Karen Berger, PharmD, is a community pharmacist and medical writer/reviewer.
Femi Aremu, PharmD, is a professional pharmacist with experience in clinical and community pharmacy. He currently practices in Chicago, Illinois.
Bydureon BCise has a boxed warning, the strongest safety warning required by the U.S. Food and Drug Administration (FDA). The warning states that Bydureon BCise has caused thyroid tumors (cancer) in animal studies. It is not known if Bydureon BCise causes thyroid tumors in humans.
Bydureon BCise should not be used in people with a history (or family history) of medullary thyroid carcinoma, a type of thyroid cancer. It should also not be used in people with multiple endocrine neoplasia syndrome type 2, a rare genetic disorder.
People who take Bydureon BCise should be aware of the possible risk of thyroid cancers and watch for symptoms such as swelling or a lump in the neck, difficulty swallowing, a hoarse voice, or shortness of breath. Report any of these symptoms to your healthcare provider immediately.
Bydureon BCise (exenatide) is a prescription drug used along with diet and exercise to improve blood sugar control in adults and children 10 years and older with type 2 diabetes.
Bydureon BCise is not insulin. It belongs to a drug class called glucagon-like peptide-1 (GLP-1) receptor agonists. These drugs work by helping the pancreas make more insulin, which helps lower blood sugar. It also slows the emptying of the stomach, which decreases your appetite.
It contains the ingredient exenatide (extended-release). To administer it, you’ll use an automatic injector pen and inject it once weekly under the skin (subcutaneous) of the stomach, thigh, or upper arm.
Generic Name: Exenatide
Brand Name(s): Bydureon BCise, Byetta
Drug Availability: Prescription
Administration Route: Subcutaneous (under the skin) injection
Therapeutic Classification: GLP-1 receptor agonist, antidiabetic agent
Available Generically: No
Controlled Substance: N/A
Active Ingredient: Exenatide
Dosage Form(s): Automatic injector pen
The U.S. Food and Drug Administration (FDA) approved Bydureon BCise to be used along with diet and exercise to improve blood sugar control in adults and children 10 years and older with type 2 diabetes.
Blood sugar control is measured in several ways. You can get real-time blood sugar (glucose) levels by using a finger stick and blood glucose monitor or a continuous glucose monitor. The hemoglobin A1C (HbA1C) measures blood glucose control over about three months.
Bydureon BCise should not be used:
If you are prescribed Bydureon BCise, your healthcare provider will show you how to inject the medication yourself. Parents or caregivers should help children mix and inject Bydureon BCise.
Read the prescription label and the information leaflet that comes with your prescription. Consult your healthcare provider if you have any questions.
Use Bydureon BCise precisely as directed by your healthcare provider, and do not skip doses. The following are general instructions for taking it:
Bydureon BCise can affect your platelet count for up to several months after you stop taking it. Follow your healthcare provider’s instructions for getting lab work. Additionally, make sure you continue following a diet, exercise, and blood sugar monitoring plan throughout your treatment.
Talk to your healthcare provider about hypoglycemia (low blood sugar) and how to treat it. Ask about a prescription for glucagon, which can increase your blood sugar in a low blood sugar emergency. Have your pharmacist show you how to use it, and teach your family, friends, and caregivers how to administer it in an emergency.
Store Bydureon BCise flat, in its original package, in the refrigerator. Protect it from light. Do not use Bydureon BCise past the expiration date.
Bydureon BCise can be kept at room temperature (between 68 F and 77 F) for up to four weeks.
Keep Bydureon BCise out of reach of children. Each injector contains one dose. After injecting the weekly dose, discard it in a sharps container. If you do not have a sharps container, you can use a laundry detergent container that is kept upright, tightly closed, and clearly marked for hazardous waste.
When your sharps container is about 3/4 full, you will need to dispose of the container. Do not reuse the sharps container. Sharps disposal guidelines may vary depending on where you live. Check with your local trash removal services or the health department about sharps disposal programs in your area.
Sometimes, exenatide is used for indications that are not FDA-approved. This is called off-label prescribing.
