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Incretin MimeticAka: Byetta, Exenatide, GLP-1 Analog, Glucagon-Like Peptide 1, GLP-1
- See Also
- Indications
- Type II Diabetes Mellitus
- Insulin deficiency and Insulin Resistance
- Adjunct to Glucophage, Sulfonylureas, Glitazones
- Contraindications
- Type I Diabetes Mellitus
- Concurrent Insulin use
- Renal Failure: Creatinine Clearance <30 ml/min
- Mechanism
- Synthetic form of exendin-4
- Originally identified in Gila Monster Saliva
- Peptide with 39 amino acids
- Incretin Mimetic
- Incretin analogue that mimics endogenous hormone
- Incretin released from GI tract following meals
- Incretin effects
- Increases glucose dependent Insulin secretion
- Delays gastric emptying
- Decreases food intake (improves satiety)
- Synthetic form of exendin-4
- Preparations
- Dosing
- Initial
- Byetta 5 mcg SQ twice daily
- Give within 60 minutes of morning and evening meals
- Later, if blood sugars not optimized
- May increase to 10 mcg bid after 1 month
- Preparations: Prefilled pen holds 30 day supply
- 5 mcg/dose pen holds 1.2 ml of 250 mcg/ml
- 10 mcg/dose pen holds 2.4 ml of 250 mcg/ml
- Initial
- Efficacy
- Lowers HBA1C 0.4 to 0.8% (at 5 and 10 mcg doses)
- Lowers weight by up to 4-10 pounds
- Cost
- Monthly: $200 per month
- Adverse effects
- Nausea (44%) or Vomiting (13%)
- Diarrhea (13%)
- Dizziness (9%)
- Headache (9%)
- Hypoglycemia
- With Sulfonylurea: 14.4% at 5 mcg, 35.7% at 10 mcg
- With Glucophage: 4.5% at 5 mcg, 5.3% at 10 mcg
- References
exenatide (C0167117) | |
|---|---|
| Concepts | Amino Acid, Peptide, or Protein (T116) , Pharmacologic Substance (T121) |
| MSH | C074031 |
| English | Ex4 peptide, exenatide, Exendin 4, exendin-4 |
| Spanish | exenatida |
| Parent Concepts | Antidiabetics (C0935929), Incretin mimetic product (C1562104) |
| Sources | MSH, MTHSPL, NCI, RXNORM, SCTSPA, SNOMEDCT, VANDF Derived from the NIH UMLS (Unified Medical Language System) |
Byetta (C1636686) | |
|---|---|
| Concepts | Amino Acid, Peptide, or Protein (T116) , Pharmacologic Substance (T121) |
| MSH | C074031 |
| English | Byetta |
| Sources | MSH, RXNORM Derived from the NIH UMLS (Unified Medical Language System) |
