drug tables supplement

8/2/2019 Drug Tables Supplement

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WORKING TOGETHER

TO MANAGE DIABETES

DIABETES

MEDICATIONS

SUPPLEMENT

This medication supplement guide is to provide health care professional withat-a-glance information on medications commonly used for people with diabetes.

For complete prescribing information, please consult the medicationspackage insert or the Physicians Desk Reference.


2/10WORKING TOGETHER TO MANAGE DIABETES

Reviewers:Pamela Allweiss, MD, MPH, Consultant, Centers for Disease Control and Prevention, Division ofDiabetes Translation, Faculty: University of Kentucky

James Cleeman, MD, National Heart, Lung and Blood Institute, National Institutes of Health(review of sections B and C only)

Jeffrey Cutler, MD, National Heart, Lung and Blood Institute, National Institutes of Health(review of sections B and C only)

Saul Malozowski, MD, National Institute of Diabetes, Digestive and Kidney Diseases,National Institutes of Health

Amy Nicholas, Pharm D, CDE, University of Kentucky

Milissa Rock, RPh, CDE, CDM, The Diabetes Center, Old Saybrook, CT

Julio Rosenstock, MD, Dallas Diabetes and Endocrine Center, Dallas, TX(review of Table 5 Incretins and Amylins only)

Robert Vigersky, MD, Director, Diabetes Institute, Walter Reed Health Care System,Professor: Uniformed Service University of Health Science

Donald Zettervall, RPH, CDE, CDM, The Diabetes Center, Old Saybrook, CT

Credits and AcknowledgementsThe NDEP thanks the following members of the NDEP Pharmacy, Podiatry, Optometry and Dental (PPOD) professionalswork group for their contributions to the NDEP publication Working Together to Manage Diabetes, English and SpanishPPOD patient education posters and this Medications Supplement:

Barbara Aung, D.P.M.W. Lee Ball, Jr. O.D.Norma Bowyer, O.D., M.P.H., F.A.O.O.Joseph M. Caporusso, DPM

Caswell Evans, D.D.S., M.P.H.Deborah Faucette, R.Ph.JoAnn Gurenlian, RDH, PhDStuart T. Haines, Pharm.D., FCCP, FASHP, BCPSLawrence Harkless, D.P.M.

Mimi Hartman, MA, RD, CDECynthia Heard, ODCynthia Hodge, D.M.D.Tom Murray, Pharm.D.

Milissa A. Rock, RPh, CDERoss Taubman, D.P.M.George W. Taylor, III, DMD, DrPHJaime R. Torres, DPM, MS

In addition, the following NDEP staff at CDC and NIH contributed to the review and revision of these materials:

Sabrina HarperMS,NDEP CDC Assistant Director

Joanne Gallivan, MS, RD

NDEP NIH Program Director

Jane Kelly, MDNDEP CDC Program Director

Betsy Rodrguez, MSN, CDENDEP CDC

Rachel Weinstein, MEdNDEP NIH Deputy Director



Table 1. Oral Agents to Treat Type 2 Diabetes

Agent Class Primary Action Typical Dosage

Tolbutamide (Ornase)Tolazamide (Tolinase)

Chlorpropamide (Diabenese)

Sulonylureas(1st generation)

Increases insulin production inthe pancreas.

Tolbutamide: 0.252.0 g/day in divided doses; maximum, 3 g/dayTolazamide: 1001,000 mg/day in divided doses; maximum, 1 g/day

Chlorpropamide: 100500 mg/day twice a day; maximum, 750 mg/d

Glyburide (Micronase, Diabeta,Glynase)Glipizide (Glucotrol, Glucotrol XL)Glimepiride (Amaryl)

Sulonylureas(2nd generation)

Increases insulin production inthe pancreas.