Healthcare providers may prescribe exenatide for weight loss. Many drugs in the GLP-1 agonist drug class are prescribed off-label for this use. The way these medications slow stomach emptying is thought to decrease appetite, making it easier to lose weight.
This drug is also being studied off-label for use in Parkinson’s disease.
After an injection of Bydureon BCise, which is extended-release, some of the drug is released initially, and the rest is released gradually over several weeks. The highest drug levels for an individual dose are reached around six or seven weeks.
You may see a difference in blood sugar levels in a few days or weeks. Your healthcare provider will tell you how and when to monitor your blood sugar.
This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the FDA at www.fda.gov/medwatch or 1-800-FDA-1088.
Like other medications, Bydureon BCise can cause side effects. Tell your healthcare provider about any side effects you experience while taking this medication.
The most common side effects of Bydureon BCise are:
Notify your healthcare provider immediately if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:
One study looked at people who took exenatide along with the oral diabetes medication Glucophage (metformin) for 82 weeks (almost 19 months). The results showed that exenatide was tolerated well and helped lower A1C.
The most common side effect was nausea, which was mild to moderate, and went away over time. Low blood sugar rarely occurred, and no severe events were reported.
Bydureon BCise may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.
If you experience a serious side effect, you or your healthcare provider may send a report to the FDA’s MedWatch Adverse Event Reporting Program or by phone (800-332-1088).
The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
You may need to use caution when taking Bydureon BCise if you are 65 years or older, especially if you also have kidney problems.
People of any age with kidney problems should consult their healthcare provider before taking this medication. Bydureon BCise may cause nausea and vomiting and can worsen kidney function. People with mild kidney problems who take this medication will be carefully monitored by their healthcare provider. Those with moderate to severe kidney problems generally cannot take Bydureon BCise.
People who are pregnant, planning to become pregnant, or are breastfeeding, should consult their healthcare provider. Bydureon BCise may cause harm to a developing fetus. Your healthcare provider may only allow you to use it during pregnancy if the potential benefit outweighs the risk. If you already take Bydureon BCise and find out that you are pregnant, tell your healthcare provider immediately.
If you miss a dose of Bydureon BCise, take it as soon as you remember, as long as your next regularly scheduled dose is at least three days from when you take the missed dose. Then, resume your regular once-a-week dosing schedule.
If you miss a dose and the next regularly scheduled dose is in one or two days, skip the missed dose and resume with your next regularly scheduled dose.
Taking too much Bydureon BCise can cause severe nausea, vomiting, and low blood sugar. Seek medical help if you experience any of these effects.
If you think you or someone else may have overdosed on Bydureon BCise, call a healthcare provider or the Poison Control Center (800-222-1222).
If someone collapses or isn’t breathing after taking Bydureon BCise, call 911 immediately.
Never share medicine pens or single-dose trays with others under any circumstances. It is not safe for one pen to be used for more than one person. Sharing needles, pens, or single-dose trays can result in transmission of infection.
It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly. Blood and urine tests may be needed to check for unwanted effects.
Tell your doctor if you are also using insulin. You should not use prandial insulin (eg, Apidra®, Lantus®) while you are using this medicine. Using these medicines together may cause unwanted effects.
It is very important to carefully follow any instructions from your health care team about:
In case of emergency—There may be a time when you need emergency help for a problem caused by your diabetes. You need to be prepared for these emergencies. It is a good idea to wear a medical identification (ID) bracelet or neck chain at all times. Also, carry an ID card in your wallet or purse that says that you have diabetes and a list of all of your medicines.
This medicine may increase the risk of having thyroid tumors. Tell your doctor right away if you have a lump or swelling in your neck or throat and if you use Bydureon® or Bydureon® BCise® . Also tell your doctor if you have trouble swallowing or breathing, or if your voice gets hoarse.
Pancreatitis (swelling of the pancreas) may occur while you are using this medicine. Check with your doctor right away if you have sudden and severe stomach pain, chills, constipation, nausea, vomiting, fever, or lightheadedness.
