Precautions and Warnings for Exenatide

There are several precautions and warnings for exenatide to be aware of, including potential drug interactions, the risk of low blood sugar when taken with certain other diabetes medications, and the possible danger of taking the drug when pregnant. Prior to taking exenatide, be sure to tell your healthcare provider about any medical conditions you may have and any medications you are currently taking.

Exenatide: What Should I Tell My Healthcare Provider?

You should talk with your healthcare provider prior to taking exenatide (Byetta®) if you have:
 
  • Kidney problems, including kidney failure (renal failure)
  • A history of diabetic ketoacidosis (a life-threatening condition that may occur with uncontrolled diabetes)
  • Diabetic gastroparesis (a slowing of the digestive tract due to diabetes)
  • Other digestive tract conditions
  • Any allergies, including allergies to foods, dyes, or preservatives.
     
Also, let your healthcare provider know if you are:
 
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
     
Tell your healthcare provider about all of the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements.
 

Some Precautions and Warnings for Exenatide

Patients taking this drug should keep the following precautions and warnings in mind:
 
  • Although exenatide is an injectable medication, it is not a form of insulin and should not be used to treat type 1 diabetes or diabetic ketoacidosis. These conditions need to be treated with insulin.
     
  • Exenatide is a man-made version of a protein found in the saliva of gila monster lizards. As such, it may be more likely to cause allergic reactions. Talk to your healthcare provider if you develop an allergic reaction after taking exenatide. Also, in some people, the immune system may attack exenatide, perhaps making it less effective.
     
  • Exenatide has not been studied in combination with the following medications for diabetes: repaglinide (Prandin®), nateglinide (Starlix®), acarbose (Precose®), or miglitol (Glyset®). Also, exenatide has not been studied in combination with insulin.
     
  • Exenatide is not recommended for use in people with severe kidney disease, including kidney failure (renal failure).
     
  • Exenatide has not been studied in people with diabetic gastroparesis or other digestive tract conditions. Exenatide is not recommended for use in people with severe digestive tract conditions, as it can slow the function of the digestive tract.
     
  • When used by itself or in combination with medications such as metformin (Glucophage®), pioglitazone (Actos®), or rosiglitazone (Avandia®), exenatide does not increase the risk of low blood sugar by much. However, the risk of low blood sugar is significantly higher when exenatide is used with the following sulfonylurea medications:
o Chlorpropamide (Diabinese®)
o Tolazamide (Tolinase®)
o Tolbutamide (Orinase®)
o Metformin and glipizide (Metaglip®)
o Metformin and glyburide (Glucovance®). 
Your healthcare provider may need to lower your dose of any of the above medications if you are taking exenatide (see Byetta and Blood Sugar).
  • Exenatide is considered a pregnancy Category C medication. This means that it may not be safe for use in pregnant women, although the full risks of exenatide in pregnancy are not known. Talk to your healthcare provider before taking exenatide during pregnancy (see Byetta and Pregnancy).
     
  • It is not known if exenatide passes through breast milk. Therefore, if you are breastfeeding or plan to start breastfeeding, be sure to talk with your healthcare provider about breastfeeding while taking exenatide.
     
(Precautions and Warnings for Exenatide Continued: Page 2)
Written by/reviewed by: Kristi Monson, PharmD; Arthur Schoenstadt, MD
Last reviewed by: Kristi Monson, PharmD;
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