Byetta (exenatide) is a prescription drug that’s used to treat type 2 diabetes in adults. This drug can interact with other medications and some supplements. For example, Byetta can interact with insulin and sulfonylureas.

An interaction can occur because one substance causes another substance to have a different effect than expected. Interactions can also occur if you have certain health conditions.

Before you start using Byetta, tell your doctor and pharmacist about any prescription, over-the-counter, or other drugs you take. Sharing this information with them may help prevent possible interactions. (To learn whether Byetta interacts with herbs or vitamins and supplements, see the “Are there other interactions with Byetta?” section.)

If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.

The table below lists drugs that may interact with Byetta. Keep in mind that this table does not include all drugs that may interact with Byetta. For more information about some of these interactions, see the “Drug interactions explained” section.

Drug group or drug nameDrug examplesWhat can happen
Angiotensin-converting enzyme (ACE) inhibitors• lisinopril (Zestril, Qbrelis)
• ramipril (Altace)		can increase the risk of kidney problems
antibiotics• azithromycin (Zithromax)
• amoxicillin (Amoxil)		can make the antibiotic less effective
birth control pills• ethinyl estradiol/drospirenone (Yasmin, others)
• ethinyl estradiol/levonorgestrel (Levonest, others)		can make birth control pills less effective
diuretics (water pills)• furosemide (Lasix)
• chlorthalidone (Thalitone)		can raise the risk of kidney problems
other diabetes drugs• insulin glargine (Lantus, others)
• glipizide (Glucotrol XL)		can increase the risk of hypoglycemia (low blood sugar)
nonsteroidal anti-inflammatory drugs (NSAIDs)• aspirin
• ibuprofen (Advil, Aleve)		can increase the risk of acute kidney injury
warfarin (Jantoven)—can increase the risk or severity of bleeding from warfarin

Certain health conditions or other factors could raise your risk of harm if you take Byetta. In such cases, your doctor may not prescribe Byetta for you. These are known as contraindications. The list below includes contraindications of Byetta.

If you have had drug-induced thrombocytopenia after using exenatide: There have been rare reports of drug-induced thrombocytopenia in people using exenatide (the active ingredient in Byetta). If you’ve had this side effect after using exenatide in the past, your doctor likely won’t prescribe Byetta for you because it could cause this reaction again. Instead, your doctor can recommend other treatments for type 2 diabetes that are safer options.

If you’ve had an allergic reaction: If you’ve had an allergic reaction to Byetta or any of its ingredients, your doctor likely won’t prescribe Byetta for you. This is because using the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better options for you.

Before you start using Byetta, talk with your doctor if any of the factors above apply to you. Your doctor can determine whether Byetta is safe for you to take.

There are no known interactions between Byetta and alcohol. But alcohol lowers blood sugar, and people with diabetes have an increased risk of hypoglycemia after consuming alcohol. Due to this, your doctor may suggest you avoid alcohol or limit the amount you drink if you have diabetes.

If you have questions about consuming alcohol with your condition or treatment plan, talk with your doctor or pharmacist.

Learn more about certain drug interactions that can occur with Byetta.

Interaction with birth control pills

Byetta can interact with birth control pills, which are used to prevent pregnancy.

Examples of birth control pills include:

  • ethinyl estradiol/desogestrel (Bekyree, others)
  • ethinyl estradiol/drospirenone (Yasmin, others)
  • ethinyl estradiol/ethynodiol diacetate (Kelnor, others)
  • ethinyl estradiol/levonorgestrel (Levonest, others)
  • ethinyl estradiol/norethindrone (Wera, others)

What could happen

Combining Byetta with birth control pills can make the birth control pills less effective. Specifically, the way Byetta works can cause your body to absorb less of the birth control pill after you take a dose.

What you can do

This interaction can be minimized by taking your birth control pill at least 1 hour before injecting Byetta. You can also talk with your doctor about other types of birth control besides birth control pills. For example, Byetta isn’t expected to interact with an IUD.

If you have questions about using Byetta with birth control pills, talk with your doctor or pharmacist.

