Indications for BYETTA:
Adjunct to diet and excercise to improve glycemic control in adults with type 2 diabetes.
Limitations of Use:
Not a substitute for insulin. Not for treating type 1 diabetes or ketoacidosis. Not studied in combination with prandial insulin or with a history of pancreatitis.
Give by SC inj into thigh, abdomen, or upper arm within 60mins before AM and PM meals (or before the 2 main meals of the day, approx. ≥6hrs apart). Initially 5mcg twice daily; may increase to 10mcg twice daily after 1 month. Moderate renal impairment (CrCl 30–50mL/min): caution when initiating or escalating doses from 5mcg to 10mcg.
History of drug-induced immune-mediated thrombocytopenia from exenatide products.
History of pancreatitis; consider other antidiabetic therapies. Monitor for pancreatitis, drug-induced thrombocytopenia; discontinue if suspected; do not restart if confirmed. Do not reuse or share pens between patients, even if the needle is changed. History of anaphylaxis or angioedema with another GLP-1 agonist; monitor closely. Severe GI disorders, renal impairment (CrCl <30mL/min), ESRD: not recommended. Renal transplantation. Elderly. Pregnancy. Nursing mothers.
Glucagon-like peptide-1 (GLP-1) receptor agonist.
Concurrent prandial insulin: not recommended. Increased risk of hypoglycemia with concomitant sulfonylurea, insulin, or other insulin secretagogues (eg, meglitinides); may need lower dose of these. May delay absorption of oral drugs (take these ≥1hr before exenatide). Monitor warfarin.
GI upset, hypoglycemia, feeling jittery, dizziness, headache, dyspepsia, constipation, asthenia; antibody formation (glycemic response may be attenuated), pancreatitis (may be fatal), hypersensitivity reactions (discontinue if occur).
Half-life: 2.4 hours.
Generic Drug Availability:
Prefilled pen (needles not included): 5mcg/dose—1 (60 doses); 10mcg/dose—1 (60 doses)