Exenatide

FDA label

Read the full label on DailyMed ↗

Titration Increase to 10 mcg BID after 1 month of therapy

Renal Not recommended in severe renal impairment (CrCl <30) or ESRD; use with caution in renal transplant

Hepatic Undefined

Two doses daily before the two main meals, ≥6 h apart; do not dose after meals

Instructions

• Inject SC within 60 min before morning and evening meals (≥6 h apart); do not give after a meal
• Inject into thigh, abdomen, or upper arm; rotate sites
• If used with insulin, give as separate injections and never mix
• Missed dose: resume with next scheduled dose
• Never share a pen between patients, even with a new needle

Contraindications

• History of drug-induced immune-mediated thrombocytopenia from exenatide products

Cautions

• Acute pancreatitis — discontinue if suspected
• Hypoglycemia with concomitant insulin secretagogues or insulin — consider reducing their dose
• Acute kidney injury from volume depletion — monitor renal function
• Severe GI reactions — not recommended in severe gastroparesis
• Immunogenicity (anti-exenatide antibodies) may attenuate glycemic response
• Serious hypersensitivity (anaphylaxis, angioedema)
• Drug-induced immune-mediated thrombocytopenia — serious bleeding may be fatal
• Acute gallbladder disease
• Pulmonary aspiration during general anesthesia/deep sedation (delayed gastric emptying)

Adverse reactions

• Nausea
• Hypoglycemia
• Vomiting
• Diarrhea
• Feeling jittery
• Dizziness
• Headache
• Dyspepsia
• Constipation
• Asthenia

Pregnancy Limited data; use during pregnancy only if potential benefit justifies risk to fetus

Lactation No human data; present in mouse milk — clinical relevance unclear