Diabetes Medicines You Don’t Inject

When you think about diabetes drugs, you may think of insulin or other medications that you get from a shot or a pump. But there are others that you take as a pill or that you inhale. 

Your doctor will consider exactly what you need, which may include more than one type of diabetes medicine. The goal is to get your best blood sugar control, and the oral drugs do that in several ways.

Acarbose (Precose)

How it works: Blocks enzymes that help digest starches, slowing the rise in blood sugar. It belongs to a group of drugs called “alpha-glucosidase inhibitors.” Side effects for these kinds of drugs include stomach upset (gas, diarrhea, nausea, cramps).

Alogliptin (Nesina)

How it works: Boosts insulin levels when blood sugars are too high, and tells the liver to cut back on making sugars. Your doctor may call this type of drug a “DPP-IV inhibitor.” These drugs do not cause weight gain. You may take them alone or with another drug, like metformin.

Bromocriptine mesylate (Cycloset, Parlodel)

How it works: This tablet raises the level of dopamine, a brain chemical. It’s approved help improve blood sugar control in adults with type 2 diabetes, along with diet and exercise. It’s not used to treat type 1 diabetes.

Canagliflozin (Invokana)

How it works: Boosts how much glucose leaves your body in urine, and blocks your kidney from reabsorbing glucose. Your doctor may call this type of drug a “SGLT2 inhibitor.” Side effects can include:

Chlorpropamide (Diabinese)

How it works: Lowers blood sugar by prompting the pancreas to release more insulin. Your doctor may call this type of drug “sulfonylureas.” This drug is not used as often as newer sulfonylureas. Side effects of sulfonylureas include:

  • Low blood sugar
  • Upset stomach
  • Skin rash or itching
  • Weight gain

Colesevelam (Welchol)

How it works: Lowers “bad” (LDL) cholesterol and improves blood sugar control in adults with type 2 diabetes. Your doctor will call this type of drug a “bile acid sequestrant.”

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Dapagliflozin (Farxiga)

How it works: Boosts how much glucose leaves your body in urine, and blocks your kidney from reabsorbing glucose. Your doctor may call this type of drug a “SGLT2 inhibitor.”

Empagliflozin (Jardiance)

How it works: Boosts how much glucose leaves your body in urine, and blocks your kidney from reabsorbing glucose. Your doctor may call this type of drug a “SGLT2 inhibitor.”

Glimepiride (Amaryl)

How it works: Lowers blood sugar by prompting the pancreas to release more insulin. Your doctor may call this type of drug “sulfonylureas.” Side effects of sulfonylureas include:

  • Low blood sugar
  • Upset stomach
  • Skin rash or itching
  • Weight gain

Glipizide (Glucotrol and Glucotrol XL)

How it works: Lowers blood sugar by prompting the pancreas to release more insulin. Your doctor may call this type of drug “sulfonylureas.” Side effects of sulfonylureas include:

  • Low blood sugar
  • Upset stomach
  • Skin rash or itching
  • Weight gain

Glyburide (DiaBeta, Glynase PresTab)

How it works: Lowers blood sugar by prompting the pancreas to release more insulin. Your doctor may call this type of drug “sulfonylureas.” Side effects of sulfonylureas include:

  • Low blood sugar
  • Upset stomach
  • Skin rash or itching
  • Weight gain

Inhaled Insulin (Afrezza)

How you take it: You put a cartridge, which contains a dose of this powdered, rapid-acting insulin, into an inhaler, and you use it before meals or soon after you start to eat.

How it works: The insulin quickly moves from lung cells into the bloodstream. It doesn’t replace long-acting insulin (which you can’t inhale). You should not use it if you have a long-term lung disease, such as asthma or COPD, or if you smoke. It’s not recommended for treating diabetic ketoacidosis.

Linagliptin (Tradjenta)

How it works: Boosts insulin levels when blood sugars are too high, and tells the liver to cut back on making sugars. Your doctor may call this type of drug a “DPP-IV inhibitor.” These drugs do not cause weight gain. You may take them alone or with another drug, like metformin.

