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Trulicity vs Byetta
Introduction
For patients with Type 2 diabetes, certain medications that alter the function of incretin hormones can help in stabilizing blood sugar levels and managing symptoms. Trulicity and Byetta are two such drugs that are prescribed for this condition. They each impact different aspects of glucose metabolism but both have blood sugar-lowering effects in patients with Type 2 diabetes. Trulicity (dulaglutide) is a once-weekly injectable drug that mimics the functions of natural incretin hormones, helping to increase insulin production after meals and slow down digestion, which assists in controlling blood sugar levels. Byetta (exenatide), on the other hand, is administered twice daily before meals; it also simulates incretin hormone activity by increasing insulin secretion when needed and slowing gastric emptying.
Trulicity vs Byetta Side By Side
| Attribute | Trulicity | Byetta |
|---|---|---|
| Brand Name | Trulicity | Byetta |
| Contraindications | Should not be used if you have a personal or family history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). | Not recommended as a first-line therapy for patients who have inadequate control of their blood sugars with diet and exercise alone. Not suitable for people with type 1 diabetes or those who are prone to diabetic ketoacidosis. |
| Cost | Around $800 for a 2.4mg pen | About $730 for two 10mcg pens |
| Generic Name | Dulaglutide | Exenatide |
| Most Serious Side Effect | Signs of a severe allergic reaction, severe pain in your stomach area (abdomen) that will not go away with nausea and vomiting, changes in vision, rapid heartbeat, low blood sugar levels, kidney problems. | Signs of a severe allergic reaction, severe gastrointestinal problems indicating pancreatitis, changes in urine output suggesting kidney problems, persistent nausea, vomiting, or diarrhea leading to dehydration. |
| Severe Drug Interactions | Not specifically mentioned, but always inform your healthcare provider about any medications you are taking as certain drugs may interact negatively. | Not specifically mentioned, but as with any medication, it's important to discuss all current medications with a healthcare provider to avoid negative interactions. |
| Typical Dose | 0.75 mg to 1.5 mg once per week | 5 mcg injected subcutaneously twice daily, can be increased to 10 mcg twice daily |
What is Trulicity?
Dulaglutide (the generic name for Trulicity) is a relatively new drug in the class of GLP-1 receptor agonists, which represent significant advancements over previous diabetes treatments. It was first approved by the FDA in 2014. Trulicity works to regulate blood sugar levels by mimicking the effects of natural hormones, slowing digestion, and preventing the liver from making too much glucose when it's not needed. It’s generally prescribed for adults with type 2 diabetes who have not had success controlling their blood sugar levels with dietary changes or other medications alone. Compared to Exenatide (Byetta), another medication in this category that requires twice-daily injections before meals, Dulaglutide only needs to be taken once per week without regard to meal timing. This makes it easier and more convenient for patients to use regularly as part of their treatment plan.
What conditions is Trulicity approved to treat?
Trulicity is approved for the treatment of certain variations of diabetes:
- Type 2 diabetes mellitus, to improve glycemic control as an adjunct to diet and exercise
- Cardiovascular disease: it's also indicated to reduce the risk of major cardiovascular events such as heart attack, stroke or death in adults with type 2 diabetes mellitus who have established cardiovascular disease or multiple risks.
How does Trulicity help with these illnesses?
Trulicity helps to manage type 2 diabetes by mimicking the effects of a hormone in the body called glucagon-like peptide-1 (GLP-1). It does this by binding to GLP-1 receptors on cells in the pancreas, triggering them to release insulin after meals. Insulin is a hormone that regulates blood sugar levels: it instructs cells to take up glucose from the bloodstream and use it for energy or storage. In people with type 2 diabetes, their bodies either don't produce enough insulin, or they become resistant to its effects, leading to high blood sugar levels. Therefore, by stimulating increased insulin production and slowing down gastric emptying (which reduces how quickly glucose enters the bloodstream), Trulicity can help patients control their blood sugar levels more effectively.
What is Byetta?
