EXENATIDE AND RELATED AGENTS

Albiglutide is indicated as an adjunctive therapy to diet and exercise for improvement of glycemic control in adult patients with type 2 diabetes mellitus (Prod Info TANZEUM subcutaneous injection powder, 2014).

DULAGLUTIDE

Dulaglutide is used as an adjunctive therapy to diet and exercise for improvement of glycemic control in adult patients with type 2 diabetes mellitus (Prod Info TRULICITY(TM) subcutaneous injection, 2014).

EXENATIDE

Exenatide is indicated as adjunctive therapy in type 2 diabetic patients who are taking metformin and/or a sulfonylurea and are not achieving adequate glycemic control (Prod Info BYETTA(TM) injection, 2005).

LIRAGLUTIDE

Liraglutide is used as adjunct therapy along with diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus; it is not a first-line therapy. Its use is not intended for type 1 diabetes or diabetic ketoacidosis (Prod Info VICTOZA(R) solution for subcutaneous injection, 2010).

LIXISENATIDE

Lixisenatide is used as adjunctive therapy along with diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. It is not intended to be used to treat type 1 diabetes or diabetic ketoacidosis (Prod Info ADLYXIN(TM) subcutaneous injection, 2016).

FORMS

ALBIGLUTIDE

Albiglutide is available as 30 mg and 50 mg in single dose pens for subcutaneous injection (Prod Info TANZEUM subcutaneous injection powder, 2014).

DULAGLUTIDE

Dulaglutide is available as 0.75 mg/0,5 mL and 1.5 mg/0.5 mL solution in single-dose pens, and 0.75 mg/0.5 mL and 1.5 mg/0.5 mL solution in single-dose prefilled syringes (Prod Info TRULICITY(TM) subcutaneous injection, 2014).

EXENATIDE

Exenatide is available as 250 mcg/mL in a sterile solution for subcutaneous injection (Prod Info BYETTA(TM) injection, 2005). It is also available for 2 mg extended-release powder for suspension for subcutaneous injection (Prod Info BYDUREON(R) subcutaneous extended release injection suspension, 2014).

LIRAGLUTIDE

Liraglutide is available in a pre-filled, multi-dose pen that delivers doses of 0.6 mg , 1.2 mg or 1.8 mg (6 mg/mL, 3 mL) for subcutaneous injection (Prod Info VICTOZA(R) solution for subcutaneous injection, 2010).

LIXISENATIDE

Lixisenatide is available as 50 mcg/mL and 100 mcg/mL in prefilled pens for subcutaneous injection (Prod Info ADLYXIN(TM) subcutaneous injection, 2016).

-CLINICAL EFFECTS

GENERAL CLINICAL EFFECTS

USES: Exenatide is a glucagon-like peptide-1 (GLP-1) receptor agonist and is used as adjunctive therapy to treat type 2 diabetes mellitus. Other GLP-1 receptor agonists include the following agents: albiglutide, dulaglutide, liraglutide, and lixisenatide.

PHARMACOLOGY: GLP-1 receptor agonists activate the GLP-1 receptor, resulting in an increase in glucose-dependent insulin secretion by the beta-cells of the pancreas and a decrease in glucagon secretion. Gastric emptying is also delayed.

EPIDEMIOLOGY: Overdose is rarely reported.

WITH POISONING/EXPOSURE

Exposure information is limited for these agents. In general, overdose effects are anticipated to be an extension of adverse effects following therapeutic doses. EXENATIDE: Three patients with type 2 diabetes experienced severe nausea, vomiting, and hypoglycemia following subcutaneous administration of 100 mcg exenatide (10 times the maximum recommended dose). Another patient developed vomiting, diarrhea, and weakness with normal blood glucose after 90 mcg exenatide. LIRAGLUTIDE: Two adults developed severe nausea and vomiting following liraglutide subcutaneous injections of 17.4 mg (10 times the maximum recommended dose) and 72 mg; hypoglycemia did not develop.