Interaction with angiotensin converting enzyme (ACE) inhibitors

Byetta can interact with ACE inhibitors, which are prescribed to lower blood pressure. They’re also used to lower certain risks, including preventing or slowing kidney damage in people with type 2 diabetes.

Examples of ACE inhibitor medications include:

  • benazepril (Lotensin)
  • enalapril (Vasotec, Epaned)
  • lisinopril (Zestril, Qbrelis)
  • ramipril (Altace)
  • trandolapril

What could happen

Using Byetta with an ACE inhibitor can increase the risk of acute kidney injury and other kidney problems.

What you can do

Before you begin Byetta treatment, talk with your doctor if you have a kidney condition. Having a kidney condition such as chronic kidney disease can raise your risk of kidney problems.

In general, these medications are often safe to take together, unless you have a severe kidney condition (such as kidney failure). Depending on your kidney function, your doctor may prescribe a lower dosage of Byetta for you.

If your doctor prescribes Byetta with an ACE inhibitor, they may monitor your kidney function closely during your treatment. They’ll likely do so using kidney function tests.

To lower your risk of kidney problems, be sure to stay hydrated while using Byetta, especially if you’re also taking an ACE inhibitor. Dehydration raises your risk of kidney injury and other kidney issues.

Interaction with other diabetes drugs

Byetta can interact with other diabetes medications. Some of these drugs are used to treat type 2 diabetes only, while others treat type 1 or type 2. (Byetta is only approved to treat type 2 diabetes. It should not be used to treat type 1 diabetes.)

Examples of other diabetes drugs include:

What could happen

Byetta and other diabetes drugs work by lowering blood sugar levels, so combining them can raise the risk of hypoglycemia.

What you can do

It’s fairly common to use Byetta with other diabetes medications. How severe the interaction could be varies depending on the other drug you use. For example, using Byetta with a rapid-acting insulin such as insulin aspart or a short-acting insulin such as regular insulin (Novolin N, Humulin N, others) is not recommended.

If you’re prescribed Byetta with another diabetes drug, your doctor will advise you on how to monitor your blood sugar for hypoglycemia. They may also prescribe a lower dosage of Byetta or the other diabetes drug for you.

If you have questions about using Byetta with other diabetes drugs, talk with your doctor or pharmacist.

Byetta may have other interactions. They could occur with supplements, foods, vaccines, or even lab tests. See below for details. Note that this information does not include all other possible interactions with Byetta.

Does Byetta interact with supplements?

Before you start using Byetta, talk with your doctor and pharmacist about any herbs or vitamins and supplements you take. Sharing this information with them may help you avoid possible interactions.

If you have questions about interactions that may affect you, talk with your doctor or pharmacist.

Byetta interactions with herbs

Byetta can interact with garlic supplements, which are used to help manage blood sugar levels. Byetta also works by lowering blood sugar. Using these products together may raise your risk of hypoglycemia.

Byetta can also interact with green tea supplements. These are used to help manage blood sugar levels, among other uses. Both Byetta and green tea supplements can lower blood sugar, so your risk of hypoglycemia may be higher if you combine them.

Your doctor may suggest you avoid taking garlic or green tea supplements during your Byetta treatment. Talk with your doctor before taking these supplements with Byetta.

Byetta interactions with vitamins and minerals

Byetta may interact with chromium supplements. Chromium is a mineral, and some people use chromium supplements to help manage blood sugar levels. Byetta works by lowering blood sugar, and chromium can also have this effect. Combining Byetta and chromium supplements may raise your risk of hypoglycemia

Due to this risk, talk with your doctor before using chromium supplements with Byetta. Your doctor may suggest that you don’t take chromium supplements during your Byetta treatment.

Does Byetta interact with food?

Byetta can interact with green tea. Byetta and green tea can both lower your blood sugar. It may be safe to consume green tea while using Byetta, but you should closely monitor your blood sugar levels to help prevent hypoglycemia.

