K. Jean Lucas, MD Diabetes & Endocrinology Consultants, PC Kristin Gainey Ferree, FNP
HOW TO USE BYETTA
BYETTA is an injectable medicine used to improve blood sugar control in people with Type 2 Diabetes. Byetta improves the action of insulin, delays stomach emptying which delays the absorption of food, and decreases appetite. It is used to prevent the blood sugar from increasing after eating. BYETTA comes in 2 doses of a pre-filled pen: 5mcg and 10mcg. Each pen contains 60 doses to provide a 30 day supply of twice a day dosing. Inject BYETTA straight into the skin of the abdomen, upper leg (thigh) or upper arm. Because of the side-effect of nausea, it is better to gradually go up on the Byetta dose. If you have a lot of nausea at any one dose, lower dose to the previous week’s dose. STARTING THE 5 MCG PEN
FIRST WEEK: Take Byetta 5mcg at least 15 minutes before supper only
SECOND WEEK: Take Byetta 5mcg at least 15 minutes before breakfast and supper daily STARTING THE 10 MCG PEN: If you have left over medication in the 5mcg pen, you may use it as follows as you go up on your dose.
FIRST WEEK: Take Byetta 5mcg at least 15 minutes before breakfast and 2 doses of 5mcg OR 1 dose of 10mcg pen at least 15 minutes before supper.(To take two doses, leave needle in the skin and redial the dose and administer the second dose) SECOND WEEK: Take 2 doses of Byetta 5mcg or 1 dose of 10mcg at least 15 minutes before breakfast and supper daily.
If you cannot tolerate the 10mcg dose, you will need to get a refill with the 5mcg pen. BYETTA is injected before breakfast and supper only. If you do not eat breakfast, you may take the injection before lunch and supper. Do not inject it after a meal. You may give it as much as 60 minutes before a meal. If you forget to take the dose, do not take it later or double up on the next dose. The major side-effect of BYETTA is nausea. The nausea usually is mild and may last for several hours after the injection. The nausea should improve in a few days. To minimize nausea, do not eat a large meal or excessive starches or sugars when you first start the BYETTA. \\W10060-2\dec forms & documents\Patient Brochures\Byetta Information.doc (252) 222-5700 ● FAX (252) 222-5705 ● www.BeachDoctor.com ● [email protected] K. Jean Lucas, MD Diabetes & Endocrinology Consultants, PC Kristin Gainey Ferree, FNP
Other less common side-effects are dizziness, diarrhea, headache, feeling jittery, and an acid stomach. BYETTA may reduce your appetite and lower your weight. These are desirable side-effects which also help control your diabetes. OTHER DIABETES MEDICATIONS
When you first start BYETTA, it is important to check your blood sugar frequently since your other diabetes medications may need to be adjusted to avoid a low blood sugar. If you are not on any other diabetes medications except for metformin, Actos, or Avandia, you should not have to make any dosage adjustments. You should not be having any hypoglycemia. If you do, you should call your physician. If you are on other diabetes medication, the addition of BYETTA may cause your blood sugar to drop too low. If you are on Novolog, Humalog, or R insulin with meals, you should lower your pre-breakfast and pre-supper insulin by one-half when you first start the BYETTA at that meal. If you are on Lantus as your only insulin, you should reduce the Lantus dose by 5 units every time your blood sugar drops below 100. Additional instructions on insulin dose: If you are not on insulin or have tapered off insulin and are taking Amaryl, glyburide, glucovance, metaglip, or glipizide, you may need to lower the dose of these medications by 50% if your blood sugar drops below 80 after starting the BYETTA. For example, if you are on Amaryl 4mg twice a day and your blood sugar drops below 80, you should only take the Amaryl once a day. If it drops again, you should lower the Amaryl to ½ tablet daily. If it drops again, stop the Amaryl.
Call your physician if you are unsure what to change as your blood sugar becomes better controlled. STORAGE OF BYETTA The BYETTA pen you are using may be kept at room temperature and does not need to be kept refrigerated. A pen not in use may be kept in the refrigerator. Once in use, the pen is only at optimal dose range for 30 days. After 30 days, the dose is weaker and will continue to weaken the longer it is used after 30 days.
\\W10060-2\dec forms & documents\Patient Brochures\Byetta Information.doc (252) 222-5700 ● FAX (252) 222-5705 ● www.BeachDoctor.com ● [email protected]
Concurso Externo Extraordinário Proposta da reunião da Mesa Negocial de 15.11.2012 As alterações introduzidas encontram-se a “negrito” 1- O presente decreto-lei estabelece um regime excecional destinado à seleção e recrutamento de pessoal docente nos estabelecimentos públicos da educação pré-escolar e dos ensinos básico e secundário na dependência do Ministério d