WITH THERAPEUTIC USE

COMMON: Albiglutide (10% or greater incidence): nausea, diarrhea, injection site reaction, and upper respiratory tract infection. Dulaglutide (5% or greater incidence): nausea, vomiting, diarrhea, abdominal pain, and decreased appetite. Exenatide (5% or greater incidence): nausea, vomiting, diarrhea, constipation, feeling jittery, dizziness, headache, dyspepsia, and asthenia. Liraglutide (5% or greater incidence): nausea, diarrhea, and headache.
LESS COMMON: Other adverse effects that may occur less frequently include hypersensitivity reactions (rash, pruritus, dyspnea) acute pancreatitis, and hypoglycemia. The risk of hypoglycemia may be increased with concomitant administration of a GLP-1 receptor agonist and insulin or an insulin secretagogue (eg sulfonylurea). Tachycardia and ECG abnormalities (increased PR intervals and first degree AV block) were infrequently reported with dulaglutide therapy.

Editor's Note: An ERG guide with information appropriate to this material does not exist.

-FIRST AID

FIRST AID AND PREHOSPITAL TREATMENT

Gastrointestinal decontamination is not recommended; administered via the parenteral route.

-RANGE OF TOXICITY

MAXIMUM TOLERATED EXPOSURE

EXENATIDE

Severe nausea, vomiting, and hypoglycemia were reported in three patients with type 2 diabetes following subcutaneous administration of single 100 mcg doses of exenatide (10 times the maximum recommended dose). All patients recovered with supportive care (Prod Info BYETTA(R) subcutaneous injection, 2011; Calara et al, 2005).
CASE REPORT: A 40-year-old woman administered 90 mcg of exenatide along with her routine morning diabetes medications in a suicide attempt. She developed nausea, vomiting, and weakness, but never became hypoglycemic nor required supportive dextrose therapy (Cohen et al, 2008).
Healthy volunteers tolerated a 10 mcg dose subQ without developing hypoglycemia (Blase et al, 2005). Infusion of 0.5 picomol/kg/minute caused lower fasting and postprandial glucose levels in volunteers, but did not cause hypoglycemia(Edwards et al, 2001).

LIRAGLUTIDE

During a clinical trial, an adult inadvertently received 17.4 mg subQ (10 time the recommended dose) of liraglutide and developed severe nausea and vomiting; hypoglycemia was not observed. Recovery was uneventful (Prod Info VICTOZA(R) solution for subcutaneous injection, 2010).
CASE REPORT: A 33-year-old woman, with type 2 diabetes, intentionally injected 72 mg of liraglutide subcutaneously and subsequently developed severe nausea and vomiting. Hypoglycemia did not develop (Nakanishi et al, 2013).
CASE REPORT: A 49-year-old woman, with type 2 diabetes mellitus, developed hypoglycemia and severe nausea and vomiting after injecting a 0.6 mg dose of liraglutide 30 times subcutaneously (total dose of 18 mg) instead of the prescribed 0.6 mg SubQ once daily. Her blood glucose concentration was 3.6 mmol/L approximately 1 hour after the overdose, and 2.5 hours post-overdose, the patient was admitted to the hospital where she was given supportive care. After vomiting a total of 19 times, her vomiting stopped approximately 13 hours post-overdose and her mean blood glucose concentration was 10.1 +/- 2.23 mmol/L (ranging from 4.49 to 12.93 mmol/L). She was discharged 24 hours post-admission (Elmehdawi & Elbarsha, 2014).

LIXISENATIDE

An increased incidence of gastrointestinal effects were noted in type 2 diabetic patients who received doses up to 30 mcg twice daily (3 times the daily recommended dose) during a clinical trial (Prod Info ADLYXIN(TM) subcutaneous injection, 2016).

Carcinogenicity Ratings for CAS141758-74-9 :

ACGIH (American Conference of Governmental Industrial Hygienists, 2010): Not Listed
EPA (U.S. Environmental Protection Agency, 2011): Not Listed
IARC (International Agency for Research on Cancer (IARC), 2016; International Agency for Research on Cancer, 2015; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2010; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2010a; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2008; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2007; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2006; IARC, 2004): Not Listed
NIOSH (National Institute for Occupational Safety and Health, 2007): Not Listed
MAK (DFG, 2002): Not Listed
NTP (U.S. Department of Health and Human Services, Public Health Service, National Toxicology Project ): Not Listed

Carcinogenicity Ratings for CAS204656-20-2 :

