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Oral Medications
| Medication Name (brand names in brackets) | How it works in the body to lower blood glucose |
| Biguanides
Metformin (Glucophage®, and multiple generics)
Meformin extended release (Glumetza®) |
Decreases the amount of glucose released from liver
Makes insulin more efficient
Initial drug of choice for most patients with type 2 diabetes |
| Insulin Secretagogues
1. Sulfonylureas** Gliclazide (Diamicron®, and multiple generics)
Glimepiride (Amaryl®)
Glyburide (Diabeta®, and multiple generics) |
Stimulates pancreas to release more insulin |
| 2. Meglitinides**
Repaglinide (Gluconorm®)
|
Stimulates pancreas to produce more insulin after a meal
Faster and shorter acting than sulfonylureas (so it only covers meal time and less chance of low blood sugar) |
| Thiazolidinediones
Pioglitazone (Actos®)
Rosiglitazone (Avandia®) |
Makes body’s insulin more efficient and decreases amount of glucose released from liver
|
| Alpha-glucosidase inhibitor
Acarbose (Glucobay®) |
Slows absorption of glucose into the bloodstream after eating |
| DPP-4 inhibitor
Sitagliptin (Januvia®)
Saxagliptin (Onglyza®)
Linagliptin (Tradjenta®)
Alogliptin (Nesina®) |
Increases the production and release of insulin from the pancreas after a meal
Decreases amount of glucose made by your body
|
| SGLT2 Inhibitors
Canagliflozin (Invokana®) Dapagliflozin (Forxiga®) Empagliflozin (Jardiance®) Ertugliflozin (Steglatro®) |
Blocks reabsorption of glucose in the kidney, increases excretion of glucose and lowers glucose levels. |
Injectable Medications
Non-insulin injectable medications
| Medication Name (brand name in bracket) | How it works in the body to lower blood glucose |
| GLP-1 agonist
Liraglutide (Victoza®)
Exenatide (Byetta®, Bydureon® - extended release) Dulaglutide (Trulicity®) Lixisenatide (Adlyxine®)
|
Increases the production and release of insulin from the pancreas after a meal
Decreases the amount of glucose released by the liver
Slows down how quickly stomach empties food into the intestine, so it makes the feeling of fullness last longer |
Insulins
| Type and Appearance | Names |
| Bolus insulin (targets after meal blood glucose levels) | |
| Rapid acting insulin
Clear |
Insulin aspart (Novorapid®)
Insulin lispro (Humalog) Insulin glulisine (Apidra®) |
| Regular (short) acting insulin
Clear |
Humulin–R®
Novolin ge Toronto® |
| Basal insulin (targets fasting blood glucose levels) | |
| Intermediate acting
Cloudy |
Humulin N®
Novolin ge NPH® |
| Long acting insulin
Clear |
Insulin detemir (Levemir®)
Insulin glargine (Lantus®, Basaglar®; Concentrated: Toujeo® – 300u/mL) |
| Premixed | |
| Premixed rapid acting and intermediate acting
Cloudy |
Humalog Mix 25®
Humalog Mix 50® Novomix 30® |
| Premixed regular insulin and intermediate acting
Cloudy |
*Humulin 30/70®
*Novolin ge 30/70®, 40/60®, 50/50® |
*In the United States, Europe, and Asia the numbers are reversed
** These medications when taken in excess in relation to food taken and/or exercise done can cause blood glucose to go low. For more information on low blood glucose, visit Dr. Maureen Clement’s blog “Walking the tightrope…the ups and downs of low blood sugars “.
For more information on medications to manage diabetes visit the pharmacist expert blog on oral agents and insulin.
