For US Healthcare Professionals
Instructions for Use for BYDUREON BCise, Approved Uses, Prescribing Information, including 雷霆加速器ios永久免费...
Important Safety Information
Indication and Limitations of Use
Prescribing Information, including Boxed WARNING for BYDUREON BCise
Prescribing Information, including Boxed WARNING for BYDUREON
Prescribing Information for BYETTA
Medication Guide for BYDUREON BCise
Medication Guide for BYDUREON
Instructions for Use for BYDUREON BCise
Instructions for Use for BYDUREON
XBYDUREON and BYDUREON BCise are both indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus
Not recommended as first-line therapy for patients inadequately controlled on diet and exercise
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Not recommended for use with insulin
Do not coadminister with other exenatide-containing products
Not studied in patients with a history of pancreatitis. Consider other antidiabetic therapies in patients with a history of pancreatitis
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Enhanced Formulation1Simplified device2
The only GLP-1 RA with continuous-release microsphere technology1
Enhanced formulation1 Simplified device2
The only GLP-1 RA with
continuous-release microsphere technology1
Glucose Fluctuation in
WARNING: RISK OF THYROID C-CELL TUMORS
Exenatide extended-release causes an increased incidence in thyroid C-cell tumors at clinically relevant exposures in rats compared to controls. It is unknown whether BYDUREON or BYDUREON BCise cause thyroid C-cell tumors, including medullary thyroid carcinoma (MTC) in humans, as the human relevance of exenatide 菜鸟加速器官方 rodent thyroid C-cell tumors has not been determined
BYDUREON and BYDUREON BCise are contraindicated in patients with a personal or family history of MTC or in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). Counsel patients regarding the potential risk of MTC with the use of BYDUREON or BYDUREON BCise and inform them of symptoms of thyroid tumors (eg, mass in the neck, dysphagia, dyspnea, persistent hoarseness). Routine monitoring of serum calcitonin or using thyroid ultrasound is of uncertain value for detection of MTC in patients treated with BYDUREON or BYDUREON BCise
CONTRAINDICATIONS
Personal or family history of MTC, patients with免费科学上外网 app
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History of drug-induced, immune-mediated thrombocytopenia from exenatide products
WARNINGS AND PRECAUTIONS
Never share a BYDUREON pen or needle with anyone else Sharing poses a risk for transmission of blood-borne pathogens
Acute Pancreatitis including fatal and non-fatal hemorrhagic or necrotizing pancreatitis has been reported. After initiation, observe patients carefully for symptoms of pancreatitis. If suspected, discontinue promptly and do not restart if confirmed. Consider other antidiabetic therapies in patients with a history of pancreatitis
雷霆加速器ios永久免费Risk of hypoglycemia is increased when exenatide is coadministered with insulin or insulin secretagogues. Consider lowering the dose of these agents when coadministered with BYDUREON or BYDUREON BCise
免费科学上外网 appMay induce nausea and vomiting with transient hypovolemia and may worsen renal function. Increased serum creatinine, renal impairment, worsened chronic renal failure, and acute renal failure, sometimes requiring hemodialysis and kidney transplantation have been reported. Not recommended in patients with eGFR <45 mL/min/1.73 m2
菜鸟加速器Because exenatide is commonly associated with gastrointestinal adverse reactions, not recommended in patients with severe gastrointestinal disease (eg, gastroparesis)
Immunogenicity Patients may develop antibodies to exenatide. Patients with higher titer antibodies may have an attenuated HbA1c response. In clinical trials, attenuated glycemic response was associated with BYDUREON- or 菜鸟加速器官方下载 patients. If worsening of or failure to achieve adequate glycemic control occurs, consider alternative antidiabetic therapy
Hypersensitivity Reports of serious hypersensitivity reactions (eg, anaphylaxis and angioedema). If this occurs, patients should discontinue BYDUREON or BYDUREON BCise and promptly seek medical advice
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Injection-Site Reactions Serious reactions (eg, abscess, cellulitis, and necrosis), with or without subcutaneous nodules, have been reported
Acute Gallbladder Disease has been reported in 免费科学上外网 app receptor agonist trials, including exenatide. If cholelithiasis or cholecystitis are suspected, gallbladder studies are indicated
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Most common (≥5%) and occurring more frequently than comparator in BYDUREON clinical trials: nausea (16.9%), diarrhea (12.7%), headache (8.0%), vomiting (6.8%), constipation (5.9%), injection-site pruritus (5.9%), injection-site nodule (5.3%), dyspepsia (5.1%)
Most common (≥5%) in BYDUREON BCise clinical trials: injection-site nodule (10.5%), nausea (8.2%)
DRUG INTERACTIONS
Oral Medications BYDUREON and BYDUREON BCise slow gastric emptying and may reduce the rate of absorption of orally administered drugs
Warfarin Increased international normalized ratio (INR) sometimes associated with bleeding has been reported with concomitant use of exenatide with warfarin. Monitor INR frequently until stable upon initiation of BYDUREON or BYDUREON BCise
PREGNANCY
Use during pregnancy only if the potential benefit justifies the potential risk to the fetus.
