing or amount of any of your medicines without your doctor's advice.
• You may be taught how to give your medicine at home. Make sure you understand all instructions before giving yourself an injection. Do not use more medicine or use it more often than your doctor tells you to.
• Allow the medicine to warm to room temperature before you inject it. Do not use this medicine if it looks cloudy or has changed color.
• Use this medicine just before a meal of at least 250 calories or 30 grams of carbohydrates.
• You will be shown the body areas where this shot can be given. Use a different body area each time you give yourself a shot. Keep track of where you give each shot to make sure you rotate body areas.
• Use a new needle and syringe each time you inject your medicine.
• Never share medicine pens, needles, or syringes. There is a risk of infection if they are used by more than one person.
• This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.
• Missed dose: If you miss a dose or forget to use your medicine, skip the missed dose. Wait until it is time for your next meal and inject your dose as usual. Do not use extra medicine to make up for a missed dose.
• Store your unopened medicine in the refrigerator, in the original carton, and protect it from light. Do not freeze it. You may store the opened medicine in the refrigerator or at room temperature for up to 30 days.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Some foods and medicines can affect how pramlintide works. Tell your doctor if you are using aspirin, atropine, disopyramide, fluoxetine, pentoxifylline, propoxyphene, a sulfa drug, medicine to lower cholesterol, blood pressure medicines, or an MAO inhibitor.
• If you take medicine by mouth (such as antibiotics, pain medicines, or birth control pills), take it at least 1 hour before or 2 hours after your pramlintide injection.
• Do not drink alcohol while you are using this medicine.

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding, or if you have digestion problem (such as gastroparesis), or vision problems.
• This medicine may cause low blood sugar.
• This medicine may make you feel dizzy. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.
• Throw away used needles in a hard, closed container that the needles cannot poke through. Keep this container away from children and pets.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Dizziness, fainting, or seizures
• Severe nausea
• Shaking, trembling, sweating, fast or pounding heartbeat, lightheadedness, hunger, confusion

If you notice these less serious side effects, talk with your doctor:

• Headache
• Loss of appetite, weight loss
• Mild nausea, vomiting, or stomach pain
• Redness, swelling, or itching where the shot was given

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088