Glyburide: 1.255 mg/once or twice a day; maximum, 20 mg/dayGlynase: 0.7512.0 mg/day; maximum 12 mg/dayGlipizide: 2.520.0 mg/once or twice a day; maximum, 40 mg/day;or XL* 2.510.0 mg/once or twice a day; maximum, 20 mg/dayGlimepiride: 18 mg/day; maximum, 8 mg/day

Repaglinide (Prandin) Meglitinide Increases insulin release rom pancreas. New diagnosis or A1C 8%, 12 mg, 1530 min beore each meal;increase weekly until results are obtained;maximum, 16 mg/day

Nateglinide (Starlix) Phenylalanine derivative Increases insulin release rom pancreas. 60120 mg beore each meal

Metormin (Fortamet,Glumetza, Glucophage) Biguanide Primarily decreases hepatic glucose production.Minor increase in muscle glucose uptake whichmay improve insulin resistance.

500 mg/day twice a day with meals, increase by 500 mg every 13 wktwice or three times a day; usually most eective at 2,000 mg/day;maximum, 2,550 mg/day

Long acting orm Glucophage XR: 500mg once/day, max dose 2000

Rosiglitazone (Avandia) Thiazolidinedione Decreases insulin resistance, increasing glucoseuptake, at redistribution; minor decrease inhepatic glucose output; preserves -cell unction;decreases vascular infammation.

Initially 4 mg/day in single or divided doses.Increase to 8 mg/day in 12 wk, i needed;maximum, 8 mg/day with or without ood

Pioglitazone (Actos) Thiazolidinedione Decreases insulin resistance, increasing glucoseuptake, at redistribution; minor decrease inhepatic glucose output; preserves -cell unction;decreases vascular infammation.

Initially 15 or 30 mg/day;maximum with or without ood 45 mg or monotherapy,30 mg or combination therapy

Acarbose (Precose)Miglitol (Glyset)

Combinations

Alpha-glucosidaseinhibitor

Slows absorption o complex carbohydraterom GI tract.

25 mg/day; increase by 25 mg/day every 46 wk;maximum, split dose beore meals (with rst bite o ood)

300 mg/day(150 mg/day or weight



Side Effects Precautions Critical Tests Comments

Hypoglycemia, weight gain,hyperinsulinemia

Disulram reaction with alcohol

Chlorpropamide remains active or up to60 hours. Use extreme caution with elderly

patients or patients with hepatic or renaldysunction.

All are metabolized in liver. Periodic evaluationo liver unction is suggested.

Use o these agents is not recommended unless the patient has a well-established history o taking them. Second-generation sulonylureas

provide more predictable results with ewer side eects and moreconvenient dosing.


Clearance may be diminished in patientswith hepatic or renal impairment.

Glipizide is preerred with renal impairment.Doses >15 mg should be divided.Glimepiride indicated or use with insulin.Shown to have some insulin-sensitizing eect.


Use with caution on patient with hepaticor renal impairment.

Patients should be instructed to take medication no more than30 minutes prior to a meal. I meals are skipped or added, themedication should be skipped or added as well. Approved or use asmonotherapy or in combinatin with TZD or metormin.

Minimal risk o hypoglycemia Currently no contraindications available.Use with caution with moderate to severehepatic disease.

Periodic evaluation o liver unction tests. Approved as monotherapy or in combination with metormin orTZD. Has only a 2-hour duration o action. I meals are skippedor added, the medication should be skipped or added as well.

Nausea, diarrhea, metallic taste,possible lactic acidosis Due to increased risk o lactic acidosis,should not use i suspect requent alcoholuse, liver or kidney disease, or CHF.

Contraindicated i serum creatinine is:>1.5 mg/dL in men or >1.4 mg/dL women.Do not use i creatinine clearance is abnormal.Monitor hematological and renal unction annually.

Especially benecial in obese patients due to potential or weightloss, improved lipid prole, and lack o potential or hypoglycemiarequiring supplemental carbohydrate intake. Discontinue or 48 hrater contrast dye procedures.

Minor weight increase o 36 lbs.,edema

Should not be used in patients withCHF or hepatic disease. Can causemild-to-moderate edema.

Avoid initiation i ALT >2.5X upper limit onormal. Measure ALT periodically. Discontinuei ALT >3X upper limit o normal.

