BYETTA

Re: Anyone use Byetta?

Hi Ken,

It's a bit confusing now that we have a Dennis and a Denis, but thanks for reminding me that we haven't re-stated the DVLA's current thinking on Byetta for a little while. It is always useful to know exactly what DVLA's current thinking is because they changed their minds about Byetta 3 times in 2008!

The current situation is dated 16 Sept 2008 and is extracted unchanged from the DVLA website:

Treatment with Exenatide (Byetta) or Gliptins

Exenatide has been licensed as a treatment for use in type 2 diabetes, in combination with metformin and or sulphonylureas. Trials published to date show a small but significant risk of hypoglycaemia when exenatide is used in conjunction with a sulphonylurea. It would also appear that when the gliptins (DPP4 inhibitors) are used with sulphonylureas, the hypoglycaemia risk is similarly raised.

The increased risk of hypoglycaemia from exenatide or gliptins when used in combination with sulphonylureas is such that these are felt to be a potentially high risk treatment for drivers holding Group 2 (LGV or PCV) licences and that individual assessment will be required.

Group 2 drivers are required to notify DVLA if they have diabetes treated with tablets. If they are then started on exenatide or a gliptin they are only required to notify DVLA if this is in combination with a sulphonylurea.

The use of exenatide or gliptins currently carries no specific driving restrictions for Group 1 (car or motorcycle) licences.

So to summarise, if you have a Group 1 (car or motorbike) licence and you take Byetta or a gliptin there are no restrictions and you do not need to inform DVLA.
If you have a Group 2 (LGV or PCV) licence then you need to advise DVLA if you take either Byetta or a gliptin together with a sulphonylurea medication. The following is a list of all drugs that are classed as sulphonylureas: Carbutamide, Chlorpropamide, Gliclazide, Tolbutamide, Tolazamide, Glipizide, Glibenclamide, Glyburide, Gliquidone, Glyclopyramide, Glimepiride. The following are the available gliptins: Sitagliptin (Januvia), Vildagliptin (Galvus).

However, it is advisable for all drivers who take Byetta or one of the gliptins to check occasionally on the DVLA website because they do seem very uncertain about these treatments and when they do change their minds they tend not to tell anyone!

Re: Anyone use Byetta?

Hi Ken,

No problem and, as I said, thanks for bringing it up. How are you getting on with the Byetta?

PS the phrase "bringing it up" was not intended to have anything to do with Byetta side effects!!!

Re: Anyone use Byetta?

Thank you Sussex, but I can't claim all the credit - we now have another Denis (his has one N, mine has 2).

Steve,
As some of the others have said, Byetta is renowned for encouraging weight loss. In fact in the States some doctors are prescribing it to non-diabetic patients as purely a weight-loss aid!!

Re: Anyone use Byetta?

maxifli said:

I can only prsume that they sart you off on 5 first as it is a strong drug and you have to become used to it ??

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Hi Maxfli,

That's exactly right. The active drug in Byetta is called exenatide and, although this is very similar to the GLP-1 hormone that the human body produces, exenatide is not natural to the human body. So quite naturally, the body reacts to it and can try to reject it, hence the nausea - and in some cases actually being physically sick. After a while the body becomes accustomed to it and stops trying to reject it, and at that point you can move up to the stronger dose. I have seen several cases both here and in the US of doctors thinking they know better than the manufacturers, ignoring the instructions, and starting patients straight on the 10mcg dose. In every case the patient was violently ill and in several cases had to be hospitalised! I'm pleased to say that GPs now seem to be following the instructions.

When you move up to the 10mcg dose you may find that the nausea feeling returns, but this is usually less severe than you get on the 5mcg pen and tends not to last as long.

Re: Anyone use Byetta?

Denis said:

Trust the americans, I wonder how much they charge over there for it, we should be thankfull we get it free. 8)

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Hi Denis,

In the States it costs around $200 per pen, which makes it about 40% more expensive than it is over here - one of the few things where we pay less than the Americans!

Re: Anyone use Byetta?

Hi Philip in Rome and a very warm welcome to you, although I bet it's a **** site warmer in Rome than it is over here right now. We have snow forecast again for tomorrow! Do you now live permanently in Italy or are you working temporarily over there?


I'm sure you will enjoy all the forums when you have had a chance to browse through them. This thread is fairly quiet and we are generally well behaved - some of them can get quite lively and we get some heated debates from time to time, especially on the subject of diet. It's interesting that you will be prescribed Byetta in Italy as I wasn't sure how widely available it is outside the UK and USA.

As the name suggests, the 10mcg dose is simply double the strength of the 5mcg dose that you are currently on. If you have a look at my note to Maxfli above you will see that you may suffer some side effects when increasing the dose. However, you have had longer to acclimatise to it than many people are allowed, so you may find it an easier transition.

In practical terms, the 5mcg dose seems to trigger quite significant weight loss, which simply continues but not at a noticably greater rate on the stronger dose. My observations of myself and others are that the reduction in blood sugar seems to be greater on the full strength dose. It doesn't last any longer, both the 5 and 10 doses remain active for 4 hours and are fully cleared from your system in 9 hours. There are some who find that both the weight loss and BG reduction are good enough at 5mcg and they simply remain on that dose. I presume your endo thinks that you need the extra boost in BG reduction that the higher dose delivers.

If there's any questions that we might be able to answer please feel free to fire away. Don't worry if a question seems silly - if it's something you don't know then you can bet that several others are wondering the same thing!