ORAL AND NONINSULIN INJECTABLE ANTIDIABETIC MEDICATIONS1, 2

BRAND NAME / GENERIC NAME / DOSING RANGE / MECHANISM OF ACTION / ADVERSE EFFECTS
BIGUANIDE
Glucophage®, Glucophage® XR / MetFORMIN /
  • 500-1000 mg twice daily
  • Total dose given once daily for XR formulations
  • Use cautiously in patients with renal insufficiency
/
  • Decreases hepatic glucose production, decreasing intestinal absorption of glucose
  • Improves insulin sensitivity
/
  • Diarrhea
  • Gas
  • Nausea
  • Abdominal Pain
  • Hold for dehydration or if undergoing contrast dye procedures

SULFONYLUREA
Amaryl® / Glimeperide /
  • 1-8 mg once daily
/
  • Stimulates insulin release from pancreatic beta cells
  • Reduces glucose output from liver
  • Insulin sensitivity increased at peripheral targets
/
  • Hypoglycemia
  • Nausea

Glucotrol®, Glucotrol XL® / GlipiZIDE /
  • 5-10 mg twice daily

Diabeta®, Micronase® / GlyBURIDE /
  • Micronized tablets: 1.5-12 mg twice daily
  • Conventional tablets: 2.5-20 mg twice daily

THIAZOLIDINEDIONE
Actos® / Pioglitazone /
  • 15-45 mg once daily
/
  • Improve target response to insulin
/
  • Edema
  • Weight gain
  • Osteoporosis
  • Macular edema

Avandia® / Rosiglitazone /
  • 5-20 mg once daily

MEGLITINIDE ANALOG
Starlix® / Nateglinide /
  • 60-120 mg 3 times daily before meals
/
  • Stimulate insulin release from pancreatic beta cells
  • Insulin release glucose-dependent
/
  • Hypoglycemia

Prandin® / Repaglinide /
  • 0.5-4 mg taken with meals

DIPEPTIDYL PEPTIDASE IV (DPP-IV) INHIBITOR
Nesina™ / Alogliptin /
  • 25 mg once daily
/
  • Inhibit dipeptidyl peptidase IV (DPP-IV) enzyme prolonging active incretin levels
  • Incretin increases insulin synthesis from pancreatic beta cells and decreases glucagons levels
/
  • Pancreatitis
  • Hypoglycemia

Tradjenta™ / Linagliptin /
  • 5 mg once daily

Onglyza™ / Saxagliptin /
  • 2.5-5 mg once daily

Januvia™ / Sitagliptin /
  • 25-100 mg once daily

ALAPHA-GLUCOSIDASE INHIBITOR
Precose® / Acarbose /
  • 25-100 mg three times daily at start of each meal
/
  • Delay digestion of ingest carbohydrates resulting in smaller rise in blood glucose levels following meals
/
  • Abdominal pain
  • Diarrhea
  • Flatulence

Glyset® / Miglitol /
  • 25-100 mg three times daily at start of each meal

SODIUM-GLUCOSE CONTRANSPORTER 2 (SGLT2) INHIBITOR
Invokana® / Canagliflozin /
  • 100-300 mg once daily
/
  • Inhibit sodium-glucose transporter 2 (SGLT2) in proximal renal tubules reducing reabsorption of filtered glucose from tubular lumen
  • Results in increased urinary excretion of glucose
/
  • Female genital mycotic infections
  • Increased urination
  • Increased thirst
  • Dehydration
  • Possible worsening renal insufficency

Farxiga™ / Dapagliflozin /
  • 5-10 mg once daily

Jardiance® / Empagliflozin /
  • 10-25 mg once daily

GLUCAGON-LIKE PEPTIDE (GLP-1) RECEPTOR AGONIST
Tanzeum™ / Albiglutide /
  • 30-50 mg once weekly subcutaneously
/
  • Increase glucose-dependent insulin secretion
  • Decrease inappropriate glucagons secretion
  • Slow gastric emptying
/
  • Hypoglycemia
  • Nausea
  • Decreased appetite

Trulicity / Dulaglutide /
  • 0.75-1.5 mg once weekly subcutaneously

Byetta®, Bydureon® (extended-release for injectable suspension) / Exenatide /
  • Immediate release: 5-10 mcg twice daily subcutaneously within 60 minutes prior to a meal
  • Extended release: 2 mg once weekly subcutaneously

Victoza® / Liraglutide /
  • 0.6-1.8 mg once daily subcutaneously

AMYLINOMIMETIC
SymlinPen® / Pramlintide /
  • 15-120 mcg prior to each major meal subcutaneously
/
  • Used only in insulin requiring patients
  • Reduces postprandial glucose by prolonging gastric emptying time and reducing postprandial glucagons secretion
  • Centrally-mediated effects on appetite suppression
/
  • Hypoglycemia
  • Nausea

References

  1. Lexi-Comp, Inc. (Lexi-Drugs® ). Lexi-Comp, Inc.; October 17, 2014
  2. Drug Facts and Comparisons. Facts & Comparisons [database online]. St. Louis, MO: Wolters Kluwer Health, Inc . Accessed October 17, 2014