Exenatide (Byetta, Bydureon)

The first GLP-1 medicine, based on a hormone found in Gila monster saliva. Comes as a twice-daily shot and a weekly version.

Evidence: Extensive clinical research
Half-life: Varies
Sources: 3 cited

Is exenatide FDA-approved?

FDA-approved for type 2 diabetes (Byetta 2005, Bydureon 2012).

Overview

Exenatide is a lab-made copy of exendin-4, a peptide found in the saliva of the Gila monster lizard. Byetta, approved in 2005, was the first GLP-1 medicine. A weekly version (Bydureon) followed. In the large EXSCEL trial, weekly exenatide was safe for the heart but didn't clearly lower heart events.

How it works

It switches on GLP-1 receptors to boost insulin after meals, slow the stomach and curb appetite. Unlike human GLP-1, it resists breakdown by the enzyme DPP-4.

How long does exenatide stay in the body?

Twice-daily Byetta: about 2.4 hours, peaking about 2 hours after a shot. The weekly version releases slowly from tiny beads, so levels build over several weeks.

What it's studied for

Type 2 diabetes
Heart outcomes

Reported side effects

Nausea, vomiting, diarrhea
Bumps at the injection site (weekly version)
Low blood sugar with sulfonylureas
Pancreatitis and kidney problems (rare)
Boxed warning (weekly version, Bydureon BCise): thyroid C-cell tumors seen in rodents. Not for people with a personal or family history of medullary thyroid cancer or MEN 2.

Sources

The studies and prescribing labels this page is written from.