ACGIH (American Conference of Governmental Industrial Hygienists, 2010): Not Listed
EPA (U.S. Environmental Protection Agency, 2011): Not Listed
IARC (International Agency for Research on Cancer (IARC), 2016; International Agency for Research on Cancer, 2015; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2010; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2010a; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2008; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2007; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2006; IARC, 2004): Not Listed
NIOSH (National Institute for Occupational Safety and Health, 2007): Not Listed
MAK (DFG, 2002): Not Listed
NTP (U.S. Department of Health and Human Services, Public Health Service, National Toxicology Project ): Not Listed

TOXICITY AND RISK ASSESSMENT VALUES

EPA IRIS

EPA Risk Assessment Values for CAS141758-74-9 (U.S. Environmental Protection Agency, 2011):

Not Listed

EPA Risk Assessment Values for CAS204656-20-2 (U.S. Environmental Protection Agency, 2011):

Not Listed

-STANDARDS AND LABELS

WORKPLACE STANDARDS

ACGIH TLV Values for CAS141758-74-9 (American Conference of Governmental Industrial Hygienists, 2010):

Not Listed

ACGIH TLV Values for CAS204656-20-2 (American Conference of Governmental Industrial Hygienists, 2010):

Not Listed

AIHA WEEL Values for CAS141758-74-9 (AIHA, 2006):

Not Listed

AIHA WEEL Values for CAS204656-20-2 (AIHA, 2006):

Not Listed

NIOSH REL and IDLH Values for CAS141758-74-9 (National Institute for Occupational Safety and Health, 2007):

Not Listed

NIOSH REL and IDLH Values for CAS204656-20-2 (National Institute for Occupational Safety and Health, 2007):

Not Listed

OSHA PEL Values for CAS141758-74-9 (U.S. Occupational Safety, and Health Administration (OSHA), 2010):

Not Listed

OSHA PEL Values for CAS204656-20-2 (U.S. Occupational Safety, and Health Administration (OSHA), 2010):

Not Listed

OSHA List of Highly Hazardous Chemicals, Toxics, and Reactives for CAS141758-74-9 (U.S. Occupational Safety and Health Administration, 2010):

Not Listed

OSHA List of Highly Hazardous Chemicals, Toxics, and Reactives for CAS204656-20-2 (U.S. Occupational Safety and Health Administration, 2010):

Not Listed

ENVIRONMENTAL STANDARDS

EPA CERCLA, Hazardous Substances and Reportable Quantities for CAS141758-74-9 (U.S. Environmental Protection Agency, 2010):

Not Listed

EPA CERCLA, Hazardous Substances and Reportable Quantities for CAS204656-20-2 (U.S. Environmental Protection Agency, 2010):

Not Listed

EPA CERCLA, Hazardous Substances and Reportable Quantities, Radionuclides for CAS141758-74-9 (U.S. Environmental Protection Agency, 2010):

Not Listed

EPA CERCLA, Hazardous Substances and Reportable Quantities, Radionuclides for CAS204656-20-2 (U.S. Environmental Protection Agency, 2010):

Not Listed

EPA RCRA Hazardous Waste Number for CAS141758-74-9 (U.S. Environmental Protection Agency, 2010b):

Not Listed
Editor's Note: The D, F, and K series waste numbers and Appendix VIII to Part 261 -- Hazardous Constituents were not included. Please refer to 40 CFR Part 261.

EPA RCRA Hazardous Waste Number for CAS204656-20-2 (U.S. Environmental Protection Agency, 2010b):

Not Listed
Editor's Note: The D, F, and K series waste numbers and Appendix VIII to Part 261 -- Hazardous Constituents were not included. Please refer to 40 CFR Part 261.

EPA SARA Title III, Extremely Hazardous Substance List for CAS141758-74-9 (U.S. Environmental Protection Agency, 2010):

Not Listed

EPA SARA Title III, Extremely Hazardous Substance List for CAS204656-20-2 (U.S. Environmental Protection Agency, 2010):

Not Listed

EPA SARA Title III, Community Right-to-Know for CAS141758-74-9 (40 CFR 372.65, 2006; 40 CFR 372.28, 2006):

Not Listed

EPA SARA Title III, Community Right-to-Know for CAS204656-20-2 (40 CFR 372.65, 2006; 40 CFR 372.28, 2006):