Byetta, a brand name for exenatide, is an injectable drug used to improve blood sugar control in adults with type 2 diabetes. It belongs to the group of incretin mimetics drugs, which means it works by simulating the functions of natural hormones called incretins that can help regulate glucose metabolism. By delaying gastric emptying and increasing feelings of fullness after meals, Byetta helps reduce post-meal spikes in blood sugar levels. Furthermore, it also promotes insulin secretion from beta cells in response to high blood sugar levels. Approved by FDA in 2005, Byetta differs from other antidiabetic medications because its action on glycemic control does not directly depend on insulin; instead it acts mainly upon the gastrointestinal tract and pancreas. Its side-effect profile also varies compared to other antidiabetic medicines such as Trulicity (dulaglutide); major ones include nausea and hypoglycemia when used with sulfonylurea or basal insulin therapy.
What conditions is Byetta approved to treat?
Byetta is an injectable prescription medication that has been approved for the treatment of type 2 diabetes. It's intended to be used alongside diet and exercise to improve blood sugar control in adults with this condition. Some specifics about Byetta include:
- It is not recommended as a first-line therapy for patients who have inadequate control of their blood sugars with diet and exercise.
- It can be used monotherapy or as part of combination therapy with other antidiabetic drugs.
- The drug is not suitable for people with type 1 diabetes or those who are prone to diabetic ketoacidosis.
How does Byetta help with these illnesses?
Byetta, like Trulicity, is a type of medication called an incretin mimetic that is used to manage blood sugar levels in people with type 2 diabetes. It works by imitating the function of GLP-1, a hormone in the body that lowers blood glucose levels after meals by increasing insulin production and release from the pancreas while reducing glucagon secretion and slowing gastric emptying. This results in better glycemic control throughout the day. Byetta differs from Trulicity mainly in its dosing schedule; it has to be administered twice daily before meals, whereas Trulicity requires only once-weekly administration. Despite this difference, Byetta can still be an effective treatment option for patients who don't mind more frequent injections or those who are unable to achieve adequate blood sugar control with other medications.
How effective are both Trulicity and Byetta?
Both dulaglutide (Trulicity) and exenatide (Byetta) are glucagon-like peptide-1 (GLP-1) receptor agonists that have proven efficacy in managing type 2 diabetes; they were approved by the FDA five years apart, with Byetta gaining approval first. Since they act on the same receptors but have different pharmacokinetic properties, their usage can vary based on individual patient factors. A head-to-head clinical trial in 2018 found Trulicity to be more effective than Byetta at reducing HbA1c levels over a six-month period.
A review of various studies conducted up until 2020 demonstrated Trulicity's effectiveness in improving glycemic control from early stages of treatment and its favorable side effect profile when compared to many other antidiabetic agents. It is well-tolerated among adults with type 2 diabetes, including those who are elderly or overweight/obese. The optimal dose ranges from 0.75 mg/week to 3 mg/week depending on kidney function and individual response.
On the other hand, meta-analysis data from multiple studies up until 2016 indicated that Byetta seems more effective than placebo for glycaemic control, showing similar efficacy to other common GLP-1 receptor agonists like liraglutide or lixisenatide. However, due to differences in dosing frequency -- twice daily for Byetta versus once weekly for Trulicity -- many patients prefer less frequent injections which may lead clinicians towards prescribing alternatives such as Trulicity first-line.
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At what dose is Trulicity typically prescribed?
Injectable dosages of Trulicity range from 0.75 mg to 1.5 mg once per week, whereas Byetta is usually administered at a dose of 5 mcg twice daily for the first month and can be increased to 10 mcg twice daily thereafter if necessary. Studies have indicated that for most people with type-2 diabetes, starting on the lower dosage of either medication is efficacious in controlling blood glucose levels. For both medications, doses can be escalated after several weeks based on individual patient response and tolerance. The maximum weekly dosage of Trulicity should not exceed 1.5mg/week, while the maximum dosage for Byetta should not exceed two injections of 10mcg/day.
At what dose is Byetta typically prescribed?
