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Overview: Exenatide is a GLP-1 agonist. It is used to help lower blood sugar levels in people with type 2 diabetes. Common side effects are nausea and skin changes at injection site. If nausea or other side effects feel severe or will not go away, call your health care provider. The brand Bydureon BCise was discontinued by the drugmaker. Your health care provider may suggest a generic alternative or similar medicine for you.

Uses

What is exenatide used for?

Exenatide is commonly used to help lower blood sugar levels in people with type 2 diabetes. 

Exenatide may also be used for other conditions as determined by your health care provider.

How does exenatide work (mechanism of action)?

Exenatide works to improve blood sugar in 3 different ways. It works to stimulate your pancreas to release more insulin after you eat, prevents your liver from releasing stored sugars, and slows down the movement of food through your body.

How is exenatide supplied (dosage forms)?

Brands and other names

  • Bydureon BCise

Dosage forms and strengths

  • 2 mg extended-release injectable suspension, single-dose autoinjector

How should I store exenatide?

Exenatide injection liquid should be stored lying flat in its original packaging, in the refrigerator, between 36 F and 46 F (2 C and 8 C). Unused exenatide can be stored until the expiration date. If needed, the medicine can be stored at room temperature up to 86 F (30 C) for up to 4 weeks (28 days). Store in a place that is not exposed to direct light and heat. Do not freeze. 

Side Effects

What are the most common side effects of exenatide?

The most common side effects of exenatide are listed below. Tell your health care provider if you have any of these side effects that bother you.

  • Bump at the injection site
  • Nausea

There may be other side effects of exenatide that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of exenatide?

While less common, the most serious side effects of exenatide are described below, along with what to do if they happen.

Severe Allergic Reactions. Exenatide may cause allergic reactions, which can be serious. Stop using exenatide and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching or skin rash
  • Bumps on the skin called hives that can be red, pink, white, or brown depending on your skin tone
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Thyroid Tumors. Exenatide may cause you to get thyroid tumors. Some of these tumors could be cancerous. Tell your health care provider right away if you notice any of the following symptoms of a thyroid tumor.

  • Swelling or a lump in your neck
  • Hoarseness
  • Trouble swallowing
  • Trouble breathing

Pancreatitis. Exenatide may cause inflammation of the pancreas, which is called pancreatitis. Stop using exenatide and call your health care provider right away if you have symptoms of pancreatitis including vomiting or severe pain in the upper part of your belly that travels to your back.

Low Blood Sugar (Hypoglycemia). Exenatide can cause low blood sugar, especially when used with insulin or other medicines that increase your insulin levels. Hypoglycemia can be serious and may lead to death. Your dose of insulin or other diabetes medicine may need to be lowered to decrease your risk of low blood sugar. Do not use exenatide and call your health care provider right away if you have any of the following symptoms of low blood sugar.

  • Headache
  • Crankiness or anxiety
  • Hunger
  • Dizziness or confusion
  • Blurry vision
  • Slurred speech
  • Sweating
  • Feeling jittery or shakiness
  • Fast heartbeat
  • Seizures

Kidney Damage.Kidney damage can happen when using exenatide. Call your health care provider right away if you have any of the following symptoms of kidney damage.

  • Reduced need to pee
  • Swelling in your feet, ankles, or legs
  • Weakness or unusual tiredness
  • Trouble catching your breath or chest pain or pressure
  • Confusion
  • Nausea
  • Seizures

Severe Stomach Problems. Severe stomach problems may happen with exenatide. Call your health care provider if you have severe nausea, vomiting, or diarrhea.

Severely Low Platelet Levels. Exenatide can cause you to have a severely low number of platelets in your blood, also called thrombocytopenia. Platelets help to form blood clots. Having a low level of platelets may increase your risk of bleeding. Tell your health care provider if you have any of the following symptoms of low platelet levels.

  • Easy bruising or bleeding
  • Bleeding that does not stop
  • Nosebleeds

Serious Injection-Site Reactions. Exenatide can cause serious injection-site reactions, which sometimes require surgery. These reactions may involve a bump at the injection site, but not always. Call your health care provider right away if you have any of the following symptoms at or near the injection site.

  • Severe pain
  • Swelling
  • Redness or discoloration
  • Blisters on the skin
  • Open sore or scab

Gallbladder Problems. Exenatide can cause gallbladder problems, including cholecystitis and cholelithiasis (also known as gallstones). Call your health care provider right away if you have any of the following symptoms.

  • Your skin or the whites of your eyes turning yellowish in color (also called jaundice)
  • Fever
  • Pain in your upper stomach area
  • Stool (poop) that is clay-colored

Antibodies to Exenatide. Some people who use exenatide can develop antibodies against exenatide, which are proteins in your blood that keep exenatide from working. This means exenatide may not work to lower your blood sugar. If you notice your blood sugar levels are not going down or your blood sugar levels are getting higher when using exenatide, tell your health care provider. They may need to change you to a different medicine for your type 2 diabetes.