Metformin (Fortamet, Glucophage, Glucophage XR, Glumetza, Riomet)

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How they work: Improve insulin's ability to move sugar into cells, especially muscle cells. They also prevent the liver from releasing stored sugar. You should not take them if you have kidney damage or heart failure. Your doctor may call this type of drug a “biguanide.” Side effects for biguanides include:

  • Upset stomach (nausea, diarrhea)
  • Metallic taste in mouth

Miglitol (Glyset)

How it works: Blocks enzymes that help digest starches, slowing the rise in blood sugar. It belongs to a group of drugs your doctor may call “alpha-glucosidase inhibitors.” Side effects for alpha-glucosidase inhibitors include stomach upset (gas, diarrhea, nausea, cramps).

Nateglinide (Starlix)

How it works: Makes the pancreas release more insulin, but only if your blood sugar levels are too high. Your doctor may call this type of drug a “meglitinide.” Side effects of meglitinides include:

  • Low blood sugar
  • Stomach upset

Pioglitazone (Actos)

How it works: Helps insulin work better in muscle and fat. It lowers the amount of sugar the liver releases and makes fat cells more sensitive to insulin’s effects. It may take a few weeks for these drugs to lower blood sugar. Your doctor should talk with you about heart risks with this type of drug, which he may call “thiazolidinediones.” Side effects from this type of drug are rare but may include:

  • Higher than normal levels of liver enzymes
  • Liver failure
  • Respiratory infection
  • Headache
  • Fluid retention

Repaglinide (Prandin)

How it works: Makes the pancreas release more insulin, but only if your blood sugar levels are too high. Your doctor may call this type of drug a “meglitinide.” Side effects of this type of drug include:

  • Low blood sugar
  • Stomach upset

Rosiglitazone (Avandia)

How it works: Helps insulin work better in muscle and fat. It lowers the amount of sugar the liver releases and makes fat cells more sensitive to insulin’s effects. It may take a few weeks for this kind of drug to lower blood sugar. Your doctor should talk with you about heart risks with this type of drug, which he may call “thiazolidinediones.” Side effects for thiazolidinediones are rare but may include:

  • Higher than normal levels of liver enzymes
  • Liver failure
  • Respiratory infection
  • Headache
  • Fluid retention

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Saxagliptin (Onglyza)

How it works: Boosts insulin levels when blood sugars are too high, and tells the liver to cut back on making sugars. Your doctor may call this type of drug a “DPP-IV inhibitor.” These drugs do not cause weight gain. You may take them alone or with another drug, like metformin.

Sitagliptin (Januvia)

How it works: Boosts insulin levels when blood sugars are too high and tells the liver to cut back on making sugars. Your doctor may call this type of drug a “DPP-IV inhibitor.” These drugs do not cause weight gain. You may take them alone or with another drug, like metformin.

Tolazamide

How it works: Lowers blood sugar by prompting the pancreas to release more insulin. Your doctor may call this type of drug “sulfonylureas.” This drug is not used as often as newer sulfonylureas. Side effects of this kind of drug include:

  • Low blood sugar
  • Upset stomach
  • Skin rash or itching
  • Weight gain

Tolbutamide 

How it works: Lowers blood sugar by prompting the pancreas to release more insulin. Your doctor may call this type of drug “sulfonylureas.” This drug is not used as often as newer sulfonylureas. Side effects of this kind of drug include:

  • Low blood sugar
  • Upset stomach
  • Skin rash or itching
  • Weight gain

Combination Medicines

Several diabetes pills combine two medications into one tablet. They include:

  • Alogliptin and metformin (Kazano)
  • Alogliptin plus pioglitazone (Oseni)
  • Dapagliflozin and metformin (Xigduo XR)
  • Empagliflozin and linaglipton (Glyxambi)
  • Empagliflozin and metformin (Synjardy)
  • Glipizide and metformin 
  • Glyburide and metformin (Glucovance)
  • Linagliptin and metformin (Jentadueto)
  • Pioglitazone and glimepiride (Duetact)
  • Repaglinide and metformin (PrandiMet)
  • Rosiglitazone and glimepiride (Avandaryl)
  • Rosiglitazone and metformin (Avandamet)
  • Saxagliptin and metformin (Kombiglyze XR)
  • Sitagliptin and metformin (Janumet, Janumet XR)

 

WebMD Medical Reference Reviewed by Jennifer Robinson, MD on October 28, 2015

Sources

SOURCES: 

News release, FDA. 

PDR.net. American Heart Association.

WebMD Health News: "FDA Restricts Use of Diabetes Drug Avandia."

News release, FDA.



 

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