This medicine may cause serious allergic reactions, including anaphylaxis and angioedema, which can be life-threatening and require immediate medical attention. Check with your doctor right away if you have a rash, itching, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, mouth, or throat while you are using this medicine.
This medicine may lower the number of platelets in your blood, causing your body to not form blood clots. This may lead to serious bleeding and death. Call your doctor right away if you have unusual bleeding or bruising. Your blood platelet count may continue to be low for about 10 weeks after stopping this medicine.
Call your doctor right away if you notice any of these side effects at the injection site, including depressed or indented skin, blue-green to black skin discoloration, or pain, redness, or peeling of the skin.
This medicine does not cause hypoglycemia (low blood sugar). However, low blood sugar can occur when you use exenatide with other medicines, such as insulin or sulfonylureas, that can lower blood sugar. Low blood sugar also can occur if you delay or miss a meal or snack, exercise more than usual, drink alcohol, or cannot eat because of nausea or vomiting.
Symptoms of low blood sugar include: anxiety, behavior change similar to being drunk, blurred vision, cold sweats, confusion, cool, pale skin, difficulty with thinking, drowsiness, excessive hunger, fast heartbeat, headache (continuing), nausea, nervousness, nightmares, restless sleep, shakiness, slurred speech, or unusual tiredness or weakness.
If symptoms of low blood sugar occur, eat glucose tablets or gel, corn syrup, honey, or sugar cubes, or drink fruit juice, non-diet soft drink, or sugar dissolved in water to relieve the symptoms. Also, check your blood for low blood sugar. Glucagon is used in emergency situations when severe symptoms including seizures or unconsciousness occur. Have a glucagon kit available, along with a syringe and needle, and know how to use it. Members of your family should also know how to use it.
Hyperglycemia (high blood sugar) may occur if you do not take enough or skip a dose of your antidiabetic medicine, overeat or do not follow your meal plan, have a fever or infection, or do not exercise as much as usual.
Symptoms of high blood sugar include: blurred vision, drowsiness, dry mouth, flushed, dry skin, fruit-like breath odor, increased urination (frequency and amount), ketones in the urine, loss of appetite, stomachache, nausea or vomiting, tiredness, trouble breathing (rapid and deep), unconsciousness, or unusual thirst.
If symptoms of high blood sugar occur, check your blood sugar level and then call your doctor for instructions.
Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.
Bydureon BCise is not appropriate for everyone. You should not take this medication if you are allergic to exenatide, any drug in the GLP-1 agonist drug class, or any inactive ingredients in Bydureon BCise.
You should not take Bydureon BCise if you have:
Bydureon BCise may be prescribed with caution in some people only if the healthcare provider determines it is safe. It may be used with caution in the following circumstances:
Tell your healthcare provider about all of the medications you take, including prescription and over-the-counter (OTC) drugs and vitamins or supplements. While taking Bydureon BCise, do not start any new medicines without approval from your healthcare provider.
Bydureon BCise may interact with insulin or certain oral diabetes drugs. The combination of drugs may lower blood sugar too much. A lower dose of insulin or an oral medicine may need to be used, and blood sugar levels will need to be monitored carefully. Examples of these medications include:
Bydureon BCise may also need to be used cautiously with the following:
Because Bydureon BCise slows stomach emptying, it may need to be separated from certain orally administered drugs by several hours, such as oral birth control pills or antibiotics taken by mouth.
Although cholesterol medications in the statin drug class, such as Lipitor (atorvastatin), may interact with certain drugs, statin drugs have not been found to interact with exenatide.
Other drug interactions may occur with Bydureon BCise. Consult your healthcare provider for a complete list of drug interactions.
Bydureon BCise is in a class of medications called GLP-1 receptor agonists. Bydureon BCise contains the ingredient exenatide (extended-release). Although GLP-1 receptor agonists control blood sugar, they are not insulin. Other injectable drugs in the GLP-1 receptor agonist class of drugs include:
Rybelsus is also a GLP-1 receptor agonist containing the ingredient semaglutide, but it is a tablet taken by mouth rather than an injection like the other GLP-1 agonists. It improves blood sugar control in adults with type 2 diabetes.
