Sulfonylureas |
Acetohexamide (Dymelor) (not available in United States) | 250 and 500 mg | 0.25–1.5 g as single dose or in two divided doses | 8–24 hours |
Chlorpropamide (Diabinese) | 100 and 250 mg | 0.1–0.5 g as single dose | 24–72 hours |
Gliclazide (not available in United States) | 80 mg | 40–80 mg as single dose; 160–320 mg as divided dose | 12 hours |
Glimepiride (Amaryl) | 1, 2, and 4 mg | Usual dose: 1–4 mg once daily; maximal dose: 8 mg once daily | Up to 24 hours |
Glipizide | | | |
(Glucotrol) | 5 and 10 mg | 2.5–40 mg as a single dose or in two divided doses 30 minutes before meals | 6–12 hours |
(Glucotrol XL) | 2.5, 5, and 10 mg | Usual dose: 2.5–10 mg once daily; maximal dose: 20 mg once daily | Up to 24 hours |
Glyburide | | | |
(Dia Beta, Micronase) | 1.25, 2.5, and 5 mg | 1.25–20 mg as single dose or in two divided doses | Up to 24 hours |
(Glynase) | 1.5, 3, and 6 mg | 1.5–12 mg as single dose or in two divided doses | Up to 24 hours |
Tolazamide (Tolinase) | 100, 250, and 500 mg | 0.1–1 g as single dose or in two divided doses | Up to 24 hours |
Tolbutamide (Orinase) | 250 and 500 mg | 0.5–2 g in two or three divided doses | 6–24 hours |
Meglitinide Analogs |
Mitiglinide (available in Japan) | 5 and 10 mg | 5 or 10 mg three times daily before meals | 2 hours |
Repaglinide (Prandin) | 0.5, 1, and 2 mg | 0.5 to 4 mg three times daily before meals | 3 hours |
d-Phenylalanine Derivative |
Nateglinide (Starlix) | 60 and 120 mg | 60 or 120 mg three times daily before meals | 4 hours |
Biguanides |
Metformin (Glucophage)1 | 500, 850, and 1000 mg | 1–2.5 g; 1 tablet with meals two or three times daily | 4 hours |
Metformin, extended release (Glucophage XR)1 | 500, 750, and 1000 mg | 500–2000 mg once daily | Up to 24 hours |
Thiazolidinediones |
Pioglitazone (Actos) | 15, 30, and 45 mg | 15–45 mg daily | Up to 24 hours |
Rosiglitazone (Avandia) | 2, 4, and 8 mg | 4–8 mg daily (can be divided) | Up to 24 hours |
Alpha-Glucosidase Inhibitors |
Acarbose (Precose) | 25, 50, and 100 mg | 25–100 mg three times daily just before meals | 4 hours |
Miglitol (Glyset) | 25, 50, and 100 mg | 25–100 mg three times daily just before meals | 4 hours |
Voglibose (not available in United States) | 0.2 and 0.3 mg | 0.2–0.3 mg three times daily just before meals | 4 hours |
GLP-1 Receptor Agonists |
Dulaglutide (Trulicity) | 0.75-, 1.5-mg single-dose pen or prefilled syringe | 0.75 mg subcutaneously once weekly. Dose can be increased to 1.5 mg if necessary. | 1 week |
Exenatide (Byetta) | 1.2 mL and 2.4 mL prefilled pens delivering 5 mcg and 10 mcg doses | 5 mcg subcutaneously twice daily within 1 hour of breakfast and dinner. Increase to 10 mcg subcutaneously twice daily after about a month AVOID if eGFR < 30 mL/min/1.73 m2 | 6 hours |
Exenatide, long-acting release (Byetta LAR, Bydureon) | 2 mg (powder) | Suspend in provided diluent and inject subcutaneously. | 1 week |
Liraglutide (Victoza) | Prefilled, multi-dose pen that delivers doses of 0.6 mg, 1.2 mg, or 1.8 mg | 0.6 mg subcutaneously once daily (starting dose). Increase to 1.2 mg after a week if no adverse reactions. Dose can be further increased to 1.8 mg, if necessary. | 24 hours |
Lixisenatide (Adlyxin, Lyxumia) | 3-mL prefilled pens delivering 10- or 20-mcg doses | 10 mcg daily. Increase to 20 mcg daily after 2 weeks. | 24 hours |
Semaglutide (Ozempic, Rybelsus) | Prefilled pens delivering 0.25 mg or 0.5 mg 1-, 3-,7-, and 14-mg tablets | 0.25 mg weekly for 1 month and increase to 0.5 mg weekly if no adverse reactions. Dose can be further increased to 1 mg weekly. Take fasting daily with water and wait 30 min to eat. Start at 3 mg for 1 month and then increase to 7 mg. Dose can be further increased to 14 mg. | 1 week Daily |
DPP-4 Inhibitors |
Alogliptin (Nesina) | 6.25, 12.5, and 25 mg | 25 mg once daily; eGFR 30–59 mL/min/1.73 m2: 12.5 mg daily; eGFR < 30 mL/min/1.73 m2: 6.25 mg daily. | 24 hours |
Linagliptin (Tradjenta) | 5 mg | 5 mg daily | 24 hours |
Saxagliptin (Onglyza) | 2.5 and 5 mg | 2.5 mg or 5 mg once daily. eGFR ≤ 50 mL/min/1.73 m2 or if also taking drugs that are strong CYP3A4/5 inhibitors such as ketoconazole: 2.5 mg daily. | 24 hours |
Sitagliptin (Januvia) | 25, 50, and 100 mg | 100 mg once daily; eGFR 30–50 mL/min/1.73 m2: 50 mg once daily; eGFR < 30 mL/min: 25 mg once daily | 24 hours |
Vildagliptin (Galvus) (not available in United States) | 50 mg | 50 mg once or twice daily. AVOID if eGFR ≤ 60 mL/min/1.73 m2 or AST/ALT three times upper limit of normal | 24 hours |
SGLT2 Inhibitors |
Canagliflozin (Invokana) | 100 and 300 mg | Usual dose: 100 mg daily. 300-mg dose can be used if normal eGFR, resulting in lowering the HbA1c an additional ~ 0.1–0.25%. AVOID if eGFR < 45 mL/min/1.73 m2. | 24 hours |
Dapagliflozin (Farxiga) | 5 and 10 mg | 10 mg daily. | 24 hours |
Empagliflozin (Jardiance) | 10 and 25 mg | 10 mg daily. 25-mg dose can be used if necessary. | 24 hours |
Ertugliflozin (Steglatro) | 5 and 15 mg | 5 mg daily. 15 mg dose can be used if necessary | 24 hours |
Others |
Bromocriptine (Cycloset) | 0.8 mg | 0.8 mg daily. Increase weekly by 1 tablet until maximal tolerated dose of 1.6–4.8 mg daily. | 24 hours |
Colesevelam (Welchol) | 625 mg | 3 tablets twice daily | 24 hours |
Pramlintide (Symlin) | 5-mL vial containing 0.6 mg/mL; also available as prefilled pens. Symlin pen 60 or Symlin pen 120 | For insulin-treated type 2 patients, start at 60-mcg dose subcutaneously three times daily (10 units on U100 insulin syringe). Increase to 120 mcg three times daily (20 units on U100 insulin syringe) if no nausea for 3–7 days. Give immediately before meal. For type 1 patients, start at 15 mcg three times daily (2.5 units on U100 insulin syringe) and increase by increments of 15 mcg to a maximum of 60 mcg three times daily, as tolerated. To avoid hypoglycemia, lower insulin dose by 50% on initiation of therapy. | 2 hours |