Warnings & Precautions

Who should not use exenatide?

Allergies to Ingredients. People who are allergic to any of the following should not use exenatide.

  • Exenatide
  • Bydureon BCise
  • Byetta
  • Any other medicine that contains exenatide
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in exenatide.

Exenatide is not used for type 1 diabetes.

Thyroid Cancer or Endocrine Condition. Exenatide should not be used if you or someone in your family has had medullary thyroid carcinoma (MTC) or if you have a condition called Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). Talk to your health care provider about your current and past health conditions and your family medical history.

Drug-Induced Thrombocytopenia. People who have had very low platelets in their blood after using other exenatide products in the past should not use this medicine. Talk to your health care provider about any reactions you have had to medicines in the past.

Kidney Problems.Exenatide should not be used if your kidneys are not working as well as they should be. If there is a concern about the health of your kidneys, your health care provider may do tests to check if they are working well enough to take this medicine.

What should I know about exenatide before using it?

Review the Instructions for Use that come with your medicine when using exenatide for the first time or when you have not used it in a while.

Do not use exenatide unless it has been prescribed to you by a health care provider. Use it as prescribed.

Do not share exenatide with other people, even if they have the same condition as you. It may harm them.

Keep exenatide out of the reach of children. Since this medicine may be kept in a refrigerator, take special precautions to keep it away from children who also use the refrigerator.

People who are 65 and older can be at greater risk for some side effects from exenatide. Talk to your health care provider about your risks if you are in this age group.

If you have nausea, vomiting, or diarrhea, drink plenty of water, so that you do not get dehydrated.

Use exenatide once each week on the same day, at any time of day.

Avoid using the same injection site each time you use exenatide by rotating where you inject it.

What should I tell my health care provider before using exenatide?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if exenatide is right for you.

In particular, make sure that you discuss any of the following.

Upcoming Surgery or Procedure. Tell your health care provider that you use exenatide before any planned surgeries or procedures that require anesthesia or deep sedation. Exenatide causes your stomach to empty more slowly which can increase the risk of food getting into your lungs (aspiration) during surgery or procedures.

Stomach Problems. Tell your health care provider if you have stomach problems, such as slowed stomach emptying (gastroparesis) or problems digesting food. Your health care provider may choose another medicine to treat your type 2 diabetes.

Pancreatitis. Tell your health care provider if you have ever had pancreatitis. Your health care provider may choose another medicine to treat your type 2 diabetes.

Other Medicines and Supplements. Exenatide may interact with other medicines and supplements. Before taking exenatide, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Kidney Problems. Tell your health care provider if you have kidney problems, including chronic kidney failure, as this may worsen while using exenatide. 

Pregnancy. It is not known if or how exenatide could affect pregnancy or harm a fetus. Tell your health care provider if you are or plan to become pregnant. Your health care provider will let you know if you should use exenatide while you are pregnant or trying to get pregnant.

Breastfeeding. It is not known if exenatide passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed.

Interactions

Does exenatide interact with foods or drinks?

There are no known interactions between exenatide and foods or drinks.

It is unknown if drinking alcohol will affect exenatide, but alcohol may affect blood sugar levels in people with diabetes. This may interfere with the effect of exenatide. It is best to limit the amount of alcohol you drink.

Does exenatide interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are taking warfarin (Jantoven), a medicine used for blood clots before using exenatide. You may need more frequent monitoring of your warfarin and this combination may increase your risk for bleeding or bruising.

Make sure that you discuss any medicines you are using for diabetes. Some diabetes medicines may increase your risk of low blood sugar (hypoglycemia).

Some medicines may increase your risk of kidney damage (see above in the serious side effects section) with exenatide. Make sure that you discuss if you are taking any of the following.

  • A diuretic, also called a water pill, which is a medicine used to reduce edema (fluid retention) and blood pressure
  • A non-steroidal anti-inflammatory drug (NSAID), such as ibuprofen, naproxen, and others, which are contained in many prescription and OTC products for pain, swelling, and fever
  • An angiotensin-converting enzyme (ACE) inhibitor, such as lisinopril, benazepril, and others which are in some prescription products to reduce blood pressure

Exenatide works by slowing down the movement of food through your body. Because of this, exenatide may affect the absorption of some other medicines that you take by mouth. Tell your health care provider about all medicines that you take or have recently taken.

This may not be a complete list of medicines that can interact with exenatide. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much exenatide?

If you or someone else has used too much exenatide, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of exenatide?

If you miss a dose of exenatide, use it as soon as possible, as long as there are at least 3 days (72 hours) before your next dose is due. Moving forward, use exenatide every 7 days. Do not use exenatide with less than 72 hours between doses. If there are less than 72 hours before your next dose is due, skip your missed dose and take your next dose on your regularly scheduled day.