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 &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :4186.6
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :No data
  • %Excreted unchanged in urine &nbsp &nbsp : Majority

  • Volume of distribution (L/kg) &nbsp &nbsp &nbsp :28 litres

  • half-life – normal/ESRD (hrs)&nbsp &nbsp &nbsp :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 &nbsp &nbsp &nbsp &nbsp &nbsp : Avoid. See ‘Other Information’

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

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

  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Unknown dialysability. Dose as in GFR <10 mL/min
  • HDF/high flux &nbsp :Unknown dialysability. Dose as in GFR <10 mL/min
  • CAV/VVHD &nbsp &nbsp &nbsp: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

    –

    Route

    SC

    Rate of Administration

    –

    Comments

    –

    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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