Many oral medications are available to help control blood sugar in adults with type 2 diabetes. They include:
Combination drugs are also available, including:
This is a list of drugs also prescribed for type 2 diabetes. It is NOT a list of drugs recommended to take with Bydureon BCise. Talk to your pharmacist or a healthcare provider if you have questions.
Bydureon BCise is an injectable prescription drug used once weekly in adults and children 10 years and older. It is used along with diet and exercise to control blood sugar in people with type 2 diabetes. It is not insulin. It is in a drug class called GLP-1 receptor agonists.
Bydureon BCise helps the pancreas make more insulin. This lowers blood sugar. It also slows stomach emptying, which may decrease appetite.
Various drugs may interact with Bydureon BCise, such as the blood thinner warfarin, certain oral medications, drugs that may affect the kidneys, and insulin or other diabetes medications. Before taking Bydureon BCise, review your medication list with your healthcare provider.
After a dose of this extended-release injection, some of the drug is released immediately, while the rest is released gradually over a few weeks. It may take several weeks to see a difference in blood sugar numbers.
Common side effects may include stomach problems like nausea, vomiting, indigestion, and constipation or diarrhea. Injection site reactions are also common. Serious side effects may also occur, including low blood sugar. Before taking Bydureon BCise, discuss the side effects with your healthcare provider.
Before taking Bydureon BCise, discuss your medical history and all medications you take with your healthcare provider.
When taking Bydureon BCise, follow your healthcare provider’s instructions for use. Read the patient information leaflet that comes with your prescription. Make sure your healthcare provider shows you how to administer it and that you fully understand how to use it. You may also want to consult with a registered dietician and/or a Certified Diabetes Care and Education Specialist (CDCES).
While taking Bydureon BCise, avoid drinking alcohol. Both alcohol and Bydureon BCise can lower blood sugar levels, so they should not be combined.
Talk to your healthcare provider about blood sugar monitoring; make sure you know how and when to test your blood sugar.
Be alert for the signs of low blood sugar, such as:
Your healthcare provider will tell you how to treat hypoglycemic episodes. Consuming some fast-acting carbohydrates, like glucose tablets, Smarties, or apple juice, can help improve your blood glucose levels. Ask your healthcare provider about a glucagon prescription, like Baqsimi, which can treat low blood sugar in an emergency. Learn how to use it, and teach your family, friends, and caregivers how to administer it.
Prepare a diabetes kit to keep on hand. You may want to include items such as:
Wear a medical alert band or necklace to signal to emergency responders that you have diabetes. Ask your healthcare provider about preventive care, such as regular eye exams with an ophthalmologist, regular foot exams with a podiatrist, and regular dental care.
Verywell Health’s drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.
U.S. Food and Drug Administration. Bydureon BCise label.
U.S. Food and Drug Administration. Sharps disposal containers.
U.S. Food and Drug Administration. Best way to get rid of used needles and other sharps.
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Vijiaratnam N, Girges C, Auld G, et al. Exenatide once weekly over 2 years as a potential disease-modifying treatment for parkinson’s disease: protocol for a multicentre, randomised, double blind, parallel group, placebo controlled, phase 3 trial: the ‘exenatide-PD3’ study. BMJ Open 2021;11:e047993. doi:10.1136/bmjopen-2020-047993
Epocrates. Bydureon BCise.
Ratner RE, Maggs D, Nielsen LL, et al. Long-term effects of exenatide therapy over 82 weeks on glycaemic control and weight in over-weight metformin-treated patients with type 2 diabetes mellitus. Diabetes Obes Metab. 2006;8(4):419-428. doi:10.1111/j.1463-1326.2006.00589.x
Kothare PA, Linnebjerg H, Skrivanek Z, et al. Exenatide effects on statin pharmacokinetics and lipid response. Int J Clin Pharmacol Ther. 2007;45(2):114-120. doi:10.5414/cpp45114
DailyMed. Label: rybelsus- oral semaglutide tablet.
Karen Berger, PharmD, is a community pharmacist and medical writer/reviewer.
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