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Oral Diabetes Medications Summary Chart

What Oral Medications Are Available for Type 2 Diabetes?
Type 2 diabetes results when the body is unable to produce the amount of insulin it needs to convert food into energy or when it is unable to use insulin appropriately. Sometimes the body is actually producing more insulin than is needed by a person to keep blood glucose in a normal range. Yet blood glucose remains high, because the body's cells are resistant to the effects of insulin. Physicians and scientists believe that type 2 diabetes is caused by many factors, including insufficient insulin and insulin resistance. They increasingly believe that the relative contribution each factor makes toward causing diabetes varies from person to person.

It is important to know the name of your diabetes medicine (or medicines), how it is taken, the reasons for taking it and possible side-effects.

 Diabetes Pills

 How to Take

 How They Work

 Side Effects

 Of Note

 Biguanides
Metformin (Glucophage)
Metformin liquid ( Riomet)

Metformin extended release  (Glucophage XR, Fortamet, Glumetza)

 Metformin: usually taken twice a day with breakfast and evening meal.

Metformin extended release: usually taken once a day in the morning.

 Decreases amount of glucose released from liver.

Bloating, gas, diarrhea, upset stomach, loss of appetite (usually within the first few weeks of starting). Take with food to minimize symptoms. Metformin is not likely to cause low blood glucose. In rare cases, lactic acidosis may occur in people with abnormal kidney or liver function.

 Always tell healthcare providers that it may need to be stopped when you are having a dye study or surgical procedure.
 Sulfonylureas

Glimepiride (Amaryl)

Glyburide  (Diabeta, Micronase)

Glipizide (Glucotrol, Glucotrol XL)

Micronized glyburide (Glynase)
 Take with a meal once or twice a day. Stimulates the pancreas to release more insulin, both right after a meal and then over several hours Low blood glucose, occasional skin rash, irritability, upset stomach

 Because these medicines can cause low blood glucose, always carry a source of carbohydrate with you.

Follow your meal plan and activity program. Call your healthcare provider if your blood glucose levels are consistently low. If there is an increase in your activity level or reduction in your weight or calorie intake, the dose may need to be lowered.

Meglitinides
Repaglinide (Prandin)

D-Phenylalanine Derivatives

Nateglinide (Starlix)

 Both of these medications should be taken with meals. If you skip a meal, skip the dose.  Stimulate the pancreas to release more insulin right after a meal.  Effects diminish quickly and they must be taken with each meal; may cause low blood glucose.

 These work quickly when taken with meals to reduce high blood glucose levels.

However, they are less likely than sulfonylureas to cause low blood glucose.

 Thiazolidinediones
Pioglitazone (TZDs)

Pioglitazone
(Actos)

 Usually taken once a day; take at the same time each day.  Makes the body more sensitive to the effects of insulin.

 May cause side effects such as swelling (edema) or fluid retention.

Do not cause low blood sugar when used alone.

Increased risk of congestive heart failure in those at risk.

Increases the amount of glucose taken up by muscle cells and keeps the liver from overproducing glucose; may improve blood fat levels.

Talk with your healthcare provider if you have the following symptoms: nausea, vomiting, fatigue, loss of appetite, shortness of breath, severe edema or dark urine.

 DPP-4 Inhibitors

Sitagliptin (Januvia)

Saxagliptin (Onglyza)

Linagliptin ( Tradjenta)

 Take once a day at the same time each day.  Improves insulin level after a meal and lowers the amount of glucose made by your body.

 Stomach discomfort, diarrhea, sore throat, stuffy nose, upper respiratory infection.

Do not cause low blood glucose.

 Can be taken alone or with metformin, a sulfonylurea or Actos.

Tell your healthcare provider if you have any side effects that bother you or that don’t go away.

 Alpha-glucosidase
Inhibitors

Acarbose
(Precose)

Miglitol
(Glyset)

 Take with first bite of the meal; if not eating, do not take.  Slows the absorption of carbohydrate into your bloodstream after eating.  Gas, diarrhea, upset stomach, abdominal pain  Take with meals, to limit the rise of blood glucose that can occur after meals; these do not cause low blood glucose.
 
Side effects should go away after a few weeks. If not, call your healthcare provider.
 Bile Acid Sequestrants

Colesevelam (Welchol)
 Take once or twice a day with a meal and liquid.  Works with other diabetes medications to lower blood glucose.  Constipation, nausea, diarrhea, gas, heartburn, headache (may interact with glyburide, levothyroxine and
contraceptives)

 Primary effect, when used either alone or with a statin, is to lower LDL cholesterol; has blood glucose-lowering effect when taken in combination with certain diabetes medications.

Before taking this medication, tell your healthcare provider if you have high triglycerides (blood fats) or stomach problems. If you take thyroid medication or glyburide, take them 4 hours before taking Welchol. Tell your healthcare provider if you have side effects that bother you or that don’t go away.

 Combination Pills

Pioglitazone & metformin) (Actoplus Met)

 Glyburide & metformin (Glucovance)

Glipizide & metformin (Metaglip)

Sitagliptin & metformin (Janumet)

Saxagliptin & metformin (kombiglyze )

Repaglinide & metformin (Prandimet)

Pioglitazone & glimepiride (Duetact)

 Check with your provider; usually taken once a day.  Combines the actions of each pill used in the combination.  Side effects are the same as those of each pill used in the combination.

Some combination pills may lead to low blood glucose levels if one of the medications contained in the combination has this effect.

 May decrease the number of pills you need to take.

 

Other drugs are on the horizon as well, as scientists work to improve the variety of medications to treat type 2 diabetes. Frequently physicians will prescribe one type of oral medication and discover it isn't really helping to control blood glucose that much. In the past, this would have meant that the patient would likely be put on insulin. Now, physicians can try another type of medication to see if it helps correct problems. Physicians often notice that a particular medication works well for a period of time and then begins to work less well for a patient. Now they can mix and match medications that work on different aspects of the diabetes problem to see if that will improve blood glucose control.

Page last updated: July 22, 2014