It’s also helpful to consume a consistent amount of green tea. Your Byetta dosage can be adjusted if you experience hypoglycemia during your treatment. It’s easier for your doctor to find the right dosage for you if the amount of green tea you consume doesn’t fluctuate too much.

Although Byetta interacts with garlic supplements, the drug isn’t expected to interact with garlic in food. This is because the amount of garlic in supplements is much higher than what’s in most foods. But if you have questions about consuming garlic during your Byetta treatment, talk with your doctor or pharmacist.

It’s important to note that you should inject Byetta within 60 minutes before your two main meals of the day. You should not inject Byetta after a meal. To work effectively, Byetta must be injected before a meal.

Does Byetta interact with vaccines?

There are currently no reports of Byetta interacting with vaccines. If you have questions about getting certain vaccines during your Byetta treatment, talk with your doctor.

Does Byetta interact with lab tests?

There are currently no reports of Byetta interacting with lab tests. If you have questions about having certain lab tests done during your Byetta treatment, talk with the healthcare professional ordering the test.

Does Byetta interact with cannabis or CBD?

There are currently no reports of Byetta interacting with cannabis (commonly called marijuana) or cannabis products such as cannabidiol (CBD). But as with any drug or supplement, talk with your doctor before using cannabis with Byetta.

Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.

Certain medical conditions or other health factors may raise the risk of interactions with Byetta. Before using Byetta, talk with your doctor about your health history. They’ll determine whether Byetta is right for you.

Health conditions or other factors that might interact with Byetta include:

Gallbladder condition: There have been rare reports of gallbladder-related side effects, such as gallstones, in people using Byetta. If you have a gallbladder condition or have experienced one in the past, be sure to let your doctor know before you begin using Byetta. They can discuss the risks and benefits of using the drug.

Gastroparesis or other condition that slows stomach emptying: Byetta causes your stomach to empty more slowly than usual. If you have gastroparesis or another condition that slows stomach emptying, you may have a higher risk of digestive side effects (such as nausea or vomiting) with Byetta. Doctors typically won’t prescribe Byetta if you have a severe condition affecting stomach emptying.

Kidney condition, including having a kidney transplant: There have been rare reports of kidney problems, such as acute kidney injury, in people using Byetta. If you have a kidney condition or have had a kidney transplant, you may have a higher risk of this side effect. Taking Byetta could also worsen your kidney function. Doctors typically won’t prescribe Byetta if you have a severe kidney condition. And they’ll discuss the risks and benefits with you before prescribing Byetta if you have a mild or moderate kidney condition.

Pancreas condition, such as pancreatitis: After Byetta was approved for use, there have been rare reports of sudden pancreatitis in people using the drug. If you have a pancreas condition, including chronic pancreatitis, your doctor may decide to prescribe a different diabetes drug instead of Byetta.

Pregnancy: It’s not known whether Byetta is safe to use during pregnancy. If you’re pregnant or planning a pregnancy, talk with your doctor before using Byetta.

Breastfeeding: It’s not known whether it’s safe to use Byetta while breastfeeding. It isn’t known whether the drug passes into breast milk and if so, whether it can cause side effects in a child who’s breastfed. If you’re breastfeeding or planning to do so, talk with your doctor about your options.

Allergic reaction: If you’ve had an allergic reaction to Byetta or any of its ingredients, your doctor will likely not prescribe Byetta. This is because using the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better choices for you.

Taking certain steps can help you avoid interactions with Byetta. Before starting treatment, talk with your doctor and pharmacist. Things to discuss with them include:

  • whether you drink alcohol or use cannabis
  • other medications you take, as well as any vitamins, supplements, and herbs (they can also help you fill out a medication list)
  • what to do if you start taking a new drug during your Byetta treatment

It’s also important to understand Byetta’s label and other paperwork that may come with the drug. Colored stickers that describe interactions may be on the label. And the paperwork (sometimes called the patient package insert or medication guide) may have other details about interactions. (If you did not get paperwork with Byetta, ask your pharmacist to print a copy for you.)

If you have trouble reading or understanding this information, your doctor or pharmacist can help.

Using Byetta exactly as prescribed can also help prevent interactions.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.