Drug HighlightExenatide: A Novel Incretin Mimetic Agent for Treating Type 2 Diabetes MellitusLam, Sum PharmD, CGP*†; See, Sharon PharmD, BCPS*‡Author Information From the *Department of Clinical Pharmacy Practice, College of Pharmacy and Allied Health Professions, St. John's University, Jamaica, New York; †Division of Geriatric Medicine, Winthrop University Hospital, Mineola, New York; and ‡Beth Israel Residency in Urban Family Practice, New York, NY. Correspondence: Sum Lam, PharmD, CGP, Department of Clinical Pharmacy Practice, College of Pharmacy & Allied Health Professions, St. John's University, St. Albert's Hall Room 114, 8000 Utopia Parkway, Jamaica, NY 11439. E-mail: email@example.com. Cardiology in Review: July-August 2006 - Volume 14 - Issue 4 - p 205-211 doi: 10.1097/01.crd.0000223655.16253.e4 Buy Metrics Abstract Maintaining glycemic control is the primary goal for preventing macrovascular and microvascular complications associated with type 2 diabetes. Currently available antidiabetic drugs work in different ways to lower blood glucose levels; unfortunately, each of them has its tolerability and safety concerns. Exenatide is the first drug in a new class known as the incretin mimetic agents. It improves glucose control by mimicking the effects of glucagon-like peptide-1, a natural mammalian incretin hormone secreted during food intake. Exenatide was approved by the U.S. Food and Drug Administration for the treatment of type 2 diabetes in conjunction with metformin and/or sulfonylurea. The recommended dosage is 5 μg to 10 μg twice daily subcutaneously before breakfast and dinner. In randomized, placebo-controlled, 30-week clinical studies, exenatide improved glycemic control and promoted weight loss of up to 2.8 kg. The most common adverse effects were nausea (44%), vomiting (13%), diarrhea (13%), and hypoglycemia (5–36%). Hypoglycemia occurred in a dose-dependent fashion. Patients should be closely monitored for hypoglycemia, especially when exenatide is added to sulfonylurea therapy. Overall, exenatide provides a treatment option for patients with type 2 diabetes who fail to obtain glycemic control while on a maximum dose of metformin and/or sulfonylurea therapy. It is also an alternative therapy for those patients who cannot tolerate other antidiabetic drugs. © 2006 Lippincott Williams & Wilkins, Inc.