Antidiabetic Medication Comparison Chart - South Dakota
[Pages:4]Antidiabetic Medication Comparison Chart
Generic Name Brand name
Expected %
decrease in A1c*
Hypoglycemia in
monotherapy
Weight
Renal/GU
GI SX
CHF
CVD Bone Health
Other
Effect on
Site of
Cost
considerations blood glucose
action
$
Acarbose^ (Precose)
Miglitol(Glyset)
0.5-0.8 0.5-0.8
Neutral Neutral
Neutral Neutral
Neutral Neutral
Alpha-Glucosidase Inhibitors
Moderate Neutral Neutral Neutral
Take with first Post prandial bite of food
Intestines liver
100
Moderate Neutral Neutral Neutral
Take with first Post prandial Intestines
200
bite of food
liver
Biguanide
Metformin^
1-2
Neutral
Slight Cont. CKD stage
Moderate Neutral Benefit
Neutral Lactic acidosis
Fasting
Liver
4
(Foramet, Glucophage,
loss 3B, 4, 5 Crcl 45-60:
(if stable)
risk increases with increased
& Basal
Intestines muscles
Glucophage
monitor
age, CHF, and
XR, Glumetza,
Crcl 30-45:
hepatic
Riomet)
decrease dose and
insufficiency
monitor
Alogliptin
0.6
(Nesina)
Neutral
Neutral Dose adj. Crcl < 60
Dipeptidyl Peptidase IV (DPP-4) Inhibitors Neutral Neutral Neutral Neutral
Pancreatitis, Post prandial Pancreas,
340
liver disease
liver
Linagliptin (Tradjenta)
0.4
Neutral
Neutral
Neutral
Neutral Neutral Neutral Neutral
Pancreatitis, liver disease
Post prandial
Pancreas, liver
350
Saxagliptin (Onglyza,)
Sitaglitptin (Januvia)
0.4-0.5 0.5-0.8
Neutral Neutral
Neutral
Dose adj. Crcl < 50
Neutral Dose adj. Crcl < 50
Neutral Neutral Neutral Neutral Neutral Neutral Neutral Neutral
Pancreatitis, liver disease
Post prandial
Pancreas, liver
350
Pancreatitis, Post prandial Pancreas,
360
liver disease
liver
Bromocriptine (Cycloset)
0.1
Neutral
Neutral
Neutral
Dopamine Agonists
Moderate Neutral Neutral Neutral
Hypotension
Unknown
Unknown
200
Expected A1c lowering based on monotherapy ^ Generic available Pricing based on
Adapted from AACE Comprehensive Diabetes Management Algorithm/Lex-Drug Antidiabetic Agents Comparison Tables
Diana G. Mercurio, RPh, CDE, CDOE, CVDOE
January 2017
Antidiabetic Medication Comparison Chart
Generic Name Brand name
Expected %
decrease in A1c*
Hypoglycemia in
Monotherapy
Weight
Renal/GU
GI SX
CHF
CVD
Bone
Other
Effect on
Site of
Cost
Health considerations blood glucose
action
$
Nateglinide^ (Starlix)
0.5-1.5
Mild
Slight gain
Repaglinide^ 0.5-1.5
Mild
Slight
(Prandin)
gain
Neutral Neutral
Meglitinide Derivatives
Moderate Neutral Neutral Neutral
Take with meals
Post prandial Pancreas
170
Hold if meal
skipped
Moderate Neutral Neutral Neutral
Take with
Post prandial Pancreas
300
meals
Hold if meal
skipped
Sodium-Glucose Co-Transporter 2 (SGLT2) Inhibitors
Canagliflozin (Invokana)
0.771.03
Neutral
Loss
Urogenital inf. Caution if eGFR <
Neutral
Neutral
Neutral or? risk
? bone loss
Hypotension Maintain
Post prandial
Kidney
375
45
adequate
hydration
DKA warning
Dapagliflozin
0.77-
Neutral
Loss
Urogenital inf.
