Recommendation:
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Pharmacotherapy
Drug classes are listed with priority given to drugs with established cardiorenal benefits, cardiorenal safety, low risks for hypoglycaemia or weight gain.
Class |
Drug |
Usual starting dose |
*see renal dosing if GFR<60 |
Biguanide |
Metformin Metformin extended-release
|
|
SGLT2 inhibitors |
Canagliflozin Dapagliflozin Empagliflozin |
100–300mg daily 5–10mg daily 10–25mg daily |
GLP1 receptor agonists |
Dulaglutide Liraglutide Semaglutide |
0.75mg weekly 0.6mg daily 0.25mg weekly |
DPP-4 Inhibitors |
Linagliptin Saxagliptin Sitagliptin |
5mg daily 5mg daily* 100mg daily* |
Insulin secretagogue |
Sulfonylureas Gliclazide Gliclazide-modified release Glimepiride Glyburide Meglitinides Repaglinide |
80mg bid 30mg daily 1–2mg daily 2.5–5mg daily*
0.5–1mg tid |
Thiazoladinediones |
Pioglitazone |
15mg daily |
Alpha-glucosidase inhibitor |
Acarbose |
25–50mg tid with meals |
Insulin |
See Insulin Prescription Tool |
|