Exenatide

Incretin mimetic Exenatide Mimic GLP-1C enhance prandial insulin secretion SC injectiond... 

Other injectable preparations Exenatide (Byetta) No 5-mcg/dose and 10-mcg/dose, 60 doses pre-... 

If a patient has inadequate control on two drugs, adding a third class can be considered (e.g., a glitazone, exenatide, a dipeptidyl peptidase-IV inhibitor, or basal insulin). Therapy should be guided by the A 1C, FPG, cost, additional benefits (e.g., weight loss), and avoidance of side effects). 

Byetta containing exenatide (incretin mimetic) is marketed by Lilly. 

Exenatide (57 Exenatide-4 (57) A 39-amino-acid NP Animal Diabetes ihances glucose- 496-504... 

Nielsen LL, Young AA, Parkes DG (2004) Pharmacology of exenatide (synthetic exendin-4) A potential therapeutic for improved glycemic control of type 2 diabetes. Regul Pept 117 77-88. 

Cvetkovic RS, Plosker GL. (2007) Exenatide A review of its use in patients with type 2 diabetes mellitus (as an adjunct to metformin and/or a sulfonylurea). Drugs 67 935-954. 

Dosage Initiate at 5 meg per dose administered twice daily at any time within the 60-minute period before the morning and evening meals. Exenatide should not be administered after a meal. The dose of exenatide can be increased to 10 meg twice daily after 1 month of therapy. Each dose should be administered as a subcutaneous injection in the thigh, abdomen, or upper arm. 

Concomitant therapy When exenatide is added to sulfonylurea therapy, a reduction in the dose of sulfonylurea may be considered to reduce the risk of hypoglycemia. 

Absorpf/on - After subcutaneous administration, exenatide reaches median peak plasma concentrations in 2.1 hours. 

Distribution - The mean apparent volume of distribution of a single dose of exenatide is 28.3 L. 

Metabolism/Excretion- Exenatide is predominantly eliminated by glomerular filtration. The mean terminal half-life is 2.4 hours. 

Lactation It is not known whether exenatide is excreted in human milk. 

Children Safety and efficacy of exenatide have not been established in pediatric patients. 

Insulin Exenatide is not a substitute for insulin in insulin-requiring patients. Do not use exenatide in patients with type 1 diabetes or for the treatment of diabetic ketoacidosis. The concurrent use of exenatide with insulin, thiazolidinediones, D-phenylalanine derivatives, meglitinides, or alpha-glucosidase inhibitors has not been studied. 

Renal function impairment Exenatide is not recommended for use in patients with end-stage renal disease or severe renal impairment (Ccr less than 30 mL/min). 

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