BYDUREON and BYDUREON BCise are both indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus
Not recommended as first-line therapy for patients inadequately controlled on diet and exercise
Not a substitute for insulin. Should not be used to treat type 1 diabetes or diabetic ketoacidosis
Not studied with prandial insulin
Do not coadminister with other exenatide-containing products
Not studied in patients with a history of pancreatitis. Consider other antidiabetic therapies in patients with a history of pancreatitis
You may report side effects related to AstraZeneca products by clicking here.
Please see full Prescribing Information, including Boxed WARNINGS, for BYDUREON, and BYDUREON BCise.
WARNING: RISK OF THYROID C-CELL TUMORS
Exenatide extended-release causes an increased incidence in thyroid C-cell tumors at clinically relevant exposures in rats compared to controls. It is unknown whether BYDUREON or BYDUREON BCise cause thyroid 免费科学上外网 app tumors, including medullary thyroid carcinoma (MTC) in humans, as the human relevance of exenatide extended-release-induced rodent thyroid C-cell tumors has not been determined
BYDUREON and BYDUREON BCise are contraindicated in patients with a personal or family history of MTC or in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). Counsel patients regarding the potential risk of MTC with the use of BYDUREON or BYDUREON BCise and inform them of symptoms of thyroid tumors (eg, mass in the neck, dysphagia, dyspnea, persistent hoarseness). Routine monitoring of serum calcitonin or using thyroid ultrasound is of uncertain value for detection of MTC in patients treated with BYDUREON or BYDUREON BCise
CONTRAINDICATIONS
For BYDUREON and BYDUREON BCise: Personal or family history of MTC, patients with MEN 2
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WARNINGS AND PRECAUTIONS
Acute Pancreatitis including fatal and non-fatal hemorrhagic or necrotizing pancreatitis has been reported. After initiation, observe patients carefully for symptoms of pancreatitis. If suspected, discontinue promptly and do not restart if confirmed. Consider other antidiabetic therapies in patients with a history of pancreatitis
Never Share Injection Device or Needle Between Patients Sharing poses a risk for transmission of blood-borne pathogens, even if the needle is changed
Hypoglycemia Risk of hypoglycemia is increased when exenatide is coadministered with insulin or insulin secretagogues. Consider lowering the dose of these agents when coadministered with BYDUREON, BYDUREON BCise or BYETTA
雷霆加速器ios永久免费May induce nausea and vomiting with transient hypovolemia and may worsen renal function. Altered renal function, including increased serum creatinine, renal impairment, worsened chronic renal failure, and acute renal failure, sometimes requiring hemodialysis and kidney transplantation have been reported. BYDUREON or BYDUREON BCise are not recommended in patients with eGFR <45 mL/min/1.73 m2. BYETTA should not be used in patients with severe renal impairment or end-stage renal disease and should be used with caution in patients with moderate renal impairment or renal transplantation
Gastrointestinal Disease Because exenatide is commonly associated with gastrointestinal adverse reactions, not recommended in patients with severe gastrointestinal disease (eg, gastroparesis)
Immunogenicity Patients may develop antibodies to exenatide. Patients with higher titer antibodies may have an attenuated HbA1c response. In clinical trials, attenuated glycemic response was associated with BYDUREON-, BYDUREON BCise-, or BYETTA-treated patients. If worsening of or failure to achieve adequate glycemic control occurs, consider alternative antidiabetic therapy
