Exenatide
Also known as Byetta, Bydureon, Exendin-4
Exenatide is a synthetic version of exendin-4, a peptide originally identified in the saliva of the Gila monster lizard, and was the first GLP-1 receptor agonist approved for type 2 diabetes. It is available in an immediate-release, twice-daily formulation and an extended-release, once-weekly formulation using microsphere technology. Both forms are prescription-only adjuncts to diet and exercise for glycemic control and are typically used when metformin or other oral agents provide insufficient control. It is not approved as a weight-loss treatment on its own, though weight reduction is a common secondary effect.
Reported benefits
- Improves post-meal and fasting glucose control in type 2 diabetes
- Glucose-dependent mechanism carries lower intrinsic hypoglycemia risk than sulfonylureas
- Extended-release formulation allows once-weekly dosing
- Associated with modest weight reduction in many patients
How it works
Exenatide activates GLP-1 receptors on pancreatic beta cells, enhancing glucose-dependent insulin secretion while suppressing glucagon secretion in a glucose-dependent manner, reducing the risk of hypoglycemia from this mechanism alone. It also slows gastric emptying and promotes satiety through central nervous system pathways. Because it is not a substrate for the DPP-4 enzyme that rapidly degrades native GLP-1, it has a longer duration of action than the endogenous hormone.
Dosing ranges
| Tier | Dose | Frequency |
|---|---|---|
| Low | 5 mcg | twice daily, within 60 minutes before a meal (immediate-release starting dose) |
| Moderate | 10 mcg | twice daily, within 60 minutes before a meal (immediate-release maintenance dose) |
| High | 2,000 mcg | once weekly, any time of day (extended-release formulation, equivalent to 2 mg) |
Estimate your dose
Dose estimator
Educational estimate for Exenatide, scaled to body size. Not medical advice.
Read before using
This tool produces a rough, educational estimate by scaling commonly-published research ranges to lean body mass. It is not a prescription, medical advice, or a substitute for a licensed clinician. Most peptides use fixed dosing, not weight-based dosing. Individual needs vary. You are solely responsible for how you use this information.
Mixing & syringe units
Target dose follows the estimate above. Change it there, or edit it directly below.
Reconstitution calculator
How much water to add and how many insulin-syringe units to draw for Exenatide. Educational only.
Draw to this mark
0.2units
= 0.002 mL for a 10 mcg dose
Concentration
5,000 mcg/mL
Doses per vial
1,000
Under 2 units is hard to measure accurately. Use less water for a larger, easier-to-read draw.
A U-100 syringe reads 100 units per mL. This is a reconstitution math helper only, not a prescription or dosing advice. Verify every calculation and consult a qualified healthcare provider.
Possible side effects
Stacking notes
Not recommended in combination with other GLP-1 receptor agonists or DPP-4 inhibitors; requires dose reduction of concurrent sulfonylureas or insulin to reduce hypoglycemia risk.
Common protocols
Common questions
What is Exenatide used for?
Exenatide is a synthetic version of exendin-4, a peptide originally identified in the saliva of the Gila monster lizard, and was the first GLP-1 receptor agonist approved for type 2 diabetes. It is available in an immediate-release, twice-daily formulation and an extended-release, once-weekly formulation using microsphere technology. Both forms are prescription-only adjuncts to diet and exercise for glycemic control and are typically used when metformin or other oral agents provide insufficient control. It is not approved as a weight-loss treatment on its own, though weight reduction is a common secondary effect. Reported benefits include improves post-meal and fasting glucose control in type 2 diabetes, glucose-dependent mechanism carries lower intrinsic hypoglycemia risk than sulfonylureas, extended-release formulation allows once-weekly dosing.
What is a typical Exenatide dose?
Reported ranges run 5-2,000 mcg. A low protocol is 5 mcg twice daily, within 60 minutes before a meal (immediate-release starting dose), and a high protocol is 2,000 mcg once weekly, any time of day (extended-release formulation, equivalent to 2 mg). This is reference information, not a dosing recommendation.
What is the half life of Exenatide?
Approximately 2.4 hours for the immediate-release form; the extended-release formulation provides sustained exposure over about 10 weeks due to slow release from injected microspheres. That is what sets the dosing frequency, and it is why the timing guidance is before meals.
How is Exenatide administered?
Subcutaneous: into fat, under the skin. Immediate-release form injected within 60 minutes before a meal; extended-release form injected once weekly regardless of meals.
How long is a Exenatide cycle?
Continuous ongoing use as part of a diabetes treatment regimen on, followed by Reassessed if glycemic targets are not met after an adequate trial period off.
What are the side effects of Exenatide?
Reported side effects include nausea and vomiting, most common when starting therapy, injection site nodules, particularly with the extended-release microsphere formulation, risk of pancreatitis, increased hypoglycemia risk when combined with sulfonylureas or insulin, rare risk of renal impairment. Evidence level for this compound is well studied.
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Educational use only, not medical advice. This profile is provided for research and educational purposes. Exenatide may be a research compound or a prescription medication; nothing here is intended to diagnose, treat, cure, or prevent any disease. Dosing figures reflect commonly-published research ranges, not a prescription. Consult a qualified healthcare provider before making any health decision. Read the full disclaimer →