|
| Drug class | Dose (mg/day) | Advantage | Combination | Side effect | Contraindication |
|
| Sulfonylurea | | Rapid FPG reduction
Early stage disease | Biguanide/TZD AGI/DPP-4/insulin | Weight gain, +hypoglycemia | Allergy, DKA Pregnancy, lactation |
| Glibenclamide | 5–20 | Low cost | | | In elderly, liver/renal |
| Glipizide | 10–40 | | | | |
| Gliclazide | 80–320 | | | | |
| Glimepiride | 1–8 | QD | | | |
|
| Meglitinides | | Fast, flexible dosing | Biguanide/TZD/insulin | Weight gain/hypoglycemia | Allergy, DKA Pregnancy, lactation |
| Repaglinide | 1.5–12 | mild weight gain and hypoglycaemia | Biguanide/TZD/insulin | | |
| Nateglinides | 60–180 | mild weight gain and hypoglycaemia | Biguanide/TZD/insulin | | |
|
| Biguanide Metformin | 1500–2500 | No weight gain, CHD benefit
−hypoglycemia, FBS | SU/TZD/DPP-4
AGI/insulin | GI upset, vitamin B12 deficiency | LA/renal/hepatic disease; CHF |
|
| Pioglitazone (TZD) | 15–45 | Insulin sparing. Low hypoglycemia CHD benefit | Biguanide/SU/insulin/DPP-4 | Edema/weight gain; High cost, Slow onset of action | Heart failure; DKA; liver disease Ca bladder, fracture |
|
| α Glucosidase inhibitor (AGI) (Acarbose and Miglitol) | 150–300 | no hypoglycemic
FBS/PPG | Biguanide/su/TZD/DPP-4/insulin | High cost
GI side effects | GI Cirrhosis; DKA; IBD, CKD |
|
| DPP-4 | | Weight, −hypo, +β cell | Biguanide/SU/TZD/insulin | URI | Pancreatitis dose adjust in CKD |
| Sitagliptin | 25–100 | QD | | URI | |
| Vildagliptin | 50–100 | BD | | URI | Liver disease |
| Saxagliptin | 5 | QD | | URI | |
| Linagliptin | 5 | QD, no dose adjust CKD | | URI, stuffy nose | |
|
| SGLT-2: Dapagliflozin | | Early and late stage of disease efficacy independent of beta cell and IR |
All OADs | Urinary tract infection | |
|