Approved or use as monotherapy and in combination withmetormin, sulonylureas, or insulin.Less interactions associated with CYP-450.

Minor weight increase o 36 lbs.,edema

Should not be used in patients withCHF or hepatic disease. Can causemild-to-moderate edema.

Avoid initiation i ALT >2.5X upper limit onormal. Measure ALT periodically. Discontinuei ALT >3X upper limit o normal.

Avoid initiation i ALT >2.5X upper limit o normal. Measure ALTperiodically. Discontinue i ALT >3X upper limit o normal.

Gas and bloating, sometimesdiarrhea or both drugs

Should not be used i GI disordersare concurrent.

Avoid i serum creatinine is >2.0 mg/dL.Monitor serum transaminase every 3 months

or 1st year o therapy.

Approved or use as monotherapy and in combinationwith metormin, sulonylureas, or insulin. I used with

hypoglycemic agents, such as sulonylureas or insulin,must treat hypoglycemia with glucose not sucrose.

Hypoglycemia, weight gain,lactic acidosis

Should not be used i suspect requentalcohol use, liver or kidney disease,or CHF.

Same caveats as individual components. Patients may requently use 2 di erent dose tablets toattain desired daily dosage and results. Discontinue or48 hr ater procedure using contrast dye.

Hypoglycemia, weight gain,lactic acidosis

Should not be used i suspect requentalcohol use, liver or kidney disease,or CHF.

Same caveats as individual components. Patients may requently use 2 di erent dose tablets toattain desired daily dosage and results. Discontinue or48 hr ater procedure using contrast dye.

Edema, possible lactic acidosis Should not be used i suspect requent

alcohol use, liver or kidney disease,or CHF.

Same caveats as individual components. Less expensive than using agents separately. Reported

decrease in GI upset associated with metormin andweight increase associated with rosiglitazone. Discontinueor 48 hr ater procedure using contrast dye.

Same caveats as individualcomponents.

Same caveats as individual componen ts . Same caveats as ind iv idual components. Same caveats as ind iv idual components.

Same caveats as individualcomponents.

Same caveats as individual componen ts . Same caveats as ind iv idual components. Same caveats as ind iv idual components.

* Agents in a class of medicines share mechanisms of action, require similar precautions, and generally have similar side effects.For proper usage, please read label. Agents should not be used in patients with type 1 diabetes.



Diabetes MedicationsTable 2. Glucose-Lowering ActivityOral Diabetes Agent

Medication Blood Glucose Most Aected Greatest Risk or Hypoglycemia

Sulonylureas Fasting and postprandial Nocturnal, asting, 46 hr ater meals

Meglitinide or phenylalanine derivative Postprandial 23 hr ater meals

Biguanide Fasting and postprandial Ater exercise i prolonged and strenuous

Alpha-glucosidase inhibitor Postprandial None

Thiazolidinedione Fasting and postprandial None

Glucovance Fasting and postprandial Nocturnal, asting, 46 hr ater meals

Metaglip Fasting Nocturnal, asting 46 hr ater meals

Avandamet Fasting and postprandial Ater exercise i prolonged and strenuous

Actoplus Met Fasting and postprandial Ater exercise i prolonged and strenuous

Avandryl Fasting and postprandial Nocturnal, asting, 46 hr ater meals

Adapted rom 2006 The Diabetes Center, Old Saybrook, CT. Used with permission.Testing requency and times may vary based on individual assessment.

Table 3. Important Insulin Information*

Insulin Onset Peak Eective Duration Maximal Duration Comments

Human insulins

Rapid Acting

Lispro (Humalog) < 15 min 12 hr 24 hr 35 hr Should be taken just prior to or just ater eating.

Aspart (Novalog) < 15 min 13 hr 35 hr 46 hr Should be taken just prior to or just ater eating.

Glulisine (Apidra) < 15 min 0.51 hr 3 hr 3 hr Should be taken just prior to or just ater eating.

Short Acting

Regular (Novolin R,Humulin R)

0.51 hr 24 hr 35 hr 8 hr Best i taken 30 min beore a meal.

