Drug Interaction Report

Exenatide Injection and Acetaminophen: Interaction Details

AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Exenatide Injection

Bydureon Bydureon BCISE® Bydureon® Byetta Byetta®
+

Acetaminophen

Acephen Actamin® Anacin AF Bactimicina Cetafen Comtrex Sore Throat Relief CounterAct Pain Feverall
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Updated Aug 8, 2026
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Interaction severity
Major
Potentially serious — often needs a change or close monitoring.
How we grade severity & evidence

Severity levels

  • Contraindicated: These should generally not be used together.
  • Major: Potentially serious — often needs a change or close monitoring.
  • Moderate: Can be significant — usually manageable with monitoring.
  • Minor: Usually limited clinical impact.

Evidence grades

  • Established: Well documented — supported by controlled studies or strong clinical data.
  • Probable: Good supporting evidence, though not definitively proven.
  • Suspected: Some evidence suggests this interaction, but it is not well established.
  • Possible: Limited or conflicting evidence; the interaction may occur.
  • Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.

Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.

Of 133 documented Exenatide Injection interactions, 87 are rated major — including this one.
Worried about symptoms right now? Contact your pharmacist or prescriber, or call Poison Control at 1-800-222-1222 (US). Call 911 for an emergency.
Onset
rapid
Evidence
probable
Severity
Major

What happens

Reduced oral acetaminophen absorption and reduced efficacy of oral acetaminophen

Interaction Deep Dive

Exenatide slows gastric emptying. Therefore, exenatide has the potential to reduce the rate of absorption of orally administered acetaminophen. Exert caution when exenatide is coadministered with oral acetaminophen, where a slower rate of oral absorption may be clinically meaningful. For oral acetaminophen that are dependent on threshold concentrations for efficacy, advise patients to take those drugs at least 1 hour before exenatide injection. If such drugs are to be administered with food, advise patients to take them with a meal or snack when exenatide is not administered. In a drug interaction study, when 1000 mg acetaminophen elixir was given with 10 mcg exenatide (0 hour) and 1 hour, 2 hours, and 4 hours after exenatide injection, acetaminophen AUCs were decreased by 21%, 23%, 24%, and 14%, respectively; Cmax was decreased by 37%, 56%, 54%, and 41%, respectively; Tmax was increased from 0.6 hour in the control period to 0.9 hour, 4.2 hours, 3.3 hours, and 1.6 hours, respectively. Acetaminophen AUC, Cmax and Tmax were not significantly changed when acetaminophen was given 1 hour before exenatide injection1.

Why it happens (mechanism)

Slowed gastric emptying by exenatide

Literature reports

1 report — tap to read

a) In a drug interaction study, when 1000 mg acetaminophen elixir was given with 10 mcg exenatide (0 hour) and 1 hour, 2 hours, and 4 hours after exenatide injection, acetaminophen AUCs were decreased by 21%, 23%, 24%, and 14%, respectively; Cmax was decreased by 37%, 56%, 54%, and 41%, respectively; Tmax was increased from 0.6 hour in the control period to 0.9 hour, 4.2 hours, 3.3 hours, and 1.6 hours, respectively. Acetaminophen AUC, Cmax and Tmax were not significantly changed when acetaminophen was given 1 hour before exenatide injection 1.

Common questions

Can I take Exenatide Injection and Acetaminophen together?

Reduced oral acetaminophen absorption and reduced efficacy of oral acetaminophen Always confirm with your pharmacist or prescriber before making any change.

How serious is the Exenatide Injection and Acetaminophen interaction?

It is rated major. Potentially serious — often needs a change or close monitoring.

How quickly could this interaction happen?

The documented onset is "rapid". Effects can appear quickly, often within about 24 hours of combining the drugs.

How strong is the evidence for this interaction?

The evidence is graded "probable". Good supporting evidence, though not definitively proven.

Questions for your pharmacist

  • Does my dose of Exenatide Injection or Acetaminophen need adjusting while I take them together?
  • What symptoms should prompt me to call you or my prescriber right away?
  • Does the timing of my doses matter for this combination?
  • Is there a safer alternative to one of these medications for me?

References (1)

  1. Product Information: BYETTA(R) subcutaneous injection, exenatide subcutaneous injection. AstraZeneca Pharmaceuticals LP (per FDA), Wilmington, DE, 2025. DailyMed
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This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.