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nausea decreases with ongoing usage a steady weight loss occurs in some patients over 2 years (may be related to nausea & CNS-mediated loss of appetite) there is an increased risk of hypoglycemia when exenatide is used with a sulfonylurea The dose of the sulfonylurea may need to be reduced if hypoglycemia occurs when combined with exenatide Most serious : rare & sometimes fatal necrotizing or hemorrhagic pancreatitis When initiating patients on Byetta, watch for signs and symptoms of pancreatitis (including persistent severe abdominal pain, sometimes radiating to the back, which may or may not be accompanied by vomiting)