Neutral
Neutral
Neutral ? bone loss Hypotension Post prandial
Kidney
375
(Farxiga)
1.03
Caution if
or? risk
Maintain
eGFR < 60
adequate
hydration
DKA warning
Empagliflozin (Jardiance)
0.771.03
Neutral
Loss
Urogenital inf. Caution if
Neutral
Neutral
? Benefit
? bone loss
Hypotension Maintain
Post prandial
Kidney
360
eGFR < 45
adequate
hydration
DKA warning
Expected A1c lowering based on monotherapy
Adapted from AACE Comprehensive Diabetes Management Algorithm/Lex-Drug Antidiabetic Agents Comparison Tables
^ Generic available
Pricing based on
Diana G. Mercurio, RPh, CDE, CDOE, CVDOE
January 2017
Antidiabetic Medication Comparison Chart
Generic Name Brand name
Expected %
decrease in A1c*
Hypoglycemia in
Monotherapy
Weight
Renal/GU
GI SX
CHF
CVD
Bone
Other
Effect on
Site of
Cost
Health considerations blood glucose
action
$
Thiazolidinediones (TZDs)
Piolglitazone^ (Actos)
0.5-1.4
Rosiglitazone (Avandia)
0.5-1.4
Neutral Neutral
Gain
Can worsen fluid retention
Neutral
Moderate Monitor
Neutral May
Moderate fracture
Edema Bladder CA
reduce
risk
Up to 3
stroke
months for full
risk
effect
Gain
Can worsen fluid retention
Neutral
Moderate Neutral
Monitor
May
Moderate fracture
Edema Bladder CA
reduce
risk
Up to 3
stroke
months for full
risk
effect
Glimepiride^ (Amaryl)
Sulfonylureas (SU)
1-2
Moderate to Gain >risk of hypo and Neutral Slight risk
?
severe
fluid retention
increase
Neutral
Preferred SU option
Fasting &
Basal
Fasting &
Basal
Fasting &
Basal
Muscles
20
Body fat
Muscles
200
Body fat
Pancreas
10
Glipizide^ (Glucotrol
1-2
Moderate to severe
Gain
>risk of hypo and fluid retention
Neutral
Slight risk increase
?
Glucotrol XL)
Neutral
Preferred SU option
Fasting &
Basal
Pancreas
10
Glyburide^
1-2
Moderate to Gain > risk of hypo and Neutral Slight risk
?
(Diabeta,
severe
fluid retention
increase
Glynase,
Micronase)
Neutral
Avoid use in patients 65+
Fasting &
Basal
Pancreas
10
Expected A1c lowering based on monotherapy ^ Generic available Pricing based on
Adapted from AACE Comprehensive Diabetes Management Algorithm/Lex-Drug Antidiabetic Agents Comparison Tables
Diana G. Mercurio, RPh, CDE, CDOE, CVDOE
January 2017
Antidiabetic Medication Comparison Chart
Generic Name Brand name
Expected %
decrease in A1c*
Hypoglycemia in
Monotherapy
Weight
Renal/GU
GI SX
CHF
CVD
Bone
Other
Effect on
Site of
Cost
Health considerations blood glucose
action
$
Colesvelam (Welchol)
0.5
Albiglutide (Tanzeum)
0.6-1.3
Exenatide (Byetta, Bydureon)
0.5-1
Neutral
Neutral
Neutral
Bile Acid Sequestrant
Mild
Neutral Benefit
Neutral
Decrease LDL-C
Post prandial Intestines
600
Large size
Neutral Neutral
Glucagon-Like Peptide Receptor Agonists (GLP-1 RA)
Loss
No dose adj
Moderate Neutral Neutral Neutral
Pancreatitis Fasting, post Pancreas,
415
Use with Caution
?thyroid cancer
prandial
liver, intestines
Half-life 5 days:
may lose effect
by end of week
Loss Contraindicated Moderate Neutral Neutral Neutral Crcl ................
................
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