| Drug Class Drugs | Dose | Common Adverse Effects | Major Drug Interactions | Counseling |
|
Biguanides Metformin (Fortamet, Glucophage, Glucophage XR, Riomet, Glumetza) |
500-2500 mg PO QDay |
-Cobalamin deficiency –Diarrhea -Flatulence -Indigestion -Malabsorption syndrome -Nausea -Vomiting -Asthenia -Headache -Lactic acidosis (rare) |
-Contraindicated with any drug that can cause or increase the risk of lactic acidosis – CIMETIDINE -FLUOROQUINOLONES – ZONISAMIDE – DOFETILIDE – TOPIRAMATE – DICHLORPHENAMIDE – ACETAZOLAMIDE |
-diarrhea, dyspepsia, flatulence, nausea, vomiting, hyper- or hypoglycemia, or asthenia lactic acidosis – take with meals and XR tablets with the evening meal -adequate hydration – avoid alcohol |
| Sulfonylureas
Glipizide (Glucotrol, Glucotrol XL) Glimepiride (Amaryl) Glyburide (Diabeta, Micronase) Chlorpropamide (Diabinese) |
IR: 5-40 mg PO QDay XR: 5-20 mg QDay or BID
1-8 mg PO QDay
Initial: 2.5-5 mg PO QDay Maintenance: 1.25-20 mg PO QDay Micronized Initial: 1.5-3 mg PO QDay Maintenance: 0.75-12 mg PO QDay or BID
Initial: 250 mg PO QDay maintenance: 100-500 mg PO QDay MAX 750 mg/day |
-Hypoglycemia (less than 3% )
–Constipation, Diarrhea, Flatulence, Nausea Asthenia, -Dizziness, Feeling nervous, Headache, Tremor -SJS Hypoglycemia (adults, 4% to 19.7%) – Nausea – Asthenia, Dizziness, Headache -SJS -Epigastric fullness, Heartburn, Nausea – Hypoglycemia
-Hypoglycemia Diarrhea, Hunger, Loss of appetite, Nausea, Vomiting
|
FLUOROQUINOLONES
DISOPYRAMIDE ACARBOSE – VORICONAZOLE
|
-may cause dizziness -may cause skin rash, diarrhea, nausea and HA -monitor hypo- or hyperglycemia -take tablet 30 mins before meal -avoid alcohol
– glyburide may cause cutaneous hypersensitivity, blurred vision, heartburn, or nausea
|
| DPP-4 Inhibitors
Sitagliptin (Januvia)
Saxagliptin (Onglyza)
Linagliptin (Tradjenta)
Alogliptin (Nesina)
|
100 mg PO QDay
2.5 or 5 mg PO QDay with or without food
5 mg PO QDay
25 mg PO QDay with or without food |
-Hypoglycemia (0.6% – 12.2% )
-Headache Nasopharyngitis ,Upper respiratory infection – pancreatitis
Peripheral edema (1.2% to 8.1% ) Hypoglycemia (4-18.5%), Headache Urinary tract infectious disease Nasopharyngitis , URTI
|
Minimal
Minimal
RIFAMPIN PHENYTOIN PHENOBARBITAL RIFABUTIN CARBAMAZEPINE
None |
-may cause HA, nasopharyngitis, or URTI – monitor for s/s of hypoglycemia -stress may require dosage adjustments – report s/s of pancreatitis (i.e, nausea, vomiting, anorexia, and persistent severe abdominal pain) -if a dose of saxagliptin and linagliptin are missed, skip the missed dose and take the next dose. – Pancreatic cancer -Linagliptin may cause arthralgia and back pain |
Last modified January 2014 by Christian Muenyi
