Exenatide

Table of contents

  • Brand Names
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Pregnancy and Lactation Implications
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Genes that may be involved
  • Drug Interactions
  • Nutrition/Nutraceutical Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics
  • Special Considerations

Brand Names

Europe

Austria: Byetta; Belgium: Byetta; Bulgaria: Byetta; Cyprus: Byetta; Czech Republic: Byetta; Denmark: Byetta; Estonia: Byetta; Finland: Byetta; France: Byetta; Germany: Byetta; Hungary: Byetta; Ireland: Byetta; Italy: Byetta; Latvia: Byetta; Malta: Byetta; Netherlands: Byetta; Poland: Byetta; Portugal: Byetta; Romania: Byetta; Slovakia: Byetta; Slovenia: Byetta; Spain: Byetta; Sweden: Byetta; UK: Byetta.

North America

USA: Byetta.

Latin America

Argentina: Byetta; Mexico: Baietta.

Drug combinations

Chemistry

Exenatide: C~184~H~282~N~50~O~60~S. Mw: 4186.57 (peptide). (1) Exendin 4; (2) L-Histidylglycyl-L-glutamylglycyl-L-threonyl-L-phenylalanyl-L-threonyl-L-seryl-L-aspartyl-L-leucyl-L-seryl-L-lysyl-L-glutaminyl-L-methionyl-L-glutamyl-L-glutamyl-L-glutamyl-L-alanyl-L-valyl-L-arginyl-L-leucyl-L-phenylalanyl-L-isoleucyl-L-glutamyl-L-tryptophyl-L-leucyl-L-lysyl-L-asparaginylglycylglycyl-L-prolyl-L-seryl-L-serylglycyl-L-alanyl-L-prolyl-L-prolyl-L-prolyl-L-serinamide. CAS-141758-74-9 (2003).

Pharmacologic Category

Antidiabetic Agents; Incretin Mimetics. (ATC-Code: A10BX04).

Mechanism of action

Analog of the hormone incretin (glucagon-like peptide 1 or GLP-1) which increases insulin secretion and B-cell growth/replication, slows gastric emptying, and may decrease food intake. When added to sulfonylureas, thiazolidinediones, and/or metformin, it results in additional lowering of hemoglobin A~1c~ by approximately 0.5% to 1%.

Therapeutic use

Used as an adjunct to therapy with metformin, a sulfonylurea, or a thiazolidinedione or the combination of metformin and a sulfonylurea or a thiazolidinedione for the management of type 2 diabetes mellitus in patients who have not achieved adequate glycemic control with these antidiabetic agents alone or in combination.

Pregnancy and lactiation implications

Use of exenatide generally not recommended in routine management of diabetes mellitus during pregnancy. Insulin is the drug of choice for the control of diabetes mellitus during pregnancy. Use caution if administered to nursing women.

Unlabeled use

Contraindications

Hypersensitivity to exenatide or any component of the formulation. Diabetic ketoacidosis. Type 1 diabetes.

Warnings and precautions

Anti-exenatide antibodies may develop with use. Gastrointestinal symptoms are common reactions (not recommended for use in gastroparesis or severe GI disease). Cases of acute pancreatitis (including hemorrhagic and necrotizing with some fatalities) reported. Weight loss might occur (due to reduced intake) independent of the change in hemoglobin A~1c~. Avoid use in type 1 diabetes (insulin-dependent) or diabetic ketoacidosis. Use not recommended in end-stage renal disease or severe renal impairment (CrCl <30 mL/minute). In combination with a sulfonylurea, may increase risk of hypoglycemia (risk not increased when added to metformin monotherapy).

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