Not Listed

DOT List of Marine Pollutants for CAS141758-74-9 (49 CFR 172.101 - App. B, 2005):

Not Listed

DOT List of Marine Pollutants for CAS204656-20-2 (49 CFR 172.101 - App. B, 2005):

Not Listed

EPA TSCA Inventory for CAS141758-74-9 (EPA, 2005):

Not Listed

EPA TSCA Inventory for CAS204656-20-2 (EPA, 2005):

Not Listed

LABELS

NFPA

NFPA Hazard Ratings for CAS141758-74-9 (NFPA, 2002):

Not Listed

NFPA Hazard Ratings for CAS204656-20-2 (NFPA, 2002):

Not Listed

-PERSONAL PROTECTION

SUMMARY

Editor's Note: An ERG guide with information appropriate to this material does not exist.

PROTECTIVE CLOTHING

CHEMICAL PROTECTIVE CLOTHING. Search results for CAS 141758-74-9.

Specific recommendations and test data for this chemical were not found in the available manufacturers' product literature. A complete list of consulted manufacturers and references is presented below.

CHEMICAL PROTECTIVE CLOTHING. Search results for CAS 204656-20-2.

Specific recommendations and test data for this chemical were not found in the available manufacturers' product literature. A complete list of consulted manufacturers and references is presented below.

-PHYSICAL HAZARDS

FIRE HAZARD

SUMMARY

Editor's Note: An ERG guide with information appropriate to this material does not exist.

FLAMMABILITY CLASSIFICATION

NFPA Flammability Rating for CAS141758-74-9 (NFPA, 2002):

Not Listed

NFPA Flammability Rating for CAS204656-20-2 (NFPA, 2002):

Not Listed

FIRE CONTROL/EXTINGUISHING AGENTS

Editor's Note: An ERG guide with information appropriate to this material does not exist.

NFPA Extinguishing Methods for CAS141758-74-9 (NFPA, 2002):

Not Listed

NFPA Extinguishing Methods for CAS204656-20-2 (NFPA, 2002):

Not Listed

EVACUATION PROCEDURES

SUMMARY

Editor's Note: An ERG guide with information appropriate to this material does not exist.

AIHA ERPG Values for CAS141758-74-9 (AIHA, 2006):

Not Listed

AIHA ERPG Values for CAS204656-20-2 (AIHA, 2006):

Not Listed

DOE TEEL Values for CAS141758-74-9 (U.S. Department of Energy, Office of Emergency Management, 2010):

Not Listed

DOE TEEL Values for CAS204656-20-2 (U.S. Department of Energy, Office of Emergency Management, 2010):

Not Listed

AEGL Values for CAS141758-74-9 (National Research Council, 2010; National Research Council, 2009; National Research Council, 2008; National Research Council, 2007; NRC, 2001; NRC, 2002; NRC, 2003; NRC, 2004; NRC, 2004; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; United States Environmental Protection Agency Office of Pollution Prevention and Toxics, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; 62 FR 58840, 1997; 65 FR 14186, 2000; 65 FR 39264, 2000; 65 FR 77866, 2000; 66 FR 21940, 2001; 67 FR 7164, 2002; 68 FR 42710, 2003; 69 FR 54144, 2004):

Not Listed

AEGL Values for CAS204656-20-2 (National Research Council, 2010; National Research Council, 2009; National Research Council, 2008; National Research Council, 2007; NRC, 2001; NRC, 2002; NRC, 2003; NRC, 2004; NRC, 2004; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; United States Environmental Protection Agency Office of Pollution Prevention and Toxics, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; 62 FR 58840, 1997; 65 FR 14186, 2000; 65 FR 39264, 2000; 65 FR 77866, 2000; 66 FR 21940, 2001; 67 FR 7164, 2002; 68 FR 42710, 2003; 69 FR 54144, 2004):

Not Listed

NIOSH IDLH Values for CAS141758-74-9 (National Institute for Occupational Safety and Health, 2007):

Not Listed

NIOSH IDLH Values for CAS204656-20-2 (National Institute for Occupational Safety and Health, 2007):

Not Listed

CONTAINMENT/WASTE TREATMENT OPTIONS

SUMMARY

Editor's Note: An ERG guide with information appropriate to this material does not exist.

SMALL LEAK/SPILL

Editor's Note: An ERG guide with information appropriate to this material does not exist.

