What is this medication?
Antidiabetic Agent, Glucagon-Like Peptide-1 (GLP-1) Receptor Agonist
Officially indicated for the treatment of Diabetes mellitus type 2.
“ALERT: US Boxed Warning
Risk of thyroid C-cell tumors (Bydureon):
Exenatide extended release (ER) causes an increased incidence in thyroid C-cell tumors at clinically relevant exposures in rats compared with controls. It is unknown whether exenatide causes thyroid C-cell tumors, including medullary thyroid carcinoma (MTC), in humans as the human relevance of exenatide-ER-induced rodent thyroid C-cell tumors 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 type 2 (MEN 2). Counsel patients regarding the potential risk for MTC with the use of exenatide ER and inform them of symptoms of thyroid tumors (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.
How does this medication 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
How should I take this medication?
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. Missed dose should be administered as soon as possible if the next scheduled dose is due in ≥3 days, then resume usual schedule thereafter. If there are <3 days until next scheduled dose, omit the missed dose and resume administration at the next scheduled weekly dose.
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.
What should I watch for while using this medication?
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 type 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.
What if I miss a dose?
If you miss a dose, skip that dose and take your next dose at the next prescribed time. Do not take an extra dose or increase the amount of your next dose to make up for a missed dose.
How should I store this medication?
Prior to first use, Byetta must be stored refrigerated at 2°C to 8°C. Do not freeze, and do not use if it has been frozen. After first use of the pen, stored at 2°C to 25°C. The pen should be discarded 30 days after first use, even if some drug remains in the pen. Do not store pen with the needle attached. Keep out of reach of children and pets.
What are the possible side effects of using this medication?
Epigastric fullness, heartburn, nausea, diarrhea, hypersensitivity reaction (rash, itch, hives)
Note this is not a complete list of side effects, only common ones.
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