Description: Antidiabetic Agent, Glucagon-Like Peptide-1 (GLP-1) Receptor Agonist
“ALERT: US Boxed Warning
Risk of thyroid C-cell tumours (Bydureon):
Exenatide extended-release (ER) causes an increased incidence in thyroid C-cell tumours at clinically relevant exposures in rats compared with controls. It is unknown whether exenatide causes thyroid C-cell tumours, including medullary thyroid carcinoma (MTC), in humans as the human relevance of exenatide-ER-induced rodent thyroid C-cell tumours has not been determined.
Exenatide ER is contraindicated in patients with a personal or family history of MTC and in patients with multiple endocrine neoplasia syndrome types 2 (MEN 2). Counsel patients regarding the potential risk for MTC with the use of exenatide ER and inform them of symptoms of thyroid tumours (eg, mass in the neck, dysphagia, dyspnea, persistent hoarseness). Routine monitoring of serum calcitonin or using thyroid ultrasound is of uncertain value for detection of MTC in patients treated with exenatide ER.
CSA NA – FDA Approved – REMS (N) – Can Ship
How Does It Work
Exenatide, Bydureon/Byetta is an analog of human glucagon-like peptide-1 (GLP-1) (an incretin hormone). Exenatide works in multiple of ways to lower blood glucose and hemoglobin A1C. Exenatide stimulates the beta cells of the pancreas to release insulin when blood glucose levels are high. Exenatide slow down gastric emptying and the rate at which glucose enters the blood after meals. Exenatide also helps lower hepatic glucose output by suppressing pancreatic glucagon secretion
Indications For Use
Officially indicated for the treatment of Diabetes mellitus type 2.
Before starting Exenatide, Bydureon/Byetta make sure your physician is aware of any allergies (sulfa), medications you currently take, history/family history of medullary thyroid carcinoma, if you have multiple endocrine neoplasia syndrome types 2, history of drug-induced immune-mediated thrombocytopenia, kidney disease, diabetic ketoacidosis, diabetic coma, diabetes mellitus type 1, gastrointestinal disease, past bariatric surgery, are pregnant or breastfeeding. Exenatide, Bydureon/Byetta use is associated with rare but serious adverse events such as hypersensitivity reactions, gallbladder disease, gastrointestinal effects, pancreatitis, renal effects, thrombocytopenia.
Immediate release: 5-10 mcg twice daily within 60 minutes prior to morning and evening meals (or before the 2 main meals of the day, ≥6 hours apart). Missed doses should be skipped and therapy should resume at the next scheduled dose.
Extended-release: 2 mg once weekly without regard to meals. If changing the day of administration is necessary, allow at least 3 days between 2 doses. The missed dose should be administered as soon as possible if the next scheduled dose is due in ≥3 days, then resume the usual schedule thereafter. If there are <3 days until the next scheduled dose, omit the missed dose and resume administration at the next scheduled weekly dose.
Pharmacist Tips On Using
How to Take: Administer via subcutaneous injection in the upper arm, thigh, or abdomen; rotate injection sites. If using concomitantly with insulin, administer as separate injections (do not mix); may inject in the same body region as insulin, but not adjacent to one another. Do not inject IV or IM. Store unopened devices in the fridge at 2-8 degrees Celsius. The device currently in use can be stored at room temperature (under 25 degrees Celsius) for up to 4 weeks.
Epigastric fullness, heartburn, nausea, diarrhea, hypersensitivity reaction (rash, itch, hives)
Note this is not a complete list of side effects, only common ones
Frequently Asked Questions
What is hypoglycemia?
Hypoglycemia is a condition of low blood sugar (>3.9mmol/L-Canada; 70mg/dL-US) which is considered a medical emergency whereas hyperglycemia is a slow progressive condition. It generally occurs with irregularities in diet, exercise, and medications in diabetic patients. It is preferably treated with simple sugars such as dextrose; regular table sugar can work but is slower acting as it needs to be digested and if blood sugar is extremely low this delay can be a problem. Hypoglycemia has a large host of progressive symptoms from hunger, headache, nausea, sweating, palpitations, mood swings, irritability to seizure, coma and in severe cases, death.