LARGE LEAK/SPILL

Editor's Note: An ERG guide with information appropriate to this material does not exist.

-PHYSICAL/CHEMICAL PROPERTIES

MOLECULAR WEIGHT

ALBIGLUTIDE: 72,970 daltons (Prod Info TANZEUM subcutaneous injection powder, 2014)

DULAGLUTIDE: 63 kilodaltons (Prod Info TRULICITY(TM) subcutaneous injection, 2014)

EXENATIDE: 4186.6 daltons (Prod Info BYETTA(R) subcutaneous injection, 2009)

LIRAGLUTIDE: 3751.2 daltons (Prod Info VICTOZA(R) solution for subcutaneous injection, 2010)

LIXISENATIDE: 4858.5 (Prod Info ADLYXIN(TM) subcutaneous injection, 2016)

DESCRIPTION/PHYSICAL STATE

ALBIGLUTIDE lyophilized powder is white to yellow in color. The solvent is a clear, colorless solution. Reconstituted solutions are yellow in color (Prod Info TANZEUM subcutaneous injection powder, 2014).

DULAGLUTIDE is a sterile, clear, colorless solution (Prod Info TRULICITY(TM) subcutaneous injection, 2014).

EXENATIDE is a clear, colorless solution (Prod Info BYETTA(R) subcutaneous injection, 2009).

LIRAGLUTIDE is a clear, colorless solution (Prod Info VICTOZA(R) solution for subcutaneous injection, 2010).

LIXISENATIDE is a clear, colorless solution (Prod Info ADLYXIN(TM) subcutaneous injection, 2016).

EXENATIDE: 4.5 (Prod Info BYETTA(R) subcutaneous injection, 2009)

-REFERENCES

GENERAL BIBLIOGRAPHY

40 CFR 372.28: Environmental Protection Agency - Toxic Chemical Release Reporting, Community Right-To-Know, Lower thresholds for chemicals of special concern. National Archives and Records Administration (NARA) and the Government Printing Office (GPO). Washington, DC. Final rules current as of Apr 3, 2006.

40 CFR 372.65: Environmental Protection Agency - Toxic Chemical Release Reporting, Community Right-To-Know, Chemicals and Chemical Categories to which this part applies. National Archives and Records Association (NARA) and the Government Printing Office (GPO), Washington, DC. Final rules current as of Apr 3, 2006.

49 CFR 172.101 - App. B: Department of Transportation - Table of Hazardous Materials, Appendix B: List of Marine Pollutants. National Archives and Records Administration (NARA) and the Government Printing Office (GPO), Washington, DC. Final rules current as of Aug 29, 2005.

62 FR 58840: Notice of the National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances - Proposed AEGL Values, Environmental Protection Agency, NAC/AEGL Committee. National Archives and Records Administration (NARA) and the Government Publishing Office (GPO), Washington, DC, 1997.

65 FR 14186: Notice of the National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances - Proposed AEGL Values, Environmental Protection Agency, NAC/AEGL Committee. National Archives and Records Administration (NARA) and the Government Publishing Office (GPO), Washington, DC, 2000.

65 FR 39264: Notice of the National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances - Proposed AEGL Values, Environmental Protection Agency, NAC/AEGL Committee. National Archives and Records Administration (NARA) and the Government Publishing Office (GPO), Washington, DC, 2000.

65 FR 77866: Notice of the National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances - Proposed AEGL Values, Environmental Protection Agency, NAC/AEGL Committee. National Archives and Records Administration (NARA) and the Government Publishing Office (GPO), Washington, DC, 2000.

66 FR 21940: Notice of the National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances - Proposed AEGL Values, Environmental Protection Agency, NAC/AEGL Committee. National Archives and Records Administration (NARA) and the Government Publishing Office (GPO), Washington, DC, 2001.

67 FR 7164: Notice of the National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances - Proposed AEGL Values, Environmental Protection Agency, NAC/AEGL Committee. National Archives and Records Administration (NARA) and the Government Publishing Office (GPO), Washington, DC, 2002.

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EXENATIDE AND RELATED AGENTS

Classification | Information to evaluate chemical incidents

Information to evaluate chemical incidents

Information to evaluate chemical incidents

Information to evaluate chemical incidents