586
P A R T 6
Drugs acting on the endocrine system
TABLE 38.3
DRUGS IN FOCUS Other oral hypoglycaemic agents
Drug name
Dosage/route
Usual indications
Sulfonylureas
glibenclamide (Daonil,
Glimel)
2.5 mg PO increased by 2.5 mg/week to
maximum of 20 mg/day
Adjunct to diet for the management of
type 2 diabetes; adjunct to insulin for
management in certain type 2 diabetics,
reducing the insulin dose and decreasing
the risk of hypoglycaemia
gliclazide (Diamicron,
Glyade)
40–160 mg PO daily adjusted according to
responses
Adjunct to diet for the management of
type 2 diabetes
glimepiride (Amaryl)
1–4 mg/day PO; lower doses with geriatric
people
Adjunct to diet for the management of
type 2 diabetes; adjunct to insulin for
management in certain type 2 diabetics,
reducing the insulin dose and decreasing
the risk of hypoglycaemia
glipizide (Melizide,
Minidiab)
5 mg PO daily, titrate based on response; do
not exceed 15 mg/day; use lower doses
with geriatric and hepatic-impaired people;
extended release: 5 mg/day, adjust to a
maximum of 20 mg/day
Adjunct to diet for the management of
type 2 diabetes; adjunct to insulin for
management in certain type 2 diabetics,
reducing the insulin dose and decreasing
the risk of hypoglycaemia
Other oral hypoglycaemic agents
Alpha-glucosidase inhibitors
acarbose (Glucobay)
100 mg PO t.d.s. at the start of each meal
Adjunct to diet to lower blood glucose in
type 2 diabetics; in combination with
sulfonylureas to control blood sugar
in people whose diabetes cannot be
controlled with either drug alone
Biguanide
metformin (Diaformin,
Glucophage)
500–850 mg/day PO in divided doses; reduce
dose in geriatric and renal-impaired people;
maximum dose: 2550 mg/day
Children 10–16 years: 500 mg/day PO with a
maximum dose of 2000 mg/day; do not use
extended release form
Adjunct to diet to lower blood glucose in
type 2 diabetes
Dipeptidyl peptidase-4 (DPP-4) inhibitors
alogliptin (Nesina)
25 mg/day PO
Adjunct to diet and exercise to improve
glucose control in people with type 2
diabetes
linagliptin (Trajenta)
5 mg/day PO
Adjunct to diet and exercise to improve
glucose control in people with type 2
diabetes as monotherapy or combined
with metformin, pioglitazone or other
agents
saxagliptin (Onglyza)
5 mg/day PO
Adjunct to metformin, a thiazolidinedione
or sulfonylurea
sitagliptin (Januvia)
100 mg/day PO
Adjunct to diet and exercise to improve
glucose control in people with type 2
diabetes, as monotherapy or combined
with metformin, pioglitazone or other
agents
vildagliptin (Galvumet,
Galvus)
individualised up to 100 mg/day
Adjunct to diet and exercise to improve
glucose control in individuals with type 2
diabetes, as monotherapy or combined
Glucagon-like peptide 1
liraglutide (Victoza)
0.6–1.8 mg/day by SC injection
Adjunct to diet and exercise to improve
glucose control in people with type 2
diabetes, as monotherapy or combined
with other agents
