Usual Adult Dose for Diabetes Type 2

Initial dose: 60 to 120 mg orally 3 times a day before meals
Maintenance dose: 60 to 120 mg orally 3 times a day before meals

Comments:

• For patients who are near HbA1c goal when therapy is initiated, initial dose should be 60 mg orally 3 times.
• Patients should take this drug 1 to 30 minutes before a meal; if a meal is skipped, the dose scheduled to be given with that meal should be skipped to avoid hypoglycemia.
• This drug should not be used in patients with type 1 diabetes mellitus or for the treatment of diabetic ketoacidosis.

Renal Dose Adjustments

No adjustment recommended

Liver Dose Adjustments

Mild hepatic impairment: No adjustment recommended
Moderate to severe hepatic impairment: Use with caution

Dose Adjustments

Elderly: No adjustment recommended; however, some individuals may have a greater sensitivity to therapy and elderly patients are generally more susceptible to hypoglycemia

This drug may need to be temporarily suspended during times of stress; insulin therapy may be temporarily needed in times of fever, infection, trauma, or surgery.

Precautions

Safety and efficacy have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:

• Take orally 1 to 30 minutes before a meal.
• Patients who skip a meal should be instructed to skip the dose for that meal.

• This drug is not indicated to treat patients with type 1 diabetes or diabetic ketoacidosis as these conditions should be treated with insulin.
• Secondary failure may occur; prior to classifying a patient as a secondary failure it is important to assess dose and dietary adherence.

• Periodic measures of fasting blood glucose and glycosylated hemoglobin should be performed to assess efficacy.

• Patients should understand the importance of adhering to dietary instructions and regular physical activity; patients should understand strenuous exercise and alcohol intake may increase the risk of hypoglycemia.
• Patients should be aware of the symptoms of hypoglycemia and its management; they should be cautioned about driving and the use of machinery, especially when optimum stabilization has not been achieved, e.g., during a transition from other medications or during irregular use.
• During periods of stress such as fever, trauma, infection, or surgery, management of diabetes may change and patients should be advised to seek medical advice.
• Drug interactions may occur and patients should speak with their healthcare provider regarding all their medications, prescription and over the counter drugs.
• Advise patient to speak to physician or health care professional if pregnant, intend to become pregnant, or are breastfeeding.