Exenatide

CLINICAL USE

Adjunctive therapy in type 2 diabetes mellitus

DOSE IN NORMAL RENAL FUNCTION

5–10 mcg twice daily within 60 minutes before the morning and evening meal

PHARMACOKINETICS

Molecular weight :4186.6

%Protein binding :No data

%Excreted unchanged in urine : Majority

Volume of distribution (L/kg) :28 litres

half-life – normal/ESRD (hrs) :2.4/5.951

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

30–50 Increase dose to 10 mcg with caution10–30 Avoid. See ‘Other Information’

<10 : Avoid. See ‘Other Information’

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Unknown dialysability. Dose as in GFR <10 mL/min

HD :Unknown dialysability. Dose as in GFR <10 mL/min

HDF/high flux :Unknown dialysability. Dose as in GFR <10 mL/min

CAV/VVHD :Unknown dialysability. Dose as in GFR=10–30 mL/min

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugs

Anticoagulants: possibly enhances anticoagulant effect of warfarinOther nephrotoxins: avoid concomitant use

ADMINISTRATION

Reconstition

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Route

Rate of Administration

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Comments

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OTHER INFORMATION

Clearance is reduced by 84% in patients with established renal failureIncreased gastrointestinal side effects in patients with severe renal impairment and on dialysisMay cause renal failure including proteinuria. Avoid in patients with pre-existing renal impairment

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