Intermediate Acting

Lente (Novolin,Humulin L)

34 hr 412 hr 1218 hr 1620 hr Limited supplies.

NPH (Novolin N,Humulin N)

24 hr 410 hr 1016 hr 1418 hr Bedtime dosing minimizes nocturnal hypoglycemia.

Long Acting Characterized by a fat or peakless concentration prole.

Insulin glargine(Lantus) analog

46 hr None 24 hr 24 hr Cannot be mixed with any other insulin. Stress site rotation and not to usesame syringe used with other insulins. Not recommended or pre-llingsyringes.

Detemir (Levemir) 34 hr 50% in 34 hr,lasting up to 14 hr

5.723.2 hr Dose dependent-5.723.2 hr

Cannot be mixed in same syringe with other insulins.Duration o action is dose dependent: 6 hrs (0.1U/kg), 12hrs (0.2U/kg),20 hrs (0.4U/kg), 23 hrs (0.8U/kg and 1.6U/kg).

Ultralente 610 hr Minimal 1820 hr 2030 hr Limited supplies.

Pre-mixed Human

Humalog 75/25Novolog Mix 70/30



Table 4. Recommended Insulin Storage

Insulin Type Rerigerated (36 F46 F) Room Temperature (59 F 86 F)

Vial Opened Unopened Opened Unopened

Humalog, Novolog, Humulin, Novolin, Apidra 28 days Until expiration date 28 days 28 days

Lantus (10 mL) 28 days Until expiration date 28 days 28 days

Detemir (Levemir) 42 days Until expiration date 42 days 42 days

Pens/Cartridges Not in use In use

Humalog Until expiration date 28 days

Humulin R( available in cartridge only) Until expiration date 28 days

Humulin N Until expiration date 14 days

Humulin 70/30 Until expiration date 10 daysHumalog Mix 75/25 Until expiration date 10 days

Novolog Until expiration date 28 days

Novolog Mix 70/30 Until expiration date 14 days

Novolin R (prelled and 1.5-mL cartridge) Until expiration date 30 days

Novolin R (3-mL cartridge) Until expiration date 28 days

Novolin N (prelled and 1.5-mL cartridge) Until expiration date 7 days

Novolin N (3-mL cartridge) Until expiration date 14 days

Novolin 70/30 (prelled and 1.5-mL cartridge) Until expiration date 7 days

Novolin 70/30 (3-mL cartridge) Until expiration date 10 days

Detemir (Levemir) Until expiration date 42 days

Apidra Until expiration date 28 days

Lantus Until expiration date 28 days

Sel-lled syringes (Note: not recommended or glargine) 14 days* 7 days

Inhaled Insulin Not in use (unopened overwrap) In use (unopened overwrap)

Exubera (insulin blisters) Room Temperature (59 F 86 F) Until expiration date Room Temperature (59 F 86 F) 90daysRelease Unit Do not rerigerate Replace every 14 days

Inhaler & Chamber ReplaceYearly (Wash Weekly)

Adapted rom 2006 The Diabetes Center, Old Saybrook, CT. Used with permission. *Suggested, not clinically established

Table 5. Incretins and Amylins

Agent Primary ActionHowSupplied/Storage

Typical DosageDurationAction

Side Eects Precautions Comments

Exenatide(Byetta)

Decreases post-meal glucagonproduction Delays gastricemptyingIncreases satiety, leading todecreased caloric intake.Degree o response depends onplasma glucose levels

250 mcg/ml:- 5 mcg/dose prelled pen-10 mcg/dose prelled pen

I not in use: rerigerateuntil expiration date.

I in use: stable at roomtemperature

Discard ater 30 days.

5 mcg BID subcutaneous orrst 1 month, then 10 mcgBID, injected within 60minutes beore morningand evening meal

Peak eectsin approx 2hours withmaximalduration o 10hours.

Nausea andhypoglycemia mostcommon; occasionalvomiting, diarrhea,jitters, dizziness,headache.

Not or use in patients withType 1 diabetes, severe renaldisease or ESRD*, or severeGI disease.

