Classes
Exenatide injectable solution (Rx)
- Classes: Antidiabetics, Glucagon-like Peptide-1 Agonists
Exenatide injectable suspension (Rx)
Brand and Other Names: Bydureon BCise
Classes: Antidiabetics, Glucagon-like Peptide-1 Agonists
Description
Subcutaneous incretin mimetic (GLP-1 receptor agonist); immediate-release injection given twice daily with meals; extended-release injection given once-weekly
Extended-release injection used to improve glycemic control in patients 10 years and older with type 2 diabetes mellitus; immediate-release injection used in adults
Not a first-line therapy because of the boxed warning regarding rodent C-cell tumor findings and the uncertain relevance to humans
Indications
exenatide injectable solution
Diabetes Mellitus, Type 2
- Adjunct to diet and exercise to improve glycemic control
- Alternative monotherapy or as adjunct therapy with thiazolidinediones, metformin, or a sulfonylurea; or add-on therapy to insulin glargine (long-acting insulin)
Exenatide injectable suspension
Type 2 Diabetes Mellitus
- Indicated as adjunct to diet and exercise to improve glycemic control with type 2 diabetes mellitus (DM)
- 2 mg SC qWeek
Contraindications
Hypersensitivity
ESRD, severe renal impairment (CrCl <30 mL/min)
History of drug-induced immune-mediated thrombocytopenia from drug or related products
Family or current history of medullary thyroid carcinoma
Hypersensitivity to exenatide or to any of the product components
Personal or family history of medullary thyroid carcinoma or in patients with multiple endocrine neoplasia syndrome type 2
Adverse Effects
- Injection-site nodule (6-77%)
- Injection-site reactions (2-18%)
- Nausea (8-11%)
- Vomiting (4-11%)
- Diarrhea (2-11%)
- Constipation (6-10%)
- Headache (5-9%)
- Dyspepsia (3-7%)
- Hyperhidrosis (3%)
- Jitteriness (<3%)
- Dizziness (<2%)
- Asthenia
- Alopecia
- Anaphylactic reaction
- Angioedema
- Pancreatitis
- Rash
- Renal impairment
- Upper respiratory infection
- Severe hypoglycemia with concomitant use of sulfonylurea or insulin
- Dysgeusia
- Somnolence
- Cholecystitis, cholelithiasis requiring cholecystectomy
Warnings
Never share a pen between patients even if the needle is changed
Not a substitute for insulin
Not a first-line therapy for patients inadequately controlled on diet and exercise alone
Evaluate insulin dose when added on to long-acting insulin (ie, insulin glargine); in patients with increased risk of hypoglycemia, consider decreasing insulin dose
Not recommended for patients experiencing severe gastrointestinal disease, including gastroparesis
Not recommended for type 1 diabetes
Do not take with short- and/or rapid-acting insulins
Animal studies show association of extended-release dosage form with the formation of thyroid tumors (effects in humans unknown)
Always administer before a meal and never after a meal
Weight loss resulting from reduced intake reported
Avoid concurrent use of extended release (Bydureon BCise) and immediate release xenatide (Byetta) formulations
Serious injection-site reactions (eg, abscess, cellulitis, and necrosis) reported, with or without SC nodules; some required surgical intervention
Thyroid C-cell tumors in animals observed; human relevance unknown
Pregnancy and Lactation
Limited data in pregnant women are not sufficient to determine a drug-associated risk for major birth defects or miscarriage
There is no information regarding presence of drug, in human milk, effects on breastfed infant, or on milk production
Maximum Dosage
2 mg/week subcutaneously for extended-release injection (e.g., Bydureon/Bydureon BCise); 20 mcg/day subcutaneously for regular-release exenatide injection (e.g., Byetta).
2 mg/week subcutaneously for extended-release injection (e.g., Bydureon/Bydureon BCise); 20 mcg/day subcutaneously for regular-release exenatide injection (e.g., Byetta).
2 mg/week subcutaneously for extended-release injection (e.g., Bydureon/Bydureon BCise); safety and efficacy have not been established for regular-release injection.
10 to 12 years: 2 mg/week subcutaneously for extended-release injection (e.g., Bydureon/Bydureon BCise); safety and efficacy have not been established for regular-release injection.
1 to 9 years: Safety and efficacy have not been established.
Safety and efficacy have not been established.
How supplied
Exenatide injectable solution
injectable solution, prefilled pen
- 250mcg/mL (1.2mL vial)
- 250mcg/mL (2.4mL vial)
Exenatide injectable suspension
injectable suspension, autoinjector
- 2mg/0.85 mL (Bydureon BCise)