Short answer: The Symlin label says that if a dose is missed, wait until the next scheduled dose and take the usual amount. The Medication Guide puts it as: wait until the next meal and take your usual Symlin dose then. Do not take more than your usual dose, and do not inject Symlin if you skip a meal.
| Situation | What the label says |
|---|---|
| Schedule | Before major meals |
| Missed a dose | Wait until the next scheduled dose; use the usual amount (2.4) |
| Extra dose | Do not take more than your usual dose (Medication Guide) |
| Skipping a meal | Do not inject Symlin (Medication Guide) |
| Half-life | About 48 minutes (12.3) |
Section 2.4 says that if a Symlin dose is missed, wait until the next scheduled dose and give the usual amount. The Medication Guide says: wait until the next meal and take your usual dose of Symlin at that meal. Do not take more than your usual dose.
Example: you forgot Symlin before lunch and remember at 3 p.m. Under the label you would not inject then; you would take your usual dose before dinner.
Symlin is taken with mealtime insulin, and the label carries a boxed warning about severe low blood sugar. The Medication Guide says not to inject Symlin if you skip a meal. Pramlintide has a half-life of only about 48 minutes (section 12.3), so it acts on the meal it is taken with, not on later ones.
The Symlin label does not say how to restart after a gap of several days. That is a question for your prescriber.
Restarting usually also means changing mealtime insulin, so talk to your diabetes team first.
This page summarizes FDA labeling. It is not personalized medical advice; confirm what to do with your prescriber or pharmacist.