New medicines
Byetta
 Composition: Exenatide.
Presentation: Solution for injection, prefilled pen.
Action: Incretin mimetic.
Indications: Treatment of type 2 diabetes mellitus in combination with
metformin and/or sulphonylureas in patients who have not achieved adequate
glycaemic control on maximally tolerated doses of these oral therapies.
Dosage: Treatment should be initiated at 5µg twice daily, by subcutaneous
injection, administered at any time within an hour before the morning
and evening meal (or the two main meals of the day at least six hours
apart). After at least one month the dose can be increased to a maximum
of 10µg twice daily.
Contraindications: Type 1 diabetes mellitus, diabetic ketoacidosis, end-stage
renal disease or severe renal impairment, and severe gastrointestinal
disease.
Precautions: Byetta should not be administered after a meal. When Byetta
is added to sulphonylurea therapy, a reduction in the dose of sulphonylurea
should be considered to reduce the risk of hypoglycaemia. Caution is
advised for patients receiving oral medicines that require rapid gastrointestinal
absorption and medicines with a narrow therapeutic index. Caution with
dose escalation is recommended for patients with moderate renal impairment.
There is no experience of Byetta use in children and adolescents below
18 years old.
Side effects: Very common (>1/10) hypoglycaemia, nausea, vomiting,
diarrhoea.
Legal category: POM.
Net price: 1 pen (60 doses) 5µg/20µl, £68.24; 1 pen
(60 doses) 10µg/40µl, £68.24.
Contact details: Eli Lilly, Lilly House, Priestly Road, Basingstoke,
Hampshire RG24 9NL (tel 01256 315 000).
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