Consider lowering dose o sulonylureato avoid hypoglycemia when starting.May reduce the rate o absorption ooral medication.Medications requiring threshold concentrationsshould be taken 1 hour prior to injection.Approved or use with sulonylureasand/or metormin or in combination with aTZD* alone or with metormin.

Pramlintide(Symlin)

Decreases post-meal glucagonproduction

Delays gastric emptying,Increases satiety, leading todecreased caloric intake.

Degree o response depends onplasma glucose levels

5 ml vials containing0.6 mg/ml. Requires U-100insulin syringe or injection

I not in use: rerigerateuntil expiration date.

I in use: roomtemperature Discard ater28 days.

Type 1 diabetes: 1560mcg starting with 15 mcgsubcutaneously beoremeals o 30gm or morecarbohydrate. Type 2 diabetes:60120 mcg starting with60 mcg subcutaneous beoremeals. Titrate as directed byprescriber.

Maximumeect in 20minuteswith rapidelimination.Maximumduration o 4hours

Nausea andhypoglycemia mostcommon. Doses areadjusted based onpresentation o theseside eects. Occasionalvomiting, stomach pain,dizziness, indigestion.

Indicated or insulin treated type2 diabetes or or type 1 diabetes.Contraindicated in patients withhypoglycemia unawareness,gastroparesis. Or poor adherence

Should never be mixed withinsulin and should be injectedseparately. Reduce insulin doseby 50% when starting.

Requires patient testing o blood sugarsbeore and ater meals, requent physicianollow up, and thorough understanding o howto adjust doses o insulin and pramlintide.May reduce the rate o absorption o orallyadministered medication. Medicationsrequiring threshold concentrations should betaken 1 hour prior to injection.

Sitagliptin(Januvia)

DPP-4 inhibitor* Inhibits theDPP-4 enzyme that degradesGLP-1 and GIP resulting in 2-3old increased levels o theseincretins. Increases insulinsecretion in presence o elevatedplasma glucose. Reduces post-meal glucagon secretion .

25mg, 50mg, 100mgtablets

100 mg po qD

Moderate renal insuciency(CrCl>30 to



Medications to Lower High Blood Pressure*

Category Generic Name Brand NameTM Minimum Daily Dose Maximum Daily Dose Special Considerations or class o drugs

Angiotensin-converting enzyme(ACE) inhibitors

benazepril Lotensin 10 mg QD 40 mg QD or divided May cause cough.

May increase potassium concentrations.

Do not use potassium or salt s ubstitutes withoutconsulting physician.

Do not use i pregnant or i trying to conceive.

Caution i creatinine >1.5.

captopril Capoten 25 mg divided dose 100 mg divided dose

enalapril Vasotec 5 mg QD 40 mg QD or dividedosinopril Monopril 10 mg QD 40 mg QD or divided

lisinopril Prinivil, Zestril 10 mg QD 40 mg QD

moexipril Univasc 7.5 mg QD 30 mg QD or divided

perindopril Aceon 4 mg QD 8 mg QD

quinapril Accupril 10 mg QD 80 mg QD or divided

ramipril Altace 2.5 mg QD 20 mg QD or divided

Angiotensin IIreceptor blockers

trandolapril Mavik 1 mg QD 4 mg QD May cause dizziness and upset stomach.

Do not use potassium or salt s ubstitutes withoutconsulting physician.

Do not use i pregnant or i trying to conceive.

Caution i creatinine >1.5.

candesartan Atacand 8 mg QD 32 mg QD or divided

eprosartan Teveten 400 mg QD 800 mg QD or divided

irbesartan Avapro 150 mg QD 300 mg QD

losartan Cozaar 25 mg QD 100 mg QD or divided

olmesartan Benicar 20 mg QD 40 mg QD

telmisartan Micardis 20 mg QD 80 mg QD

valsartan Diovan 80 mg QD 320 mg QD

Calcium channelblockers

amlodipine Norvasc 2.5 mg QD 10 mg QD May cause constipation, dizziness, upset stomach,and fushing.

