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

Key takeaways

Saxagliptin (Onglyza) and exenatide (Byetta, Bydureon BCise) are both medications used to manage Type 2 diabetes, but they have some key differences. Saxagliptin is a dipeptidyl peptidase-4 (DPP-4) inhibitor taken orally once daily, while exenatide is a GLP-1 agonist that is injected under the skin. Saxagliptin is available in a generic form, whereas exenatide is only available as a brand-name medication. Exenatide comes in two versions: Byetta, which is short-acting and taken twice daily, and Bydureon BCise, which is long-acting and taken once a week. Saxagliptin is less likely to cause weight gain, while exenatide might help with weight loss. However, exenatide has a higher risk of causing nausea and vomiting. Both medications can cause serious side effects like pancreatitis and low blood sugar, but exenatide also carries a risk of thyroid cancer and severe kidney problems.

Saxagliptin

(Onglyza)

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Exenatide

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Summary for Onglyza

Prescription only

Saxagliptin (Onglyza) is an add-on medication to exercise and a balanced, nutritious diet to improve blood sugar control in adults with Type 2 diabetes. It belongs to the drug class called dipeptidyl peptidase-4 (DPP-4) inhibitors. The saxagliptin (Onglyza) dosage is taken by mouth once daily. Possible side effects include certain infections and headaches. The brand name, Onglyza, is no longer available. But the lower-cost generic version is still available.

Indications for Onglyza

Type 2 diabetes in adults

Pros and Cons for Onglyza

Pros

Taken once daily (with or without food)
Less likely to cause weight gain (compared to some other diabetes medications)
Very low risk of causing hypoglycemia (low blood sugar) when it's taken by itself

Cons

Doesn't lower A1C and blood sugar levels as well as other diabetes medications
Might raise risk of hospitalization due to heart failure in certain people
Not for treating Type 1 diabetes or diabetic ketoacidosis

Common Side Effects for Onglyza

Warnings for Onglyza

Pancreas problems
Heart failure
Low blood sugar (hypoglycemia)
Joint pain
Large blisters
Risk of allergic reaction

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.