Medication Chart For Type 2 Diabetes

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Medication Chart for Type 2 Diabetes
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Dosing
Med Group Descriptor,
Action, Side Effects, Notes
Considerations
Dosage
Drug Class, Drug Name
Frequency/Day
Ranges
FDA Indication is always the following except where noted differently:
Adult (> 18 yo): T2DM as monotherapy and combo therapy. Pediatrics (< 18 yo): Role has not been established in T2DM
Biguanides
Action: Reduces the amount of
For metformin:
glucose the liver releases between
2–3 times/day. Take with
Cautious use of metformin
meals.
Metformin (GLUCOPHAGE)
meals to avoid stomach upset.
500-2,550
with renal impairment
Side effects: Gas, diarrhea, upset
mg/day
(Scr >1.5 md/dL in men;
Also available in sustained release
stomach, nausea, abdominal pain. In
For sustained release:
Scr >1.4 mg/dL in women or
and oral solution: GLUCOPHAGE
1–2 times/day, with meals.
Maximum
rare cases, lactic acidosis may occur in
GFR <60).
XR, FORTAMET, GLUMETZA,
effective dose =
people with abnormal liver or kidney
For oral solution:
RIOMET
2,000 mg/day
function.
Average A1c decrease 1-2%.
2–3 times/day, with meals.
Notes: Take with food to decrease
gas, diarrhea.
Sulfonylureas (SU)
1–2 times/day, 30 minutes
2.5-40 mg/day (IR
Preferred sulfonylurea in CKD,
Glipizide (GLUCOTROL)
pre-meal.
product)
elderly. Average A1c decrease
Also available in extended release:
1-2%.
Action: Stimulates pancreas to
(GLUCOTROL XL)
For extended release:
5-20 mg/day (XL
Less hypoglycemia than
release more insulin right after a meal
1–2 times/day, with meals.
product)
glyburide.
and then over many hours.
Glyburide (MICRONASE,
1.25-20 mg/day
Side effects: Potential for
MICRONASE DIABETA)
1–2 times/day. Take with
Near maximal
Average A1c decrease 1-2%.
hypoglycemia.
Also available in micronized:
meals to avoid hypoglycemia.
effect is observed
GLYNASE PRESTABS
at 10 mg/day
Glimepiride (AMARYL)
1 time/day, with meals.
1-8 mg/day
Average A1c decrease 1-2%
Meglitinides (Glinide)
2–4 times/day, 0–30 min pre
meals. Skip meal, skip dose.
Action: Stimulates pancreas to
Repaglinide (PRANDIN)
0.5-16 mg/day
Add meal, add dose to total of
release more insulin right after a meal.
Average A1c decrease 0.5-1%.
4 doses/day.
Side effects: Potential for
hypoglycemia.
1–3 times/day, 0–30 min pre
Nateglinide (STARLIX)
180-360 mg/day
meals. Skip meal, skip dose.
Thiazolidinediones (TZD)
Action (both): improves insulin
Black box warning.
sensitivity.
(contraindicated in
Side effects (both): Weight gain,
established New York Heart
fluid retention, osteopenia, increase
Association [NYHA] Class III
Pioglitazone (ACTOS)
1 time/day, same time daily.
15-45 mg/day
in congestive heart failure in those
or IV heart failure and not
at risk.
recommended for use in
Notes: Don’t prescribe with family or
symptomatic heart failure).
personal history of bladder cancer.
Average A1c decrease 1-1.5%.
DPP-4 Inhibitors (Dipeptidyl peptidase-4)
Average A1c decrease 0.5-
Sitagliptin (JANUVIA)
Action: Increases insulin secretion
25-100 mg/day
0.8%.
following meal. Lowers hepatic
glucose production.
1 time/day, unrelated to food.
Average A1c decrease 0.5-
Linagliptin (TRADJENTA)
5 mg/day
Side effects: Stuffy nose, sore throat,
Same time daily.
0.8%.
occasional diarrhea and stomach
Average A1c decrease 0.5-
Saxagliptin (ONGLYZA)
discomfort.
2.5-5 mg/day
0.8%.
This medication chart is designed to assist clinicians in diabetes management. It is not intended to replace a clinician’s judgment or establish a protocol for all patients.
For national recommendations, references and additional copies of the guideline, go to or call (303) 446-7200. This medication chart was supported with funds from The Colorado Health Foundation.
Developed February 2012.

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