Call physician or shortness o breath, unusual heartbeat,or swelling o eet or hands.

diltiazem Cardizem LA 120 mg QD 540 mg QD

diltiazem Cardizem CD 180 mg QD 420 mg QD

diltiazem Dilacor XR* 180 mg QD 420 mg QD

diltiazem Tiazac 180 mg QD 420 mg QD

elodipine Plendil* 2.5 mg QD 20 mg QD

isradipine DynaCircCR* 2.5 mg QD 10 mg QD

nicardipine Cardene SR* 60mg in divided dose 120 mg divided dose

niedipine Adalat CC* 30 mg QD 60 mg QD

niedipine Procardia XL* 30 mg QD 60 mg QD

nisoldipine Sular* 10 mg QD 40 mg QDverapamil Calan 80 mg QD in divided dose 320 mg divided dose

verapamil Calan SR 120 mg QD 480 mg divided dose

verapamil Covera HS* 120 mg QD 360 mg QD

verapamil Isoptin 80 mg QD in divided dose 320 mg divided dose

verapamil Isoptin SR* 120 mg QD 480 mg QD or divided

verapamil Verelan 80 mg QD in divided dose 320 mg divided dose

verapamil Verelan PM 120 mg QD 360 mg QD

Thiazides andrelated diuretics

bedrofumethiazide Naturetin 2.5 mg QD 20 mg QD May increase blood glucose concentrations.

Take in morning to minimize diuretic eect at night.

May cause low potassium, need to monitor level.

chlorothiazide Diuril 125 mg QD 500 mg QD or divided

chlorthalidone Hygroton 12.5 mg QD 25 mg QD

hydrochlorothiazide HydroDIURIL 12.5 mg QD 50 mg QD or divided

hydrochlorothiazide Microzide 12.5 mg QD 50 mg QD or divided

indapamide Lozol 1.25 mg QD 2.5 mg QDmethyclothiazide Enduron 2.5 mg QD 5 mg QD

metolazone Mykrox 0.5 mg QD 1.0 mg QD

metolazone Zaroxolyn 2.5 mg QD 5 mg QD

* Agents in a class of medicines share mechanisms of action, require similar precautions and generally have similar side effects.CC= extended release XL=extended release SR=sustained release CR=controlled release CD=extended release XR=extended releasePM=extended release, controlled onset HS=extended release, controlled onset Dosages based on JNC7 usual dose range.

SECTION B



Medications to Lower High Blood Pressure* (continued)

Category Generic Name Brand NameTM Minimum Daily Dose Maximum Daily Dose Special Considerations or class o drugs

Loop diuretics bumetanide Bumex 0.5 mg QD 2 mg QD or divided May cause low potassium.

Need blood test to monitor level.

(Parenteral drug available) May causephotosensitivity:sunscreen recommended.

ethacrynic acid Edecrin 25 mg QD 200 mg divided dose

urosemide Lasix 20 mg QD 80 mg QD or dividedtorsemide Demadex 2.5 mg QD 10 mg QD

Potassium-sparingdiuretics

amiloride Midamor 5 mg QD 10 mg QD Do not use potassium or salt substitutes withoutconsulting physician. Need to monitor potassium leve l.triamterene Dyrenium 50 mg QD or divided 100 mg divided dose

Aldosterone receptorblockers

eplerenone Inspra 50 mg QD 100 mg divided dose

spironolactone Aldactone 25 mg QD 50 mg divided dose

-blockers acebutolol Sectral 200 mg QD 800 mg divided dose Intrinsic sympathomimetic activity.

May alter blood glucose, may mask signs o low blood.

Call physician or slow heart rate (



Medications for the Treatment of Dyslipidemia

Category Generic Name Brand Name Minimum Daily Dose Maximum Daily Dose Special Considerations or class o drugs

HMG-CoA reductaseinhibitors (statins)

atorvastatin Lipitor 10 mg QD 80 mg in divided doses Main action: Lowers LDL (bad) cholesterol.Also lowers TG and modestly raises HDL.