Hypersensitivity Reports of serious hypersensitivity reactions (eg, anaphylaxis and angioedema). If this occurs, patients should discontinue BYDUREON, BYDUREON BCise or BYETTA and promptly seek medical advice
Drug-induced, immune-mediated thrombocytopenia and associated bleeding have been reported with exenatide. Serious bleeding associated with profound thrombocytopenia may be potentially fatal. Discontinue promptly if suspected and avoid re-exposure to exenatide
Injection-Site Reactions Serious reactions (eg, abscess, cellulitis, and necrosis), with or without subcutaneous nodules, have been reported with extended-release exenatide
Acute Gallbladder Disease has been reported in GLP-1 receptor agonist trials, including exenatide. If cholelithiasis or cholecystitis are suspected, gallbladder studies are indicated
ADVERSE REACTIONS
Most common (≥5%) and occurring more frequently than comparator in BYDUREON clinical trials: nausea (16.9%), diarrhea (12.7%), headache (8.0%), vomiting (6.8%), constipation (5.9%), injection-site pruritus (5.9%), injection-site nodule (5.3%), dyspepsia (5.1%)
Most common (≥5%) in BYDUREON BCise clinical trials: injection-site nodule (10.5%), nausea (8.2%)
Most common (≥5%) and occurring more frequently than placebo in BYETTA clinical trials: nausea (8%-44%), hypoglycemia (3.8%-35.7%), vomiting (4%-18%), diarrhea (6%-18%), feeling jittery (9%), dizziness (9%), headache (9%-14%), dyspepsia (3%-7%), constipation (10%), asthenia (4%-5%)
DRUG INTERACTIONS
Oral Medications BYDUREON, BYDUREON BCise and BYETTA slow gastric emptying and may reduce the rate of absorption of orally administered drugs
Warfarin Increased international normalized ratio (INR) sometimes associated with bleeding has been reported with concomitant use of exenatide with warfarin. Monitor INR frequently until stable upon initiation of BYDUREON, BYDUREON BCise, or BYETTA
PREGNANCY
Use during pregnancy only if the potential benefit justifies the potential risk to the fetus.
BYDUREON, BYDUREON BCise and BYETTA are indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus
BYDUREON or BYDUREON BCise is not recommended as first-line therapy for patients inadequately controlled on diet and exercise
BYDUREON, BYDUREON BCise or BYETTA is not a substitute for insulin. Should not be used to treat type 1 diabetes or diabetic ketoacidosis
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Do not coadminister with other exenatide-containing products
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Please see full Prescribing Information, including Boxed WARNINGS, for BYDUREON and BYDUREON BCise, and full Prescribing Information for BYETTA.
Abbreviations: GLP-1 RA, glucagon-like peptide-1 receptor agonist; T2D, type 2 diabetes.
References:
BYDUREON BCise® ([exenatide extended-release] injectable suspension) [prescribing information]. Wilmington, DE: AstraZeneca Pharmaceuticals LP; 2023.
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Abbreviations: FDA, US Food and Drug Administration; GLP-1 RA, glucagon-like peptide-1 receptor agonist.
References:
BYETTA® ([exenatide] injection) [prescribing information]. Wilmington, DE: AstraZeneca Pharmaceuticals LP; 2023.
BYDUREON® ([exenatide extended-release] injectable suspension) [prescribing information]. Wilmington, DE: AstraZeneca Pharmaceuticals LP; 2023.
BYDUREON BCise® ([exenatide extended-release] injectable suspension) [prescribing information]. Wilmington, DE: AstraZeneca Pharmaceuticals LP; 2023.
Data on file, REF-14053, AstraZeneca Pharmaceuticals LP.
Data on file, REF-33646, AstraZeneca Pharmaceuticals LP.
