Nesina vs. Byetta for Diabetes Type 2: Important Differences and Potential Risks.

Key takeaways

Alogliptin (Nesina) and exenatide (Byetta, Bydureon BCise) are both medications used to treat Type 2 diabetes, but they belong to different medication classes. Alogliptin is a dipeptidyl peptidase-4 (DPP-4) inhibitor, which helps lower blood sugar by increasing insulin production in the body. Exenatide is a glucagon-like peptide-1 (GLP-1) receptor agonist that helps your body release insulin after eating and reduces the amount of sugar released from your liver. Alogliptin is taken orally once a day, while exenatide is injected under the skin (subcutaneously), with Byetta being a short-acting version taken twice daily and Bydureon BCise being a long-acting version taken once a week. Alogliptin and exenatide are available as both brand-name and lower-cost generic medications. Common side effects of alogliptin include headaches and cold-like symptoms, while exenatide can cause nausea, vomiting, and injection site reactions. Both medications can cause pancreatitis, but exenatide also carries a risk of thyroid cancer and kidney problems.

Alogliptin

(Nesina)

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Exenatide

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Summary for Nesina

Prescription only

Alogliptin (Nesina) is a medication that treats Type 2 diabetes. It's added to diet and exercise to help lower your blood sugar levels. But it isn't a first-choice treatment for this condition. Alogliptin (Nesina) is typically taken by mouth once a day. Some people may experience certain side effects, such as headaches or symptoms of the common cold (e.g., sore throat or runny nose), after starting this medication.

Indications for Nesina

Type 2 diabetes

Pros and Cons for Nesina

Pros

Taken once daily by mouth
Can be taken with or without food
Is available as a lower-cost generic

Cons

Dose may change if you have kidney problems, while other similar medications, like Tradjenta (linagliptin), don't need dose changes
Not a first-choice treatment for Type 2 diabetes
Isn’t approved for Type 1 diabetes

Common Side Effects for Nesina

Upper respiratory tract infection (5%)
Common cold (5%)
Headache (4%)

Warnings for Nesina

Heart failure
Severe joint pain
Inflammation of the pancreas
Liver problems
Severe itching rash

Summary for Byetta

Prescription only

Exenatide is an injectable medication used to lower blood sugar in people with type 2 diabetes. It should be used along with an appropriate diet and exercise plan. This medication comes in short-acting (Byetta) and long-acting (Bydureon BCise) versions.

Indications for Byetta

Type 2 diabetes, in combination with diet and exercise (adults) - Byetta only
Type 2 diabetes, in combination with diet and exercise (adults and children age 10 years and older) - Bydureon BCise only

Pros and Cons for Byetta

Pros

Can lower your A1c (average blood sugar over time)
Not as likely to cause very low blood sugar as other diabetes medications
Might help some people with weight loss
Bydureon BCise (once-weekly injections) can be taken any time of day, with or without food

Cons

Slows stomach emptying, which can affect how other medications are absorbed
Short-acting version (Byetta) must be used within 60 minutes before meals
Not safe for people with severe kidney problems
Brand-name only, so it can be expensive

Common Side Effects for Byetta

Nausea (Up to 44%)
Vomiting (Up to 18%)
Diarrhea (Up to 18%)
Headache (Up to 14%)
Injection-site lump (11%)
Constipation (Up to 10%)

Note: These side effects were reported by people taking either exenatide alone or with other diabetes medications. The side effects you experience might differ depending on what other diabetes medications you're taking.