Exenatid för diabetes

About exenatide

Insulin är ett hormon som naturligt bildas i din kropp, i bukspottkörteln. Det hjälper till att kontrollera nivåerna av socker (glukos) i ditt blod. Om din kropp inte producerar tillräckligt med insulin, eller om den inte använder det insulin den producerar effektivt, resulterar detta i tillståndet som kallas diabetes (diabetes mellitus).

People with diabetes need treatment to control the amount of sugar in their blood. This is because good control of blood sugar levels reduces the risk of complications later on. Some people can control the sugar in their blood by making changes to the food they eat but, for other people, medicines are given alongside the changes in diet. Exenatide is one of the medicines that are prescribed for people with typ 2 diabetes.

Exenatide works in three ways. It increases the amount of insulin produced by your body which then reduces the level of sugar in your blood. It also reduces the amount of a substance called glucagon being produced by your pancreas. Glucagon causes your liver to produce more sugar, so by reducing the amount of glucagon in your body, this also helps to reduce the levels of sugar in your blood. Exenatide also works on your stomach so that food passes more slowly through it. This means that the sugar from your meals takes longer to get into your blood.

Exenatide is given as an injection just under the surface of the skin. It is administered using a syringe and needle or by using an injection device called a pre-filled pen. It is used in addition to other antidiabetic medicines. There are two types of exenatide injection available. There is a standard-release injection (brand name Byetta®) which is given twice daily, and there is a prolonged-release injection (brand name Bydureon®) which is given once a week.

Before using exenatide

Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start using exenatide it is important that your doctor knows:

• Om du är gravid, försöker bli gravid eller ammar.

• Om du har problem med magen eller matsmältningssystemet.

• If you have ever had an inflamed pancreas (pancreatitis).

• Om du har några problem med hur dina njurar fungerar.

• Om du tar några andra läkemedel. Detta inkluderar alla läkemedel du tar som finns att köpa utan recept, samt växtbaserade och komplementära läkemedel.

• Om du någonsin har haft en allergisk reaktion mot en medicin.

How to use exenatide

• Innan du påbörjar behandlingen, läs tillverkarens tryckta informationsblad som finns i förpackningen samt all information du får av din läkare eller diabetesklinik. Tillverkarens informationsblad ger dig en fullständig lista över de biverkningar du kan uppleva.

• Use exenatide exactly as your doctor tells you to. Your doctor or diabetes nurse will show you how to inject yourself. Exenatide should be injected into the skin on your upper arms, thigh, or tummy (abdomen). Try to choose a slightly different injection site for each of your injections as this will help to prevent skin problems and difficulties in injecting.

• If you are using Byetta®, you will be advised to inject two doses a day. You should have each injection within the 60-minute period before a main meal, and the two doses should be at least six hours apart. The best way to achieve this is to have your first injection during the hour before your first meal of the day, and the second injection during the hour before your evening meal.

• If you forget to use exenatide before a meal, do not inject it after you have eaten, but instead just wait until your next dose is due.

• If you are using Bydureon®, you will be advised to inject one dose a week, on the same day of each week. Each pre-filled pen provides a single dose. The injection can be given at any time of the day, and it can be given either before or after a meal. If you forget to use the injection on your usual day, use it as soon as you remember and keep to your normal weekly schedule. However, if your next scheduled dose is due within three days, miss out the forgotten dose and take your next dose when it is due.

Få ut det mesta av din behandling

• Det är viktigt att du håller dina regelbundna läkar- och klinikbesök. Detta är så att dina framsteg kan övervakas. Du kommer att behöva regelbundna kontroller hos en ögonklinik och en fotklinik samt hos din läkare och diabetesklinik.

• Din läkare kan rekommendera att du regelbundet testar socker (glukos) i ditt blod eller urin för att kontrollera att din diabetes är under kontroll. Din läkare eller diabetessköterska kommer att visa dig hur du gör detta.

• Om du har fått råd från din läkare om förändringar i din kost, att sluta röka eller att motionera regelbundet, är det viktigt att du följer de råd du har fått.

• Each time you collect a prescription, check that you have been given the brand and strength of exenatide that you are expecting. If anything looks different from what you have had before, ask your pharmacist to check the prescription for you.

• Make sure you know what it feels like if your blood sugar is low. This is known as hypoglycaemia, or a 'hypo'. Although exenatide is unlikely to cause low blood sugar, other medicines that you are taking for diabetes alongside it may. The first signs of hypoglycaemia are feeling shaky or anxious, sweating, looking pale, feeling hungry, having a feeling that your heart is pounding (palpitations), and feeling dizzy. If this happens, eat something containing sugar, such as dextrose tablets, jelly babies or a sugary drink (non-diet), and then follow this up with a snack such as a sandwich or a banana.

• Om du är förare bör du vara extra försiktig, eftersom din förmåga att koncentrera dig kan påverkas om din diabetes inte är välkontrollerad. Du kan bli rekommenderad att kontrollera ditt blodsockernivå innan du reser och att ha ett mellanmål med dig på långa resor.

• Drick inte alkohol, eftersom det kan påverka kontrollen av ditt blodsocker. Fråga din läkare om du behöver ytterligare råd om detta.

• Om du blir ovanligt törstig, kissar oftare än normalt eller känner dig mycket trött, bör du informera din läkare. Dessa är tecken på att det finns för mycket socker i ditt blod och din behandling kan behöva justeras.

• Konsultera din läkare innan du börjar med någon ny fysisk aktivitet, eftersom detta kan påverka dina blodsockernivåer och du kan behöva kontrollera dina blod- eller urinnivåer mer regelbundet.

• Om du ska genomgå en operation eller tandbehandling bör du informera den som utför behandlingen att du har diabetes och ge dem en lista över de mediciner du tar.

• Denna medicin ska inte användas under graviditet. Kvinnor och flickor i fertil ålder måste använda effektiv preventivmedel under behandlingen och i två månader efter avslutad behandling.

• If you buy any medicines, always check with a pharmacist that they are suitable for you to take. Exenatide can interfere with the way some other medicines are absorbed. Because of this, some medicines should not be taken during the hour before exenatide is given, or during the four hours after it has been given.

• Treatment for diabetes is usually lifelong. Continue with exenatide unless you are told otherwise by your doctor.

Can exenatide cause problems?

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the most common ones associated with exenatide. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.

Om du upplever några andra symtom som du tror kan bero på injektionerna, tala med din läkare eller apotekare för vidare råd.

How to store exenatide

• Förvara alla läkemedel utom räckhåll och synhåll för barn.

• Exenatide can be kept for four weeks at room temperature as long as this is below 25°C and it is kept away from direct heat and sunlight. It is, however, best to store unopened packs in a refrigerator. Do not freeze exenatide.

• Byetta® pens must be discarded 30 days after being first used.

• Bydureon® pens are for single use only and should be discarded after first use.

Viktig information om alla läkemedel