BYETTA ( Exenatide)

Manufacturer: Astra Zeneca

Used for: Treatment of Type 2 DM in combination with Metformin, or sulfonylurea, or pioglitazone, or metformin and sulfonylurea, or metformin and pioglirazone, when these, whether combined or alone, are not sufficient to achieve adequate blood glucose control.

Monotherapy License: No

Insulin License: Yes

Dose: 5ug twice daily for one month, followed by 10ug twice daily if the drug is tolerated. The medication should be administered 60 minutes before breakfast and an evening meal. It should not be administered after a meal. If missed, continue with the next scheduled dose.

Side Effects

Very common: hypoglycaemia when used with sulfonylurea, nausea, vomiting, diarrhoea. 

Common: decreased appetite, abdominal bloating (distension), abdominal pain, constipation, flatulence, gastroesophageal reflux, headache, dizziness, feeling jittery, sweating, itching and rash (urticaria). 

Uncommon: injection site reactions, hair loss, sweating, taste disturbance, feeling sleepy, dehydration, changes in renal function (renal failure), rapid weight loss. 

Rare: Bowel obstruction, anaphylactic reactions. Incidence of pancreatitis: not known but presumed very rare.Renal impairment: Not recommended if Cr clearance is < 30ml/min.

Pregnancy and lactation: Stop before pregnancy, do not use during pregnancy. Do not use while breast feeding.

Contraindications: Allergy to any of the ingredients. In addition to this, in the US, also a past medical history or family history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Hyperplasia Type 2 (MEN 2). If a patient develops pancreatitis while taking this medication, do not restart the medication after the episode of pancreatitis.