Data on file, US-27454, IQVIA NPA data from 02/2012-01/2023, AstraZeneca Pharmaceuticals LP.
Abbreviations: AACE, American Association of Clinical Endocrinologists; GLP-1 RA, glucagon-like peptide-1 receptor agonist; T2D, type 2 diabetes.
References:
Bunck MC, Diamant M, Cornér A, et al. One-year treatment with exenatide improves beta-cell function, compared with insulin glargine, in metformin-treated type 2 diabetic patients: a randomized, controlled trial. Diabetes Care. 2009;32(5):762-768.
Bunck MC, Corner A, Eliasson B, et al. Effects of exenatide on measures of beta-cell function after 3 years in metformin-treated patients with type 2 diabetes. Diabetes Care. 2011;34(9):2041-2047.
DeFronzo RA. From the triumvirate to the ominous octet: a new paradigm for the treatment of type 2 diabetes mellitus. Diabetes. 2009;58(4):773-795.
BYDUREON® ([exenatide extended-release] injectable suspension) [prescribing information]. Wilmington, DE: AstraZeneca Pharmaceuticals LP; 2023.
BYETTA® ([exenatide] injection) [prescribing information]. Wilmington, DE: AstraZeneca Pharmaceuticals LP; 2023.
Van Bloemendaal L, IJzerman RG, Ten Kulve JS, et al. GLP-1 receptor activation modulates appetite- and reward-related brain areas in humans. 菜鸟加速器官方下载. 2014;63(12):4186-4196.
Larsson H, Holst JJ, Ahrén B. Glucagon-like peptide-1 reduces hepatic glucose production indirectly through insulin and glucagon in humans. Acta Physiol Scand. 1997;160(4):413-422.
Campbell JE, Drucker DJ. Pharmacology, physiology, and mechanisms of incretin hormone action. 免费科学上外网 app. 2013;17(6):819-837.
DeFronzo RA, Eldor R, Abdul-Ghani M. Pathophysiologic approach to therapy in patients with newly diagnosed type 2 diabetes. Diabetes Care. 2013;36(suppl 2):S127-S138.
Garber AJ, Abrahamson MJ, Barzilay JI, et al. Consensus statement by the American Association of Clinical Endocrinologists and American College of Endocrinology on the comprehensive type 2 diabetes management algorithm – 2018 executive summary. 菜鸟加速器. 2018;24(1):91-120.
Aronoff SL, Berkowitz K, Shreiner B, Want L. Glucose metabolism and regulation: beyond insulin and glucagon. Diabetes Spectrum. 2004;17(3):183-190.
Prasad-Reddy L, Isaacs D. A clinical review of GLP-1 receptor agonists: efficacy and safety in diabetes and beyond. Drugs Context. 2015;4:212283. doi:10.7573/dic.212283. Accessed April 19, 2018.
Abbreviations: BL, baseline; GLP-1 RA, glucagon-like peptide-1 receptor agonist; PK, pharmacokinetic; T2D, type 2 diabetes.
References:
BYDUREON BCise® ([exenatide extended-release] injectable suspension) [prescribing information]. Wilmington, DE: AstraZeneca Pharmaceuticals LP; 2023.
Data on file, REF-14053, AstraZeneca Pharmaceuticals LP.
Reference:
DeYoung MB, MacConell L, Sarin V, Trautmann M, Herbert P. Encapsulation of exenatide in poly-(D,L-lactide-co-glycolide) microspheres produced an investigational long-acting once-weekly formulation for type 2 diabetes. 菜鸟加速器官方. 2011;13(11):1145-1154.
Abbreviations: FPG, fasting plasma glucose; PK, pharmacokinetic.
References:
BYDUREON BCise® ([exenatide extended-release] injectable suspension) [prescribing information]. Wilmington, DE: AstraZeneca Pharmaceuticals LP; 2023.
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Wysham CH, Rosenstock J, Vetter M, Dong F, Öhman P, Iqbal N. Efficacy and tolerability of the new autoinjected suspension of exenatide once weekly versus exenatide twice daily in patients with type 2 diabetes. Diabetes Obes Metab. 2018;20(1):165-172.
