Before using exenatide

Before using exenatide make sure your doctor or pharmacist knows:

• If you have a problem with your stomach or digestive system.
• If you have kidney problems.
• If you have ever had pancreatitis (inflammation of the pancreas).
• If you are pregnant, trying for a baby or breast-feeding.
• If you are taking other medicines, including those available to buy without a prescription, herbal and complementary medicines.
• If you have ever had an allergic reaction to this or to any other medicine.

How to use exenatide

• Before starting this treatment, read the manufacturer's printed information leaflet from inside the pack as well as the information you have been given by your doctor or diabetes clinic.
• Use your exenatide exactly as your doctor has told you. Your doctor or diabetes nurse will show you how to inject yourself. Exenatide is injected into your skin usually in your upper arms, thigh, or stomach.
• Try to choose a different injection site for each of your injections.This will help to prevent skin problems and difficulties in injecting.
• If you are using Byetta®, you will be advised to inject two doses a day. Inject your doses within one hour before your morning and evening meals. These two doses must be at least six hours apart. If you forget a dose, do not inject it after you have eaten your meal, but instead just carry on with your next dose when it is due.
• If you are using Bydureon®, you will be advised to inject one dose a week which can be given at any time of day either before or after meals.

Getting the most from your treatment

• It is important that you keep your regular doctor's and clinic appointments. This is so that your progress can be monitored. You are likely to need regular check-ups with an eye clinic and a foot clinic as well as with your doctor and diabetes clinic.
• Your doctor may recommend that you test for sugar in your blood or urine regularly to check that your diabetes is being controlled. Your doctor or diabetes nurse will show you how to do this.
• If you have been given advice by your doctor about changes to your diet, stopping smoking or taking regular exercise, it is important for you to follow the advice you have been given.
• Keep to the recommended alcohol limits. Drinking alcohol will affect the control of your blood sugar. Do not drink alcohol on an empty stomach as this can cause low blood sugar levels.
• If you get unusually thirsty, pass urine more frequently, and feel very tired, then let your doctor know. Your dose of exenatide may need adjusting.
• If you are due to have an operation or dental treatment, you should tell the person carrying out the treatment that you are diabetic and using exenatide.
• If you are a driver you should take special care, as your ability to concentrate may be affected if your diabetes is not well-controlled. Make sure you know what it feels like if your blood sugar is low. This is known as hypoglycaemia or a 'hypo'. The first signs of hypoglycaemia are: feeling shaky or anxious, sweating, looking pale, feeling hungry, and having palpitations (a feeling that your heart is pounding). If these happen you should eat or drink something containing sugar or have a snack straightaway. It is advisable to check your blood or urine glucose levels before you travel on long journeys and to have a snack with you.

Can exenatide cause problems?

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. These usually improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.

How to store exenatide

• Keep all medicines out of the reach and sight of children.
• Exenatide can be kept for four weeks at room temperature, as long as this is below 25°C and it is kept away from direct heat and sunlight. It is however best to store your unopened packs in a refrigerator. Do not freeze exenatide.
• Any prefilled pens must be discarded 30 days after being first used.

Important information about all medicines

References

• Manufacturer's PIL, Byetta® 5 micrograms solution for injection, prefilled pen. Byetta® 10 micrograms solution for injection, prefilled pen, Eli Lilly and Company Limited, electronic Medicines Compendium. Dated September 2011.
• Manufacturer's PIL, Bydureon® 2 mg powder and solvent for prolonged-release suspension for injection, Eli Lilly and Company Limited, electronic Medicines Compendium. Dated June 2011.
• British National Formulary; 62nd Edition (Sep 2011) British Medical Association and Royal Pharmaceutical Society of Great Britain, London (link to current BNF)