Diabetes pills help control blood sugar (glucose) levels in people whose bodies still produce some insulin. These drugs are usually prescribed along with recommendations for making specific dietary changes and getting regular exercise . Often, several of these drugs are used in combination to achieve optimal blood sugar control.
The guide below provides general information about different oral drugs for diabetes. Always take your medicine exactly as prescribed and discuss any specific concerns you might have with your health care provider.
The following are the seven categories of diabetes pills:
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Types of Pills
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How They Work for Diabetes
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Sulfonylureas (first and second generation)
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Lower blood sugar by stimulating the pancreas to release more insulin.
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Biguanides
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Improve insulin's effectiveness and lower blood sugar by decreasing the amount of glucose released by the liver.
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Sulfonylurea and biguanide combination
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Stimulates the pancreas to release more insulin, improves insulin's action in the body, and lowers the amount of glucose released by the liver.
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Thiazolidinediones
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Improve insulin's effectiveness and lower the amount of glucose made by the liver.
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Alpha-glucosidase inhibitors
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Lower blood sugar by slowing glucose absorption in the small intestine. Block certain body chemicals (enzymes) to slow down the digestion of certain starches.
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Meglitinides
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Lower blood sugar by stimulating the pancreas to release more insulin. Must be taken before meals or the insulin released will be blocked, preventing lowering of blood sugar
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First Generation Sulfonylureas for Diabetes
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Medication Name
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Tablet Form
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Recommended Dosage Range
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acetohexamide (Dymelor)
chlorpropamide (Diabinese)
tolbutamide (Orinase)
tolazamide (Tolinase)
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250 mg, 500 mg
100 mg, 250 mg
500 mg
100 mg, 250 mg, 500 mg
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250-1,500 mg
100-500 mg
250-3,000 mg
100-1,000 mg
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How They Work:
Stimulate pancreas to release more insulin
Side Effects:
- Hypoglycemia (low blood sugar)
- Upset stomach
- Skin rash or itching
- Weight gain
Comments/Special Instructions:
Take 1/2 to 1 hour before meals.
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Second Generation Sulfonylureas for Diabetes
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Medication Name
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Tablet Form
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Recommended Dosage Range
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glipizide
(Glucotrol)
(Glucotrol XL)
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5 mg, 10 mg
5 mg, 10 mg
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5-40 mg
5-20 mg *
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glyburide
(DiaBeta, Micronase)
(Glynase PresTab)
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1.25 mg, 2.5 mg, 5 mg
1.5 mg, 3 mg, 6 mg
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1.25-20 mg
0.75-12 mg
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glimepiride (Amaryl)
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1 mg, 2 mg, 4 mg
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1-8 mg *
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How They Work:
Stimulate pancreas to release more insulin
Side Effects:
- Hypoglycemia (low blood sugar)
- Upset stomach
- Skin rash or itching
- Weight gain
Comments/Special Instructions:
Take 1/2 to 1 hour before meals.
Note: Glimepiride is taken with first meal of the day.
* once a day
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Biguanides for Diabetes
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Medication Name
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Tablet Form
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Recommended Dosage Range
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Metformin
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(Glucophage)
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500 mg, 850 mg
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500-2,550 mg
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(Glucophage XR)
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500 mg
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500-2,000 mg
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How They Work:
Improve insulin's effectiveness
Lower amount of glucose released by the liver
Side Effects:
- Upset stomach (nausea, diarrhea)
- Metallic taste in mouth
Comments/Special Instructions:
Do not cause hypoglycemia (low blood sugar) when prescribed as the only diabetes drug.
Usually do not cause weight gain.
Should be temporarily stopped before hospitalization, surgery, or when getting certain X-ray tests.
Patient should have regular tests to detect liver and/or kidney problems.
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Sulfonylurea and Biguanide Combination for Diabetes
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Medication Name
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Tablet Form
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Recommended Dosage Range
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glyburide
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(Glyburide/metformin)
1.25 mg/250 mg
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1.25 mg-250 mg
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metformin
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2.5 mg/500 mg
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20 mg-2,000 mg
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(Glucovance)
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5 mg/500 mg
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How It Works:
Stimulates pancreas to release more insulin
Improves insulin's effectiveness
Lowers the amount of glucose released by the liver
Side Effects:
- Upset stomach (nausea, diarrhea)
- Metallic taste in mouth
- Hypoglycemia
- Skin rash or itching
- Weight gain
Comments/Special Instructions:
Usually does not cause weight gain.
Should be temporarily stopped before hospitalization, surgery, or X-ray tests using contrast material (dye).
Patient should have regular tests to detect any liver and/or kidney problems.
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Thiazolidinediones for Diabetes
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Medication Name
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Tablet Form
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Recommended Dosage Range
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rosiglitazone (Avandia)
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4 mg, 8 mg
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4-8 mg
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pioglitozone (Actos)
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15 mg, 30 mg, 45 mg
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15-45 mg *
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How They Work:
Improve insulin's effectiveness
Lower the amount of glucose made by the liver
Side Effects:
- Rare: respiratory infection, headache, or pain
Comments/Special Instructions:
Do not cause hypoglycemia (low blood pressure) when prescribed as the only diabetes drug.
Rosiglitazone and pioglitozone can be taken with or without food.
Patient should have regular tests to detect any liver problems.
* once a day
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Alpha-Glucosidase Inhibitors for Diabetes
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Medication Name
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Tablet Form
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Recommended Dosage Range
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acarbose (Precose)
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50 mg, 100 mg
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75-300 mg
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miglitol (Glyset)
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25 mg, 50 mg, 100 g
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75-300 mg
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How They Work:
Block enzymes that help digest starches, slowing the rise in blood sugar
Side Effects:
- Stomach upset (gas, diarrhea, nausea, cramps)
Comments/Special Instructions:
Do not cause hypoglycemia when prescribed as the only diabetes medication.
Take with the first bite of a meal.
If prescribed in combination with sulfonylurea, treat low blood sugar with glucose tablet or gel, not sugar.
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Meglitinides for Diabetes
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Medication Name
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Tablet Form
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Recommended Dosage Range
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repaglinide (Prandin)
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0.5 mg, 1 mg, 2 mg
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0.5-2 mg (before meals)
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nateglinide (Starlix)
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60 mg, 120 mg
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120 mg (before meals)
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How They Work:
Stimulate pancreas to release more insulin. Insulin release is less effective at low sugar levels.
Side Effects:
- Hypoglycemia
- Stomach upset
Comments/Special Instructions:
Take before meals. If you skip a meal, skip the dose.
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