Byetta treatment for type 2 diabetes typically begins with a dosage of 5 micrograms (mcg) injected subcutaneously twice daily, at least 60 minutes before morning and evening meals. This regimen should be maintained for at least a month. If well-tolerated and needed, the dose can then be increased to 10 mcg twice daily. To optimize its effect on blood sugar control while minimizing adverse gastrointestinal effects, Byetta should not be taken after a meal. The maximum dose is set at 10 mcg twice per day which may be administered if there is no satisfactory response to initial treatment after several weeks.
What are the most common side effects for Trulicity?
Common side effects of Trulicity can include:
- Nausea
- Diarrhea
- Vomiting
- Abdominal pain or discomfort
- Decreased appetite
- Indigestion (Dyspepsia)
On the other hand, Byetta is also known to produce similar side effects such as:
- Nausea
- Hypoglycemia (low blood sugar)
- Vomiting
- Diarrhea
-Increased sweating
While both medications are used for the treatment of Type 2 diabetes, they may affect individuals differently. Always consult with a healthcare provider regarding any concerning symptoms or potential side effects.
Are there any potential serious side effects for Trulicity?
Trulicity and Byetta are both injectable medications used to manage type 2 diabetes. However, they can have serious side effects in rare cases:
- Signs of a severe allergic reaction: hives or other rashes; difficulty breathing or swallowing; swelling in the face, lips, tongue, or throat.
- Severe pain in your stomach area (abdomen) that will not go away with nausea and vomiting. These may be symptoms of pancreatitis.
- Changes in vision including blurred vision.
- Rapid heartbeat or fluttering sensation in the chest.
- Low blood sugar levels - symptoms include dizziness, confusion, shakiness, sweating, fast heartbeat.
- Kidney problems (increased serum creatinine). Symptoms may include changes in urination such as an increase or decrease amount of urine passed each day; swellings on body parts like hands and feet due to fluid retention.
In case you experience any of these side effects while taking Trulicity or Byetta, it would be best to immediately seek medical help from a healthcare professional.
What are the most common side effects for Byetta?
The side effects of Byetta, though similar to Trulicity, can vary and may include:
- Nausea, vomiting, stomach pain or discomfort
- Decreased appetite leading to weight loss
- Feelings of nervousness or jitteriness
- Dizziness or headache
- A sour taste in the mouth or metallic taste
- Sweating
- Weakness and fatigue.
For some people on Byetta, there could be a change in bowel movements such as constipation. It is also not uncommon for users to experience skin reactions at the site of injection such as redness and itching. Remember that everyone's body reacts differently to medication; it's essential to discuss any concerns with your healthcare provider to make an informed decision about your treatment options.
Are there any potential serious side effects for Byetta?
While Byetta is generally well-tolerated, it's important to be aware of potential serious side effects. Be on the lookout for symptoms such as:
- Signs of a severe allergic reaction: hives; itching; difficulty breathing; swelling in your face or throat.
- Severe gastrointestinal problems: persistent severe abdominal pain which might radiate to your back, with or without vomiting; these could indicate pancreatitis.
- Changes in urine output: this may include color changes, frequency, and/or volume, which could suggest kidney problems.
- Persistent nausea, vomiting, or diarrhea leading to dehydration: signs can include dizziness, fainting spells due to low blood pressure, or weakness.
If you experience any of the above symptoms while using Byetta, seek medical attention immediately.
Contraindications for Trulicity and Byetta?
Both Trulicity and Byetta, as with most other medications for type 2 diabetes, might cause serious complications in some individuals. If you notice any severe symptoms such as persistent nausea or vomiting, severe stomach/abdominal pain, or yellowing of eyes/skin (jaundice), please seek immediate medical attention.
Neither Trulicity nor Byetta should be used if you have a personal or family history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). Always inform your healthcare provider about any medications you are taking; certain drugs may interact negatively with these diabetes treatments.
Additionally, both Trulicity and Byetta come with the risk of pancreatitis. Carefully monitor any abdominal pain that does not subside since this could indicate a more serious condition. Reach out to your healthcare provider right away if these symptoms persist.
