Exenatide

Exenatide is a type of medication you might need to take if you have type 2 diabetes medication. 

• What is exenatide?
• How does exenatide work?
• Is there a shortage of exenatide?
• How do I take exenatide?
• Who can take exenatide?
• Your prescription
• Side effects of exenatide
• More information and support 

What is exenatide? 

Exenatide is part of a group of medications called GLP-1 agonists. It has been known as the brand names Byetta and Bydureon. 

You can take exenatide on its own or with other diabetes medications such as metformin, sulphonylureas or insulin. 

How does exenatide work? 

Exenatide works by increasing the levels of incretins – hormones – which help the body produce more insulin when needed. It also reduces the amount of glucose produced by the body and slows down how quickly food is digested. This all helps lower blood sugar levels and HbA1c.  

Byetta has been discontinued 

Byetta, one of the brand names for exenatide, was discontinued in March 2024. Healthcare professionals have been working to move people affected by this onto a new diabetes treatment.  

In January 2024, a National Patient Safety Alert was issued by NHS England and the Department for Health and Social Care to address supply issues with GLP-1 agonist medication.  

Healthcare professionals have since identified people who were taking Byetta injections and, in line with guidance from the National Institute for Health and Care Excellence, or NICE for short, switched them to Rybelsus tablets. Rybelsus is another type of diabetes medication 

You should contact your healthcare team if you’re affected by shortages of GLP-1 agonists or have questions about treatment with Byetta. 

Is there a shortage of exenatide? 

There are shortages of most GLP-1 medications including Bydureon. You can read more about our response to these GLP-1 medication shortages. 

The shortages are having a global impact including across the UK. Scotland, Northern Ireland and Wales have all issued guidance which reflects that issued by the Department of Health and Social Care in England. 

Contact your healthcare team if you’re affected by shortages of GLP-1 analogues. These shortages mean that some people may need to change to a different medication or management plan. Your healthcare team should be able to discuss the options with you. 

How do I take exenatide? 

Exenatide is an injection that you take. Your healthcare team will give you more information about how to take exenatide, and how to inject.   

Bydureon is a long-acting version of exenatide which you inject once a week. You can take Bydureon at any time of the day with or without meals, but it should be taken on the same day of each week.  

Always take this medication exactly as your healthcare professional has told you. The Patient Information Leaflet inside the box will tell you how to take it but always check with your healthcare professional if you are not sure.    

Who can take exenatide? 

Adults over the age of 18 years old or children over 10 years old with type 2 diabetes can take Byduroen. 

Guidelines from the National Institute for Health and Care Excellence, or NICE for short, recommend that Exenatide can be prescribed to adults with type 2 diabetes when:

• Using three medications has not been effective in managing diabetes.
• Or you have not been able to take the medications. This might be because of side effects or because of other medical conditions.

Exenatide is only prescribed to people who have a Body Mass Index, known as BMI, of 35kg/m2 or more, or who have additional psychological or other medical conditions that are related to obesity.    

However, someone with type 2 diabetes can be prescribed Ozempic if they have a BMI below 35kg/m2 and: 

• Using insulin would affect their job due to the risk of low blood sugar, also known as hypoglycemia or hypos; 
• Weight loss would lead to improvements in other obesity-related health issues. 

NICE recommends – due to their risk from obesity-related health problems at a lower BMI – that people from Black African, African-Caribbean, Asian, South Asian, Chinese, and Middle Eastern backgrounds receive treatment with exenatide at a lower BMI.    

Who can’t take exenatide? 

Some medications might not be suitable for some people, which might be because of medical conditions or other reasons: 

• Your doctor will tell you to stop taking exenatide if you develop diabetic ketoacidosis, also called DKA; 
• Exenatide might not be suitable for you if you have severe problems with your stomach emptying, including gastroparesis, or problems with your digestion; 
• If you have kidney disease you might not be able to take exenatide, but this will depend on the stage of your kidney disease;
• You may need to temporarily stop taking exenatide if you're going to have an operation;
• You should not take this medication if you are pregnant of breastfeeding. If you’re planning a pregnancy speak with a healthcare professional if you are using this medication.    

When you start a new medication always check with your healthcare team that it’s suitable for you to take.   

Your prescription 

You should only be given a prescription for exenatide following an assessment by your healthcare team to make sure that you meet the criteria and that you’ll benefit from its use.    

This should be an individual assessment that includes how exenatide will fit into your current treatment plan and considers any diet or activity programme that you are following, as well as the risk of side effects, the dose you’ll need, and your personal choices. 

Your healthcare team should explain your prescription to you but it's important to make sure you ask if you don't feel you know enough.   

And make sure you talk to your GP or your diabetes team if you struggle to take your medication. They might be able to help by giving you a different dose. 

In England, if you need to take any medication to manage your diabetes, your prescriptions will be free. Ask your healthcare team about a prescription exemption certificate if you don't have one, to make sure you don't get charged for your medication. Prescriptions are already free for everybody in the rest of the UK, so you shouldn't pay for your medication.  

Side effects of exenatide  

Like all medications, exenatide can cause side effects. But when side effects are listed as common in the Patient Information Leaflet, it doesn’t mean that everyone who takes the medication will get them.   

The information about side effects is based on the likelihood of people having them. For example, if a side effect is very common then it can affect more than one in ten people, and if a side effect is very rare then it affects fewer than one in 10,000 people.   

Because medicines can affect people differently, your healthcare team will speak to you about what’s best for you and discuss any side effects.  

You might feel sick (nauseous) when you first start taking exenatide. This normally improves over time.  

Some people who take this medication might lose weight because it can reduce your appetite and the amount of food you eat.   

Risk of low blood sugar 

When taken on its own, exenatide does not usually cause blood sugar levels to become too low. However, hypos are more likely to happen when you take exenatide with other diabetes medications, such as insulin or a sulphonylurea. 

Your healthcare team may advise reducing the dose of your sulphonylureas or insulin medicine when you start taking exenatide to reduce the risk of hypos.  

Risk of high blood sugar 

If you take exenatide with insulin and your insulin dose is reduced too quickly it can cause high blood sugar levels, also known as hyperglycaemia or hypers, and there is an increased risk of diabetic ketoacidosis, also called DKA. Your health care team should discuss with you the signs and symptoms of DKA. 

These are not all the side effects. You will find a full list of known side effects in the Patient Information Leaflet. This comes in the medication box.   

It’s also important that you take individual advice from your healthcare team before starting treatment and report any side effects to your healthcare professionals, if you experience any.  

You can also report these side effects to the Yellow Card Scheme, which is the government system used for recording side effects with medicines in the UK.   

More information and support 

Still have more questions? Or is there anything you're not sure about exenatide after reading this page? Contact our helpline on 0345 123 2399. 

You can visit the NHS website for more information.