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Physicians should avoid prescribing to: Patients with a history of medullary thyroid carcinoma (MTC) or multiple endocrine neoplasia syndrome type 2 (MEN2) Individuals with severe gastrointestinal disorders (such as gastroparesis) Patients with a known hypersensitivity to GLP-1 or GIP receptor agonists Pregnant or breastfeeding women, unless deemed necessary by a healthcare provider Potential Side Effects Like any medication, this may cause side effects, though most are mild and transient. Common Side Effects (Usually Improve Over Time) Mild nausea (most common, usually decreases after the first few weeks) Vomiting or diarrhea in some cases, especially during dose escalation Constipation or bloating as digestion slows Mild fatigue or headaches as the body adjusts Less Common But Serious Side Effects Severe gastrointestinal distress (persistent nausea, vomiting, or diarrhea requiring discontinuation) Pancreatitis (rare) Monitor for severe abdominal pain Hypoglycemia (rare in non-diabetics) May occur if combined with other insulin-stimulating agents Allergic reactions (very rare) Swelling, rash, or difficulty breathing Physicians should titrate doses gradually to minimize side effects and improve patient tolerance

Revised: 5/2025 Full Prescribing Information WARNING: RISK OF THYROID C-CELL TUMORS Exenatide extended-release causes an increased incidence in thyroid C-cell tumors at clinically relevant exposures in rats compared to controls