Pharmacologic Agents for Treatment of Type 2 Diabetes

Transcription

1 Pharmacologic Agents for Treatment of Type 2 Diabetes SCAN Drugs Medication Biguanides 1 1 er uncoated tabs 500 mg & 750 mg Sulfonylureas mg QD - TID mg glimepiride mg glipizide mg glipizide er mg glipizide / 1 1 glyburide** glyburide** / 2.5 / 500 mg BID mg 1.25 / 250 mg QD BID Nausea/ vomiting, GI upset, metallic taste, diarrhea, flatulence, lactic acidosis (rare) Nausea/ vomiting, GI upset, diarrhea, flatulence, lactic acidosis Dizziness, headache, hypoglycemia, nausea, weight gain Rash, diarrhea, dizziness, headache, diarrhea, hypoglycemia, nausea, weight gain Asthenia, headache, dizziness, rash, nausea, hypoglycemia, weight gain Rash, diarrhea, dizziness, headache, nausea, flatulence, hypoglycemia, lactic acidosis Rash, heartburn, hypoglycemia, nausea, hypoglycemia, weight gain Rash, heartburn, hypoglycemia, nausea, vomiting, lactic acidosis, flatulence

2 Medication Thiazolidinediones & Thiazolidinedione Combination Agents mg pioglitazone / 500 mg pioglitazone / / 1500mg pioglitazone / glimepiride 2 [QL] 2 [QL] Alpha-Glucosidase Inhibitor acarbose 2 2 Meglitinides 15 / 500 mg 45 / 2550 mg mg TID Administered at the start of each meal to decrease postprandial glucose peaks nateglinide mg TID before meals repaglinide mg TID before meals DPPIs (Dipeptidyl Peptidase-4 Inhibitors) JANUVIA (sitagliptin) mg JANUMET, JANUMET XR (sitagliptin / / 2000 mg Anemia, edema, weight gain, headache, myalgia, bone fracture, heart failure Rash, diarrhea, dizziness, headache, nausea, flatulence, hypoglycemia, lactic acidosis Anemia, edema, weight gain, headache, myalgia, dizziness, hypoglycemia, nausea Abdominal pain, diarrhea, flatulence, elevated serum transaminases Dizziness, arthralgia, diarrhea, hypoglycemia, weight gain, increased uric acid Hypoglycemia, arthralgia, diarrhea, weight gain Abdominal pain, diarrhea, headache, nasopharyngitis, nausea, URI, Abdominal pain, diarrhea, headache, nasopharyngitis, nausea, flatulence, lactic acidosis,

3 Medication KOMBIGLYZE Individualize XR 3 3 dose; 5 / 2000 (saxagliptin / mg max ONGLYZA (saxagliptin) mg TRADJENTA (linagliptin) 5 mg Insulins Vial Pen Vial Pen HUMALOG HUMALOG MIX 50/50, 75/25 HUMULIN 70/30 HUMULIN N HUMULIN R HUMULIN R U-500 LANTUS (insulin glargine) LEVEMIR (insulin detemir) Patient specific dosing applies Nausea/ vomiting, GI upset, asthenia, diarrhea, flatulence, lactic acidosis, Abdominal pain, diarrhea, URI,, nausea, hypoglycemia Nasopharyngitis, diarrhea, cough, back pain, arthralgia, URI, headache Hypoglycemia, injection site reaction, lipodystrophy, hypokalemia NOVOLIN & NOVOLOG TOUJEO - 3-3

4 Medication GLP-1 Agonist (Glucagon-Like-Peptide-1) BYDUREON 2 mg SC (exenatide er) weekly BYETTA 5 10 mcg SC (exenatide) BID OZEMPIC mg (semaglutide) weekly VICTOZA 0.6 mg 1.8mg (liraglutide) SC Amylinomimetic 60 mcg 120 SYMLIN PEN 3 [PA] 5 [PA] mcg SC prior to (pramlintide) main meals SGLT2 Inhibitor (Sodium-Glucose Cotransporter 2) FARXIGA 5 10 mg (dapagliflozin) XIGDUO XR (dapagliflozin/ INVOKANA (canagliflozin) INVOKAMET (canagliflozin/ INVOKAMET XR (canagliflozin/ 3 [ST] 3 [ST] 5 / / 2000 mg mg 50 / / 1000 mg BID 100 / / 2000 mg Nausea, anorexia, dizziness, fatigue Genital mycotic infections, nasopharyngitis, UTI, back pain, increased urination, nausea Low vitamin-b12, diarrhea, headache, UTI, genital mycotic infection, nasopharyngitis Genital mycotic infections, UTI, thirst, increased urination, nausea Abdominal discomfort, constipation, diarrhea, flatulence, increased thirst, indigestion, N/V, asthenia, headache, UTI, polyuria pruritis Abdominal discomfort, constipation, diarrhea, flatulence, increased thirst, indigestion, N/V, asthenia, headache, UTI, polyuria pruritis Brand-name drugs are capitalized and generic drugs are listed in the lower-case italics. = Non-formulary [PA] = Prior Authorization [QL] = Quantity Limit [ST] = Step Therapy * 2009 AACE/ACE Consensus Statement ** High Risk Medication

5 Diabetes Guidelines References SCAN Health Plan Diabetes Guidelines adapted from: American Diabetes Association; Standards of Medical Care in Diabetes-: Diabetes Care January vol. 41 no. Supplement 1 S1-S159 C_41_S1_Combined.pdf Consensus Statement by the American Association of Clinical Endocrinologists and American College of Endocrinology on the Comprehensive Type 2 Diabetes Management Algorithm 2017 Executive Summary. Endocrine Practice. (2017, Feb). 23(2) Drug Facts & Comparisons. (, Sept). Retrieved from W olters Kluwer Health: Deventer, TheNetherlands. Epocrates Online (, Sept). Retrieved from: Epocrates, Inc.: San Mateo, California. Reuben, D. B., Herr, K. A., Pacala, J. T., Pollock, B. G., Potter, J. F., & Semla, T. P. (2015). Geriatrics at your fingertips. 17th ed. (Based on AGS Guidelines.) Online Lexicomp (09/): 1100 Terex Road, Hudson, OH 44236