Byetta vs. Bydureon for Type 2 Diabetes: How Do They Compare?
Key takeaways:
Byetta and Bydureon BCise are the short-acting and the long-acting versions of exenatide. Byetta is given twice daily, and Bydureon is given once weekly.
Bydureon BCise has been shown to work better than Byetta at lowering hemoglobin A1C and fasting blood sugar. But Byetta may be preferred to lower blood sugar after meals.
Byetta and Bydureon BCise are both only available as brand-name medications, so they can be expensive. GoodRx discounts and manufacturer coupons can help you save money on your prescription.
Table of contents
Can the saliva of a venomous lizard help you control your blood sugar? Surprisingly, yes! If you have Type 2 diabetes, you may be familiar with Byetta and Bydureon. They both contain exenatide, the synthetic form of a substance found in the saliva of the Gila monster.
Byetta was approved in 2005 as the first medication of its kind for diabetes. Its approval was followed by several other medications from the same class, including Bydureon and Bydureon BCise. Bydureon was discontinued in 2018.
Byetta and Bydureon BCise are now the two available formulations for exenatide. But how are they different? And is one better than the other?
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What are Byetta and Bydureon BCise used for?
Byetta and Bydureon BCise are injectable medications. They both contain the active ingredient, exenatide. Byetta is the shorter-acting version of exenatide, whereas Bydureon is the extended-release version.
Byetta is FDA-approved to help manage blood sugar in adults with Type 2 diabetes. Bydureon BCise can be used for this purpose in adults and children ages 10 and older.
Both medications work best when used in combination with diet and exercise.
How do Byetta and Bydureon BCise work?
Byetta and Bydureon BCise belong to a group of medications called glucagon-like peptide-1 (GLP-1) agonists. These medications work by acting like GLP-1, a gut hormone involved in blood sugar control and digestion.
GLP-1 agonists have a few different effects in your body. First, they stimulate the release of insulin from your pancreas in response to a meal. They also block your liver from releasing more sugar. These effects can help keep your blood sugar under control.
GLP-1 agonists also slow the movement of food in your stomach, making you feel less hungry. Because of this, Byetta and Bydureon can cause a small amount of weight loss in some people.
Byetta vs. Bydureon BCise dosing
Both medications are given as subcutaneous (under the skin) injections that can be given into the thigh, stomach, or upper arm. But how often you need to inject depends on the medication.
Byetta dosing
The recommended starting dose for Byetta is 5 mcg twice daily, with doses given within 60 minutes before your morning and evening meals. After a month, your healthcare provider may raise your dose to 10 mcg twice daily. Starting at a lower dose helps lessen nausea and vomiting.
Before administering the medication, you’ll need to dial up your correct dose. And it’s important to use a new pen needle each time. Make sure to rotate injection sites with each dose, as well.
Your unused Byetta pen should be stored in the refrigerator. But after you’ve used it, the pen can be stored at room temperature. Discard the pen 30 days after first use, even if medication is left in the pen.
Bydureon BCise dosing
Bydureon BCise has a fixed dose of 2 mg once weekly, given on the same day each week. This can be at any time of day, with or without food.
Bydureon BCise is available as an autoinjector, so the needle is already in the pen. Bydureon BCise autoinjectors should be stored in the refrigerator, but you’ll need to bring one to room temperature before injecting yourself. You also have the option of storing them at room temperature for up to 4 weeks, if needed.
Before administering your dose, shake your unopened pen hard for at least 15 seconds to mix the medication. Once mixed, you have to use it immediately. Again, you’ll need to rotate injection sites with each dose.
Switching medications
If you’re having difficulty remembering to take Byetta twice daily, or you’re interested in a once-weekly option, talk to your healthcare provider. They can determine if Bydureon BCise is right for you and help you make the switch.
