Exenatide

Exenatide was the first GLP-1 receptor agonist approved in the US, derived from a compound found in Gila monster saliva. Available as Byetta (twice daily) and Bydureon (once weekly extended-release).

Mechanism of Action

Synthetic version of exendin-4, which activates GLP-1 receptors to enhance glucose-dependent insulin secretion, suppress glucagon, slow gastric emptying, and promote satiety.

Typical Dosage (Research)

Byetta: 5mcg twice daily for 1 month, then 10mcg twice daily. Bydureon: 2mg subcutaneously once weekly.

Byetta: Inject within 60 minutes before morning and evening meals. Bydureon: Any time of day, with or without meals. Do not mix with insulin in same syringe.

Side Effects & Risks

Nausea (especially initially), vomiting, diarrhea, dizziness, headache, and injection site reactions (particularly with Bydureon).

Pancreatitis risk, renal impairment concerns, thyroid tumor warnings. Not recommended with severe GI disease or CrCl <30 mL/min.

Who Uses Exenatide

Type 2 diabetics seeking glycemic control, those who prefer the original GLP-1 agonist with extensive long-term safety data.