Adverse Effects
Dyspepsia, loose stools, or diarrhea. Can be associated with the development of vitamin B12 deficiency over time. Small increased risk of lactic acidosis.
Few adverse events; very low risk of hypoglycemia.
Contraindications
Acute illness, GI or hepatic disease, renal dysfunction, CHF, hypoxic states or alcohol abuse, Cr > 1.4 mg/dL (women) or > 1.5 (men). Withhold in IV contrast dye procedure.
Comments
The addition of an SU to metformin is associated with a greater than 5-fold increase in likelihood of hypoglycemia over that seen with metformin alone or when an SU is administered in conjunction with TZDs, a DPP-4 inhibitor, or nateglinide.
Reduce dosage in severe renal insuffiency.
Few adverse events. Well tolerated. Possible GI side effects. Low risk of hypoglycemia. Minimal drug-drug interactions.
Significant risk of hypoglycemia; oſten associated with weight gain. The average weight gain with SU is comparable to that with TZDs.
SUs contraindicated in severe liver/ renal disease.
Subcutaneous injection.
Timing is more important for glinides.
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