Hormone analogue not eliminated via Cyp metabolism. Side effects such as nausea, vomiting and diarrhoea may be potentially porphyrinogenic through reduction in carbohydrate intake.

Synthetic Exendin-2, a 39 amino acid peptide present in the saliva of the Gila monster lizard, which is a functional analog of Glucagon-Like Peptide-1.

Exenatide is used in type 2 diabetes in combination with other anti-diabetics, when adequate glycaemic control has not been achieved by mono or dual therapy with metformin and a sulfonylurea. It is administered as a subcutaneous injection. The pharmacodynamics effects of exenatide, such as incretin-induced pancreatic liberation of insulin and subsequent tissue uptake of glucose, as well an inhibition of glucagon secretion, are theoretically anti-porphyrinogenic. Side effects such as nausea, vomiting and diarrhoea may be potentially porphyrinogenic through reduction in carbohydrate intake. Common adverse reactions of exenatide that may be confused with an acute porphyric attack are nausea, vomiting, constipation and abdominal discomfort.

Nonclinical studies suggest that exenatide is predominantly eliminated via glomerular filtration and subsequent proteolytic break down of the peptide.