Antidiabetic Agents
| ANTIDIABETIC AGENTS◊ | |||||
|---|---|---|---|---|---|
| Generic | Brand & Company | Strength | Formu- lations† |
Usual Maintenance Range* | Usual Max Dose |
| ALPHA-GLUCOSIDASE INHIBITORS | |||||
| acarbose | Precose
Bayer |
25mg, 100mg | tabs | 50–100mg three times daily | ≤60kg: 150mg/day in divided doses.
>60kg: 300mg/day in divided doses |
| 50mg | scored tabs | ||||
| miglitol | Glyset
Pfizer |
25mg, 50mg, 100mg | tabs | 50mg three times daily | 300mg/day in 3 divided doses |
| AMINO ACID DERIVATIVES | |||||
| nateglinide | Starlix
Novartis |
60mg, 120mg | tabs | 120mg 1–30min before meals three times daily | 360mg/day in 3 equal divided doses |
| AMYLIN ANALOGUE/AMYLINOMIMETIC | |||||
| pramlintide | Symlin
Amylin |
0.6mg/mL | injectable soln | Type 1: initially 15micrograms; titrate in 15microgram increments
if no significant nausea occurs for at least 3 days; maintenance: 60micrograms (30micrograms
only if 60micrograms is not tolerated). If nausea occurs at 45 or 60microgram dose, reduce to
30micrograms; if not tolerated, consider discontinuing therapy.
Type 2: initially 60micrograms; may increase to 120micrograms if no significant nausea occurs for 3–7days; if nausea occurs at 120micrograms reduce to 60micrograms. |
— |
| BIGUANIDES | |||||
| metformin | Fortamet
Shionogi |
500mg, 1000mg | ext-rel tabs | 500mg–2.5g once daily | 2.5g/day |
| Glucophage
Bristol-Myers Squibb |
500mg, 850mg, 1000mg | tabs | 500mg–2.55grams in 2 or 3 divided doses | 2.55grams/day | |
| Glucophage XR
Bristol-Myers Squibb |
500mg, 750mg | ext-rel tabs | 500mg–2g in single or 2 divided doses | 2g in single or in 2 divided doses | |
| Glumetza
Santarus, Inc. |
500mg | ext-rel tabs | 500mg–2g once daily | 2g/day | |
| Riomet
Ranbaxy |
500mg/5mL | oral soln | 500mg–2.55grams (5mL–2.5mL) in 2 or 3 divided doses | 2.55grams/day (25.5mL/day) | |
| BILE ACID SEQUESTRANT | |||||
| colesevelam | Welchol
Daiichi Sankyo |
625mg | tabs | 6 tablets once daily or 3 tablets twice daily | 4.5g/day |
| Welchol for Oral Suspension
Daiichi Sankyo |
1.875g, 3.75g | pwd pkts | One 1.875g pkt twice daily or one 3.75g pkt once daily | ||
| DIPEPTIDYL PEPTIDASE-4 INHIBITOR | |||||
| linagliptin | Tradjenta
Boehringer Ingelheim and Lilly |
5mg | tabs | 5mg once daily | — |
| saxagliptin | Onglyza
Bristol-Myers Squibb |
2.5mg, 5mg | tabs | 2.5mg or 5mg once daily | — |
| sitagliptin | Januvia
Merck |
25mg, 50mg, 100mg | tabs | — | 100mg once daily |
| COMBINATION DIPEPTIDYL PEPTIDASE-4 INHIBITOR + BIGUANIDE | |||||
| linagliptin + metformin | Jentadueto
Boehringer Ingelheim and Lilly |
2.5mg/500mg, 2.5mg/850mg, 2.5mg/1000mg | tabs | — | 2.5mg/1000mg twice daily |
| saxagliptin + metformin (ext-rel) | Kombiglyze XR
Bristol-Myers Squibb |
5mg/500mg, 5mg/1000mg, 2.5mg/1000mg | tabs | — | 5mg/2g per day |
| sitagliptin + metformin | Janumet
Merck |
50mg/500mg, 50mg/1000mg | tabs | — | 100mg/2g per day |
| Janumet XR
Merck |
50mg/500mg, 50mg/1000mg, 100mg/1000mg | ext-rel tabs | |||
| COMBINATION DIPEPTIDYL PEPTIDASE-4 INHIBITOR + STATIN | |||||
| sitagliptin + simvastatin | Juvisync
Merck |
100mg/10mg, 100mg/20mg, 100mg/40mg | tabs | Initially 100mg/40mg once a day in the evening | — |
| GLUCAGON-LIKE PEPTIDE-1 RECEPTOR AGONIST | |||||
| liraglutide [rDNA origin] | Victoza
Novo Nordisk |
6mg/mL | injectable soln | Initially 0.6mg/day for 1 week, then 1.2mg/day; may increase to 1.8mg/day. If >3 days elapsed since last dose, reinitiate at 0.6mg/day, then titrate. | — |
| INCRETIN MIMETIC | |||||
| exenatide | Byetta
Amylin and Lilly |
250micrograms/mL | injectable soln | Initially 5micrograms twice daily; may increase to 10micrograms twice daily after 1 month | — |
| exenatide extended-release | Bydureon
Amylin and Alkermes |
2mg/vial | injectable soln | 2mg once every 7 days (weekly) | — |
| MEGLITINIDES | |||||
| repaglinide | Prandin
Novo Nordisk |
