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Diabetes Treatments

April 16, 2012

Antidiabetic Agents (download)

ANTIDIABETIC AGENTS◊

Generic & Class	Brand & Company	Strength	Formulations†	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
acarbose	Precose Bayer	50mg	scored tabs	50–100mg three times daily
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
colesevelam	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	4.5g/day
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
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.	—
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
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
glipizide 2nd generation	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
glyburide 2nd generation	Micronase Pfizer	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	Metaglip Bristol-Myers Squibb	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
pioglitazone + metformin	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. 4/2012)

Screening for Retinopathy Every Two Years Deemed Safe

May 15, 2012

For patients with type 2 diabetes without evidence of retinopathy, increasing the screening interval to every two years yields no increased risk of retinopathy-mediated vision loss and reduces screening costs.

Substantial Survival for Older Adults With Diabetes

May 10, 2012

Middle-aged and older adults with diabetes have substantial five-year survival, with survival exceeding 50% for almost all age and clinical groups.

Glycemic Variability Affects Mood and Quality of Life

May 10, 2012

Glycemic variability appears to be associated with lower quality of life and negative moods in women with type 2 diabetes.

Team-Centered Multicondition Care Deemed Cost-Effective

May 10, 2012

For adults with depression and poorly controlled diabetes and/or coronary heart disease (CHD), a collaborative care intervention is cost-effective.

Amino Acid Levels Linked to Type 2 Diabetes Risk

May 09, 2012

Levels of some amino acids are associated with glycemia and insulin resistance and predict the development of type 2 diabetes in men.

ACTOPLUS MET XR

Endocrine System > Diabetes

Pioglitazone (as HCl), metformin HCl extended-release; 15mg/1000mg, 30mg/1000mg; tabs.

AMARYL

Endocrine System > Diabetes

Glimepiride 1mg, 2mg, 4mg; scored tabs.

AVANDIA

Endocrine System > Diabetes

Rosiglitazone (as maleate) 2mg, 4mg, 8mg; tabs.

HUMALOG MIX50/50

Endocrine System > Diabetes

Insulin lispro protamine suspension 50% (recombinant), insulin lispro 50% (recombinant) 100 Units/mL; SC inj; contains zinc, m-cresol.

WELCHOL

Endocrine System > Diabetes

Colesevelam HCl 625mg; tabs.

BYDUREON

Endocrine System > Diabetes

Monograph added.

Updated: 4/20/2012

JENTADUETO

Endocrine System > Diabetes

Monograph added.

Updated: 4/18/2012

ASTELIN

Respiratory Tract > Rhinitis/rhinorrhea (intranasal products)

Adverse reactions updated.

Updated: 5/8/2012

ATRAPRO ANTIPRURITIC HYDROGEL

Dermatological Disorders > Pruritus and dry skin

Monograph added.

Updated: 4/25/2012

ATRAPRO DERMAL SPRAY

Dermatological Disorders > Pressure/neuropathic ulcers

Monograph added.

Updated: 4/24/2012

Endocrine System > Diabetes

Insulin is the mainstay of therapy for the treatment of type 1 diabetes. Pharmacologic therapy for the management of type ...
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Blood Glucose Monitors for Diabetes

May 07, 2012

Blood glucose meters comparison chart including injection site, sample size, range, result time, calibration method, memory size, and battery type.

Compatibility of Glucose Meters with Lancets and Test Strips

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Glucose meters with lancets and test strips compatibility chart.

Insulin Products

June 30, 2011

Insulin products table with pharmacokinetic properties.

Insulin Administration

June 30, 2011

Insulin preparations categorized by rapid-, short-, intermediate- and long-acting. Information such as the route, administration as well as the mixing of insulins is provided.