BMA Concise Guide to Medicine & Drugs

Exenatide

Brand names Bydureon, Byetta

Used in the following combined preparations None

QUICK REFERENCE

Drug group Drug for diabetes

Overdose danger rating High

Dependence rating Low

Prescription needed Yes

Available as generic No

GENERAL INFORMATION

Exenatide is an injected antidiabetic drug used to treat type 2 diabetes. It is a synthetic protein that mimics the action of a natural hormone called GLP-1, which is involved in regulating blood sugar levels. The drug works by increasing secretion of insulin from the pancreas in response to high blood sugar levels. It also slows emptying of the stomach, so smoothing out the rise in blood sugar after meals. It is used to treat patients with type 2 diabetes together with other antidiabetic drugs, as well as diet, exercise, and weight control.

INFORMATION FOR USERS

Your drug prescription is tailored for you. Do not alter dosage without checking with your doctor.

How taken/used Injection.

Frequency and timing of doses 2 x daily, each dose at least 6 hours apart. Take within 1 hour before a meal (do not take after a meal).

Adult dosage range 10–20mcg daily.

Onset of effect Within 1 hour.

Duration of action 8–12 hours.

Diet advice An individualized diabetic diet must be maintained for the drug to be fully effective. Follow your doctor’s advice.

Storage Store unused exenatide injection pens in the refrigerator, protected from light. After first use of a pen, it may be stored at room temperature, away from heat and bright light. Keep out of the reach of children.

Missed dose Take as soon as you remember, but only if you have not yet eaten a meal. If you have already eaten a meal, wait until your next scheduled dose.

Stopping the drug Do not stop the drug without consulting your doctor. Stopping the drug may lead to worsening of the underlying condition.

OVERDOSE ACTION

Seek immediate medical advice. If you may notice signs of low blood sugar, eat or drink something sugary. Take emergency action if seizures or unconsciousness occur.

POSSIBLE ADVERSE EFFECTS

Exenatide commonly causes gastrointestinal side effects, such as nausea, vomiting, diarrhoea, decreased appetite, and weight loss, but these generally improve with continued use. It may also cause symptoms of low blood sugar, such as sweating, tremor, dizziness, and confusion. Discuss with your doctor if any of these symptoms are severe. Very rarely, exenatide may cause severe inflammation of the pancreas. If you experience severe abdominal pain, wheezing, an itchy rash, or swelling of the face or lips, you should stop taking the drug and contact your doctor without delay.

INTERACTIONS

General note Many drugs, especially other antidiabetic drugs, may interact with exenatide to affect blood sugar levels. Some medicines also contain sugar and may upset control of diabetes. Check with your doctor or pharmacist before taking any other medicines.

Anticoagulants (e.g. warfarin) Exenatide may increase the anticoagulant effect of these drugs.

Oral contraceptives and antibiotics These should be taken at least 1 hour before exenatide to ensure adequate absorption.

SPECIAL PRECAUTIONS

Be sure to tell your doctor if:

· You have long-term kidney problems.

· You have stomach or bowel problems.

· You have a history of pancreatitis.

· You are taking other medicines.

Pregnancy Safety not established. Switching to insulin is safe. Discuss with your doctor.

Breast-feeding Safety not established. Switching to insulin is safe. Discuss with your doctor.

Infants and children Not prescribed.

Over 60 No special problems.

Driving and hazardous work Usually no problem but be aware of warning signs of low blood sugar and avoid such activities if you have these signs.

Alcohol Avoid. Alcohol may upset diabetic control.

Surgery and general anaesthetics Notify your doctor or dentist that you have diabetes. Surgery may affect diabetic control and your diabetes treatment may need to be adjusted or, in some cases, insulin may need to be substituted.

PROLONGED USE

No problems expected.

Monitoring Regular monitoring of your diabetes control is necessary. You may also have periodic assessment of the eyes, heart, and kidneys.