0.5mg, 1mg, 2mg | tabs | 0.5mg–4mg within 30 min of meals 2–4 times daily | 16mg/day |
| COMBINATION MEGLITINIDES + BIGUANIDE | |||||
| repaglinide + metformin | PrandiMet
Novo Nordisk |
1mg/500mg
2mg/500mg |
tabs | — | 10mg/2500mg per day |
| SODIUM-GLUCOSE CO-TRANSPORTER 2 INHIBITORS | |||||
| canagliflozin | Invokana
Janssen |
100mg, 300mg | tabs | Initially 100mg once daily; may increase to 300mg once daily if tolerant. If eGFR 45–<60mL/min/1.73m²: 100mg once daily. If eGFR <45mL/min/1.73m²: not recommended | — |
| SULFONYLUREAS | |||||
| chlorpropamide
1st generation |
Diabinese
Pfizer |
100mg, 250mg | scored tabs | 250–750mg in single or divided doses | 750mg/day in single or divided doses |
| glimepiride | Amaryl
Sanofi Aventis |
1mg, 2mg, 4mg | scored tabs | 1–4mg once daily | 8mg/day |
| glipizide
2nd generation |
Glucotrol
Pfizer |
5mg, 10mg | scored tabs | 5–15mg once daily or 5–40mg in divided doses | 15mg once daily or 40mg in divided doses |
| Glucotrol XL
Pfizer |
2.5mg, 5mg, 10mg | ext-rel tabs | 5–10mg once daily | 20mg/day | |
| glyburide
2nd generation |
Diaßeta
Sanofi Aventis |
1.25mg, 2.5mg, 5mg | scored tabs | 1.25–20mg in single or divided doses | 20mg/day in single or divided doses |
| various | 1.25mg, 2.5mg, 5mg | scored tabs | 1.25–20mg in single or divided doses | 20mg/day in single or divided doses | |
| glyburide, micronized
2nd generation |
Glynase PresTab
Pfizer |
1.5mg, 3mg, 6mg | scored tabs | 0.75mg–12mg in single or divided doses | 12mg/day in divided doses |
| COMBINATION SULFONYLUREA + BIGUANIDE | |||||
| glipizide + metformin | various | 2.5mg/250mg
2.5mg/500mg 5mg/500mg (mg glipizide/ mg metformin) |
tabs | — | 20mg/2000mg per day in single or divided doses |
| glyburide + metformin | Glucovance
Bristol-Myers Squibb |
1.25mg/250mg
2.5mg/500mg 5mg/500mg (mg glyburide/ mg metformin) |
tabs | — | 20mg/2000mg per day in single or divided doses |
| THIAZOLIDINEDIONES | |||||
| pioglitazone | Actos
Takeda |
15mg, 30mg, 45mg | tabs | 15–45mg once daily | 45mg once daily |
| rosiglitazone | Avandia
GlaxoSmithKline |
2mg, 4mg, 8mg | tabs | 4mg–8mg in single or 2 divided doses | 8mg/day |
| COMBINATION THIAZOLIDINEDIONE + BIGUANIDE | |||||
| pioglitazone + metformin | ACTOplus met
Takeda |
15mg/500mg, 15mg/850mg | tabs | — | 45mg/2550mg per day in divided doses |
| ACTOplus met XR
Takeda |
15mg/1000mg, 30mg/1000mg | ext-rel tabs | — | 45mg/2000mg per day | |
| rosiglitazone + metformin | Avandamet
GlaxoSmithKline |
2mg/500mg, 4mg/500mg, 2mg/1000mg, 4mg/1000mg
(mg rosiglitazone/ mg metformin) |
tabs | — | 8mg/2000mg per day in divided doses |
| COMBINATION THIAZOLIDINEDIONE + SULFONYLUREA | |||||
| pioglitazone + glimepiride | Duetact
Takeda |
30mg/2mg, 30mg/4mg
(mg pioglitazone/ mg glimepiride) |
tabs | — | One 30mg/4mg tab once daily |
| rosiglitazone + glimepiride | Avandaryl
GlaxoSmithKline |
4mg/1mg, 4mg/2mg, 4mg/4mg
(mg rosiglitazone/ mg glimepiride) |
tabs | — | 8mg/4mg per day |
| NOTES | |||||
|
† tabs = tablets, ext-rel tabs = extended-release tablets, soln = solution, pwd pkts = powder packets * Usual Maintenance Range is the manufacturer's suggested guideline. Patients' individual needs may vary. Adjust dose based on clinical effect. Start at a low dose and gradually titrate upwards according to clinical effect (especially in the elderly, malnourished, debilitated, or those who have renal and/or hepatic dysfunction). • These products are intended for use as part of a total treatment regimen to maintain glycemic control that includes diet, regular exercise, blood glucose monitoring, and glycosylated hemoglobin monitoring. Patients should maintain regular caloric intake. • See individual product entries for initial dosing information and other important information. ◊Drug Information on insulins can be found on the Insulin Administration or Insulins Charts in the Diabetes Section. (Rev. 5/2013) |
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