Byetta vs. Bydureon BCise side effects
The most common side effect of Byetta is nausea. For most people, this side effect subsides within a few months as your body adjusts to the medication. Your healthcare provider will typically start you on a lower dose and raise it over time to help minimize nausea.
The most common side effects of Bydureon BCise are bumps at the injection site and nausea. Compared to Byetta, nausea may happen less frequently with Bydureon BCise. It also tends to improve over time.
Below is a comparison of side effects, along with the percentage of people who reported them during clinical trials:
| Side effect | Byetta | Bydureon BCise |
|---|---|---|
| Nausea | 44% | 8% |
| Vomiting | 13% | 3% |
| Diarrhea | 13% | 4% |
| Injection-site bumps | Not reported | 11% |
| Dizziness | 9% | 3% |
| Headache | 9% | 4% |
| Upset stomach | 6% | Not reported |
Although rare, Byetta and Bydureon BCise can cause serious side effects. For example, Bydureon BCise has a boxed warning (the FDA’s strictest warning) about the risk of thyroid C-cell tumors. Because of this, it shouldn’t be used in people with a personal or family history of certain thyroid cancers.
Other serious side effects of both medications include:
Pancreatitis (inflammation of the pancreas)
Kidney damage
Severe allergic reactions
Antibodies that destroy cells involved in blood clotting
Gallbladder disease, including gallstones
Low blood sugar (hypoglycemia)
Which works better for diabetes: Byetta or Bydureon BCise?
Overall, head-to-head studies suggest that Bydureon BCise works better than Byetta at lowering hemoglobin A1C (HbA1C or A1C). This is your average blood sugar level over 3 months. It also appears to work better at lowering fasting blood sugar. This is your blood sugar level on an empty stomach.
However, Byetta may provide a benefit if your blood sugar levels after meals (called postprandial glucose) aren’t well-controlled. That’s because it tends to have the most effect on postprandial glucose.
Depending on your blood sugar goals and preferences, your healthcare provider will determine which medication is right for you.
What’s the difference between Byetta and Bydureon BCise?
As we’ve reviewed, Byetta and Bydureon BCise have several similarities. But they differ in several important ways. Below is a summary of their differences.
| Byetta | Bydureon BCise | |
|---|---|---|
| Dosing schedule | Twice a day | Once a week |
| Availability | Injection pen (needles separate) | Autoinjector (needle included) |
| Dose(s) in each pen | 60 doses (multi-dose pen) | 1 dose (single-use pen) |
| Dosing in relation to meals | Must be taken within 60 minutes before a meal, with doses at least 6 hours apart | Can be taken at any time of day, with or without meals |
| Most common side effects | Nausea, vomiting, and diarrhea | Injection site bumps, nausea |
| Works best for lowering | Postprandial glucose | A1C, fasting blood sugar |
How to save on Byetta and Bydureon BCise
Since Byetta and Bydureon BCise are only available as brand-name products, they can be expensive. The good news is that there are a few ways for you to save on your prescription.
Byetta’s price at certain pharmacies is less than $800 with a free GoodRx discount. If you’re eligible, Byetta’s manufacturer has a patient assistance program that offers the medication at no charge.
Bydureon BCise’s price at certain pharmacies is less than $750 with a free GoodRx discount. If you’re eligible, Bydureon BCise’s manufacturer offers a copay savings card. You may pay as little as $0 if you have commercial insurance, or save up to $150 each month if you pay cash.
The bottom line
Byetta and Bydureon BCise are two GLP-1 agonists that are FDA-approved to treat Type 2 diabetes. They both contain exenatide, but Byetta is injected twice daily and Bydureon BCise is injected once weekly.
Bydureon BCise has been shown to work better at lowering A1C and fasting blood sugar than Byetta. But Byetta may be more helpful in lowering blood sugar levels after a meal. Depending on your blood sugar goals and preferences, your healthcare provider can determine which would be best for you. Check with GoodRx for ways to help you save on your prescription.
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References
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