Finally, it's essential to always share your full medical history with your doctor before starting treatment involving either Trulicity or Byetta. This includes all prescription and over-the-counter medications plus dietary supplements.
How much do Trulicity and Byetta cost?
For the brand-name versions of these drugs:
- The price of a 2.4mg pen of Trulicity averages around $800, which works out to roughly $114/day if used once weekly.
- The price for Byetta (10mcg) is about $730 for two pens, working out to approximately $26/day when taken twice daily.
So, if you are in the higher dosage range for Byetta (i.e., 20 mcg/day), then brand-name Trulicity could be less expensive on a per-day treatment basis due to its once-weekly administration schedule. Please note that cost should not be a primary consideration in determining which of these drugs is right for you.
Currently, there are no generic versions available for either Trulicity (dulaglutide) or Byetta (exenatide). Costs can vary significantly depending upon insurance coverage and any manufacturer discounts or patient assistance programs you may qualify for.
Popularity of Trulicity and Byetta
Dulaglutide, under the brand name Trulicity, is a once-weekly injection for type 2 diabetes. In 2020, it was estimated to have been prescribed to about 4 million patients in the US. Dulaglutide accounted for just over 15% of GLP-1 receptor agonist prescriptions in the US. It has become increasingly popular due to its convenience and effectiveness in managing blood sugar levels and weight loss.
Exenatide, known by its brand name Byetta, is another medication used to manage type 2 diabetes but requires twice-daily injections. In comparison with dulaglutide's numbers, exenatide was prescribed to approximately half a million people in the USA during 2020. This represents roughly around 3% of all GLP-1 receptor agonist prescriptions within that year. The prevalence of usage for this drug has remained steady over recent years despite growing competition from other medications offering more convenient dosing schedules.
Conclusion
Both Trulicity (dulaglutide) and Byetta (exenatide) are used as a part of the treatment plan for type 2 diabetes. They belong to a class of drugs known as GLP-1 receptor agonists, improving blood sugar control by mimicking the action of a hormone called glucagon-like peptide-1. However, their administration frequency differs: Trulicity is taken once weekly while Byetta is administered twice daily before meals.
Trulicity may be more convenient because it requires fewer injections per week compared to Byetta which can improve adherence to medication. Nevertheless, both have demonstrated efficacy in controlling blood glucose levels when combined with diet and exercise or other antidiabetic medications.
Each drug comes in an easy-to-use injector pen; however, neither has a generic version available at this time which could impact cost considerations for patients paying out-of-pocket.
The side effect profiles are similar between these two drugs - common side effects include nausea, vomiting, diarrhea, and potential weight loss. As with any new medication regimen for diabetes management, patients should monitor their blood glucose levels regularly and report any significant changes or concerns to their healthcare provider promptly.
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Refrences
- Thompson, A., & Trujillo, J. (2016, May). Advances in the treatment of type 2 diabetes: impact of dulaglutide. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy. Informa UK Limited.http://doi.org/10.2147/dmso.s75452
- Dungan, K. M., Povedano, S. T., Forst, T., González, J. G. G., Atisso, C., Sealls, W., & Fahrbach, J. L. (2014, October). Once-weekly dulaglutide versus once-daily liraglutide in metformin-treated patients with type 2 diabetes (AWARD-6): a randomised, open-label, phase 3, non-inferiority trial. The Lancet. Elsevier BV.http://doi.org/10.1016/s0140-6736(14)60976-4
- Cvetkovi??, R. S., & Plosker, G. L. (2007). Exenatide. Drugs. Springer Science and Business Media LLC.http://doi.org/10.2165/00003495-200767060-00008
- Drucker, D. J., Buse, J. B., Taylor, K., Kendall, D. M., Trautmann, M., Zhuang, D., & Porter, L. (2008, October). Exenatide once weekly versus twice daily for the treatment of type 2 diabetes: a randomised, open-label, non-inferiority study. The Lancet. Elsevier BV.http://doi.org/10.1016/s0140-6736(08)61206-4