Diabetes
Pramlintide
Amylinomimetic
Other names: Symlin
FAA guidance
Do not issue.
Examiner
Do not issue: the examiner cannot issue a certificate
The FAA's Do Not Issue table names pramlintide, where it says the examiner should defer the exam and says do not issue a medical certificate.
Track your medicationsCompare FAA documents: pramlintideWhat each of the two FAA documents says, in plain wordsOpen
Its Acceptable Combinations of Diabetes Medications chart, to which the same table points, lists pramlintide in Group G. The two FAA documents do not say the same thing; both are quoted.
FAA rule for diabetes medication: The FAA makes the initial certification decision and the examiner must defer; combinations of up to three non-insulin medications, only one from each group, are considered acceptable, with an observation period when starting one. Each component in a combination medication is counted separately (for example, rosiglitazone + metformin counts as 2 medications), 4 or more medications may be considered on a case-by-case basis, and for unlisted medications the chart says to consult AMCD or RFS. Under medication adjustment, the chart lists 48 hours within Groups B to G, 7 days within Group A2, 7 days within Group A1 if a new type of insulin is added (with a note that no time is needed for a minor dose change within the same drug class), and 7 days if transitioning between insulin injection to or from a pump, or for new insulin/CGM devices. The FAA's diabetes disposition table says that for diabetes treated with one or more non-insulin diabetic medications the examiner should defer and submit the information to the FAA, and that the initial special issuance requires an FAA decision. The FAA's AME Assisted Special Issuance page for type II diabetes controlled by medication says that, once the FAA has granted the Authorization, examiners may re-issue a medical certificate under it, provided the applicant does not require insulin, remains on an acceptable oral medication therapy according to the chart of acceptable combinations, and provides the documents it lists. For insulin, the chart says to see Medical Certification Using Insulin, and for starting or adding insulin it gives separate lines for third-class pilots or agency ATCS and for first- or second-class pilots, who must use the CGM protocol; insulin has its own entry, which asks for the class of medical. FAA, Acceptable Combinations of Diabetes Medications
Show the FAA's words: pramlintideThe official FAA wording: two passages, each with its document and dateOpen
DO NOT ISSUE (DNI) MEDICATIONS
If the applicant is taking any of the following medications, AMEs should DEFER the exam. DO NOT issue a medical certificate to applicants who are using any of the following drug classes or medications for any condition:
DIABETIC MEDICATION: pramlintide (Symlin). Most diabetes medications are allowed. See Acceptable Combinations of Diabetes Medications.
USE NO MORE THAN 1 MEDICATION FROM ANY GROUP (A-G)
G Amylinomimetics - pramlintide (Symlin)