Have blood tests or liver enzyme concentrations.

Notiy physician i muscle aches or weaknessdevelops.

Use caution i combined with bric acidderivatives due to the increased risk orhabdomyolysis.

fuvastatin Lescol 20 mg QD 80 mg in divided doses

fuvastatin Lescol XL 80 mg QD 80 mg in divided doses

lovastatin Mevacor 10 mg QD 80 mg in divided doses

lovastatin (extended-release) Altocor 20 mg QD 60 mg QD

pravastatin Pravachol 10 mg QD 80 mg QD

rosuvastatin Crestor 5 mg QD 40 mg QD

simvastatin Zocor 5 mg QD 80 mg in divided doses

Cholesterol absorptioninhibitors

ezetimibe Zetia 10 mg QD 10 mg QD Main action: Lowers LDL cholesterol; inhibits absorption ocholesterol.

I used with a statin, take together.

I used with bile acid sequestrant, ezetimibe should be taken2 hr beore or 4 hr ater bile acid sequestrant.

Nicotinic acid (niacin) nicotinic acid(extended release)

Niaspan 50100 mg QD 2,000 mg QD Main action: Lowers LDL cholesterol increases HDL (good)

cholesterol, lowers triglycerides.

Take with ood.

May cause fushing.

May increase blood glucose levels.

Have blood tests or liver enzyme concentrations.

Long-acting orms may be more likely to cause livermalunction.

nicotinic acid 250 mg/day QD Titrated up to 1500mgtherapeutic dose in3 divided doses.Maximum dose= 3000mg

Lipid combinations lovastatin-niacin Advicor 20 mg/500 mg QD 40 mg/2,000 mg QD Main Action: Reduces LDL, TC , and TG and increases HDLdue to the individual actions o niacin and lovastatin.

simvastatin-ezetimibe Vytorin 10 mg/10 mg QD 80 mg/10 mg QD Main Action: Reduces LDL cholesterol.

Amlodipine+atorvastatin Caduet 2.5mg/10mg QD 10 mg/80 mg QD Blood Pressure medication (Calcium channel blocker(see Blood pressure med chart)+lipid (statin)medication. Same comments as individual

Fibric acid derivatives enobrate Tricor 48 mg QD 145 mg QD Main action: Lowers triglycerides, increases HDL cholesterol.Perorm blood tests or liver enzyme concentrations.

Adjust dose based on age and renal impairment.

Notiy physician i muscle aches or weakness develops.

enobrate Lobra 67 mg QD 200 mg QD

enobrate Triglide 50 mg QD 160 mg QD

enobrate Antara 43 mg QD 130 mg QD

gembrozil Lopid 1,200 mg BID 1,200 mg BID

Bile acid sequestrants cholestyramine LoCHOLEST 4 g QD 24 g in divided doses Main action: Lowers LDL cholesterol.

May cause constipation and stomach upset.

May need to be taken at a dierent time than othermedications to avoid drug interactions.

May increase triglycerides blood concentrations.

Can be combined with other agents such as statins.

cholestyramine light LoCHOLEST light 4 g QD 24 g in divided doses

cholestyramine Questran 4 g QD 24 g in divided doses

cholestyramine light Questran light 4 g QD 24 g in divided doses

cholestyramine Prevalite 4 g QD 24 g in divided doses

cholestipol Colestid 2g QD or BID 6g QD or BID

colesevelam Welchol 1,875 mg (3 tablets) QD 4,375 mg (7 tabs) QDor BID

HMG-Coa = 3-hydroxy-3-methylglutaryl coenzyme A LDL = low-density lipoprotein HDL = high-density lipoprotein TC = total cholesterolTG = plasma triglycerides generic = generic drug manufacturers

SECTION C


10/10

The U.S. Department of Health and Human Services'National Diabetes Education Program (NDEP) is jointlysponsored by the National Institutes of Health and theCenters for Disease Control and Prevention with the

support of more than 200 partner organizations.

www.ndep.nih.gov1-800-438-5383

revised 3/07 NDEP 54 SCS109012

drug tables supplement

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