Dosage of Diabetic Medications in Chronic Kidney Disease
| Diabetic Medication | Renal Dosage* |
|---|---|
| Biguanines | |
| Glucophage (metformin) | Renal impairment: avoid use |
| Sulfonureas | |
| Glucotrol (glipizide) | CrCl† <50: decrease dose by 50% |
| Diabeta (glyburide) | CrCl† <50: avoid use |
| Amaryl (glimepiride) | Renal impairment: start 1 mg daily, increase slowly, monitor glucose |
| Glitazones | |
| Actos (pioglitazone) | No adjustment |
| Avandia (rosiglitazone) | No adjustment |
| Alpha-glucosidase inhibitors | |
| Precose (acarbose) | Creatinine >2: avoid use |
| Glyset (miglitol) | Creatinine >2: avoid use |
| Meglitinides | |
| Starlix (nateglinide) | No adjustment |
| Prandin (repaglinide) | CrCl 20–40: start 0.5 mg before every meal, use titrate with cautionCrCl <20: not defined |
| Incretin mimetics | |
| Byetta (exenatide) | CrCl 30–80: no adjustmentCrCl <30 & HD: not recommended |
| Januvia (sitagliptin) | CrCl 30–49: 50 mg dailyCrCl <30: 25 mg dailyHD/CAPD: no supplement |
* Dosing recommendations according to Epocrates Essentials (Epocrates Inc., San Mateo, CA).
† Calculated by Cockroft-Gault equation.
CrCl, creatinine clearance (mL/min); HD, hemodialysis; CAPD, continuous ambulatory peritoneal dialysis.