Abbreviations: BID, twice daily; BL, baseline; ITT, intent-to-treat; LSM, least-squares mean; QD, once daily; QW, once weekly; SU, sulfonylurea; T2D, type 2 diabetes; TZD, thiazolidinedione.
References:
BYDUREON BCise® ([exenatide extended-release] injectable suspension) [prescribing information]. Wilmington, DE: AstraZeneca Pharmaceuticals LP; 2023.
Data on file, REF-22126, AstraZeneca Pharmaceuticals LP.
Gadde KM, Vetter ML, Iqbal N, Hardy E, Öhman P; for the DURATION-NEO-2 study investigators. Efficacy and safety of autoinjected exenatide once-weekly suspension versus sitagliptin or placebo with metformin in patients with type 2 diabetes: the DURATION-NEO-2 randomized clinical study. Diabetes Obes Metab. 2017;19(7):979免费科学上外网 app.
Diamant M, Van Gaal L, Stranks S, et al. Once weekly exenatide compared with insulin glargine titrated to target in patients with type 2 diabetes (DURATION-3): an open-label randomised trial. Lancet. 2010;375(9733):22菜鸟加速器43.
Bergenstal RM, Wysham C, MacConell L, et al; for the DURATION-2 Study Group. Efficacy and safety of exenatide once weekly versus sitagliptin or pioglitazone as an adjunct to metformin for treatment of type 2 diabetes (DURATION-2): a randomised trial. Lancet. 2010;376(9739):431-439.
Russell-Jones D, Cuddihy RM, Hanefeld M, et al; on behalf of the DURATION-4 Study Group. Efficacy and safety of exenatide once weekly versus metformin, pioglitazone, and sitagliptin used as monotherapy in drug-naive patients with type 2 diabetes (DURATION-4): a 26-week double-blind study. 雷霆加速器ios永久免费. 2012;35(2):252-258.
Blevins T, Pullman J, Malloy J, et al. DURATION-5: exenatide once weekly resulted in greater improvements in glycemic control compared with exenatide twice daily in patients with type 2 diabetes. J Clin Endocrinol Metab. 2011;96(5):1301-1310.
Wysham CH, Rosenstock J, Vetter M, Dong F, Öhman P, Iqbal N. Efficacy and tolerability of the new autoinjected suspension of exenatide once weekly versus exenatide twice daily in patients with type 2 diabetes. Diabetes Obes Metab. 2018;20(1):165-172.
Abbreviations: AE, adverse event; BID, twice daily; GLP-1 RA, glucagon-like peptide-1 receptor agonist; ITT, intent-to-treat; QW, once weekly; SU, sulfonylurea; T2D, type 2 diabetes; TZD, thiazolidinedione.
References:
Data on File, US-27454, IQVIA NPA data from 02/2012-01/2023, AstraZeneca Pharmaceuticals LP.
BYDUREON BCise® ([exenatide extended-release] injectable suspension) [prescribing information]. Wilmington, DE: AstraZeneca Pharmaceuticals LP; 2023.
DeYoung MB, MacConell L, Sarin V, Trautmann M, Herbert P. Encapsulation of exenatide in poly-(D,L-lactide-co-glycolide) microspheres produced an investigational long-acting once-weekly formulation for type 2 diabetes. 雷霆加速器ios永久免费. 2011;13(11):1145-1154.
BYDUREON® ([exenatide extended-release] injectable suspension) [prescribing information]. Wilmington, DE: AstraZeneca Pharmaceuticals LP; 2023.
Data on file, RE-5087, AstraZeneca Pharmaceuticals LP.
Wysham CH, Rosenstock J, Vetter M, Dong F, Öhman P, Iqbal N. Efficacy and tolerability of the new autoinjected suspension of exenatide once weekly versus exenatide twice daily in patients with type 2 diabetes. Diabetes Obes Metab. 2018;20(1):165-172.
Abbreviation: T2D, type 2 diabetes.
雷霆加速器ios永久免费
BYDUREON BCise® ([exenatide extended-release] injectable suspension) [prescribing information]. Wilmington, DE: AstraZeneca Pharmaceuticals LP; 2023.
