Brand Name (Generic Name)
Byetta (exenatide injection)
Byetta Prescribing Information
What is Byetta?
Byetta, also known as exenatide, is the first member of the family of drugs called GLP-1 agonists to be marketed in the US. It is used along with diet and exercise to treat people with type 2 diabetes. It mimics the action of the natural hormone human-glucagon-like peptide-1 (GLP-1) which is a part of the incretin system in the gut. These gut hormones are able to detect rises in blood sugar due to food intake and they go to work telling the pancreas to squirt out insulin. At the same time they tell the liver NOT to release stored glucose. They act sort of like a thermostat in that when the blood sugar goes up they turn up the insulin and when it goes down they turn down the insulin. In a person with type 2 diabetes this incretin system does not function properly and needs some help. Byetta works in several places in the body and addresses four different defects. Byetta has the following actions in the body:
• Stimulates the pancreas to produce insulin when the blood sugar goes up due to food intake.
• Keeps the pancreas from telling the liver to squirt out stored insulin after a meal when it is not needed.
• Slows the stomach emptying time. Having type 2 diabetes seems to make the food clear the stomach quicker than normal which in turn causes a rapid spike in blood sugar. The rapid spike is hard for the body to handle but a slower entry of the sugar into the system is easier to handle.
• Stimulates the satiety center in the brain. The satiety center or the "I've had enough to eat" center in the brain tells you that are ready to push away from the plate of food.
• Causes weight loss. Many people will lose weight when they take these medicines and that in turn usually translates to better blood sugar control.
Who can use Byetta?
Selected adults with type 2 diabetes can use Byetta. You will probably have already started diet and exercise along with one of the other diabetes medicines before your health care provider prescribes Byetta.
Who should not use Byetta?
• People with type 1 diabetes or diabetic ketoacidosis (DKA)
• Pregnant or breastfeeding women since it is not known if Byetta is safe in these situations
• Those with kidney disease or on dialysis
• People poor digestion caused by stomach disorders such as gastroparesis
Byetta is very effective at reducing after meal blood sugar spikes and also helps the fasting blood sugar. Byetta may cause weight loss and this can be a good thing for people with diabetes who are overweight. It is unlikely to cause low blood sugar when used alone and it can be used with some of the other type 2 diabetes medicines.
Byetta must be given by injection twice daily and in addition it should be given within one hour of the morning and evening meals. It often causes nausea during the first few weeks but that usually goes away over time. Some medicines that are taken by mouth can be interfered with when taking Byetta so check with your pharmacist or other healthcare provider for advice.
What dosage can I take and how should I take it?
The initial dose is 5 mcg, twice a day, and is injected into the arm, abdomen, or thigh. After one month the dose may be increased to 10 mcg twice daily. It should be given within 60 minutes before the morning and evening meals. Byetta is available in a 5 mcg preloaded pen and a 10 mcg preloaded pen.
What are the most common side effects?
• Stomach ache or indigestion
• Jitteriness or weakness
What else should you know about Byetta before you start?
There are warnings about possible pancreatitis issues. Please consult the accompanying FDA approved Medication Guide for further information.
Reviewed by James A. Bennett 5/14
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