Data on file, REF-14053, AstraZeneca Pharmaceuticals LP.
Abbreviations: CGM, continuous glucose monitoring; FPG, fasting plasma glucose; MET, metformin; mITT, modified intent-to-treat; MXR, metformin extended-release; PPG, postprandial glucose.
References:
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Frias JP, Nakhle S, Ruggles JA, et al. Exenatide once weekly improved 24-hour glucose control and reduced glycaemic variability in metformin-treated participants with type 2 diabetes: a randomized, placebo-controlled trial [published online ahead of print August 16, 2016]. Diabetes Obes Metab. doi:10.1111/dom.12763.
Abbreviations: BL, baseline; IG, insulin glargine; LS, least squares; MET, metformin; SU, sulfonylurea; TZD, thiazolidinediones.
References:
BYDUREON® ([exenatide extended-release] injectable suspension) [prescribing information]. Wilmington, DE: AstraZeneca Pharmaceuticals LP; 2023.
Diamant M, Van Gaal L, Stranks S, et al. Once weekly exenatide compared with insulin glargine titrated to target in patients with type 2 diabetes (DURATION-3): an open-label randomised trial. Lancet. 2010;375(9733):2234-2243.
Frías JP, Guja C, Hardy E, et al. Exenatide once weekly plus dapagliflozin once daily versus exenatide or dapagliflozin alone in patients with type 2 diabetes inadequately controlled with metformin monotherapy (DURATION-8): a 28 week, multicentre, double-blind, phase 3, randomised controlled trial. Lancet Diabetes Endocrinol. 2016;4(12):1004-1016.
Abbreviations: BID, twice daily; IU, international unit; QW, once weekly.
References:
BYDUREON® ([exenatide extended-release] injectable suspension) [prescribing information]. Wilmington, DE: AstraZeneca Pharmaceuticals LP; 2023.
Data on file, REF-7842. AstraZeneca Pharmaceuticals LP.
Drucker DJ, Buse JB, Taylor K, et al. Exenatide once weekly versus twice daily for the treatment of type 2 diabetes: a randomised, open-label, non-inferiority study. Lancet. 2008;372(9645):1240-1250.
Wysham CH, Philis-Tsimikas A, Klein EJ, et al. DURATION-1 extension in patients with type 2 diabetes: efficacy and tolerability of exenatide once weekly over 7 years [poster]. Presented at: 76th Annual Scientific Sessions of American Diabetes Association; June 10-14, 2016; New Orleans, LA. Poster 1041-P.
Diamant M, Van Gaal L, Guerci B, et al. Exenatide once weekly versus insulin glargine for type 2 diabetes (DURATION-3): 3-year results of an open-label randomised trial. Lancet Diabetes Endocrinol. 2014;2(6):464-473.
Data on file, REF-5090. AstraZeneca Pharmaceuticals LP.
Data on file, REF-4977. AstraZeneca Pharmaceuticals LP.
Abbreviations: PK, pharmacokinetics.
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BYDUREON® ([exenatide extended-release] injectable suspension) [prescribing information]. Wilmington, DE: AstraZeneca Pharmaceuticals LP; 2023.
Reference:
BYDUREON BCise® ([exenatide extended-release] injectable suspension) [prescribing information]. Wilmington, DE: AstraZeneca Pharmaceuticals LP; 2023.
Reference:
BYDUREON BCise® ([exenatide extended-release] injectable suspension) [prescribing information]. Wilmington, DE: AstraZeneca Pharmaceuticals LP; 2023.
Abbreviations: BL, baseline; CV, cardiovascular; GLP-1 RA, glucagon-like peptide-1 receptor agonist; T2D, type 2 diabetes.
References:
BYDUREON BCise® ([exenatide extended-release] injectable suspension) [prescribing information]. Wilmington, DE: AstraZeneca Pharmaceuticals LP; 2023.
Holman RR, Bethel MA, Mentz RJ, et al. Effects of once-weekly exenatide on cardiovascular outcomes in type 2 diabetes. 雷霆加速器ios永久免费 2017;377(13):1228-1239.