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. Author manuscript; available in PMC: 2020 Sep 16.
Published in final edited form as: Curr Diabetes Rev. 2020;16(8):851–858. doi: 10.2174/1573399816666200206112318

Table.

Overview of low-cost oral hypoglycemic medications (OHMs)

OHM Initial dose (mg/day) MAXa(mg/day) EFFb(mg/day) Time-to-peak HbA1c effect(week) Change in HbA1c (%)(range)c Adverse events
Glimepiride 1–2 8 4–8 12–14 −1.0 to −1.9

  • non-severe

  • hypoglycemiad
Glipizide
IRe
ERf

  • hypoglycemia

  • weight gain
 IRe 5 40 20 16 −0.9 to −1.8
 ERf 5 20 5
Glyburide/Glibenclamide 2.5–5 20 2.5–5 12–20 −1.1 to −1.2

  • Beta-cell loss

  • CVDg

  • CIhin RIi

  • hypoglycemia

  • weight gain
Metformin

  • B12 deficiency

  • CI in RI

  • stomach upset
 IR 500–850 2550 1500–2000 25–39 −0.5 to −2.0
 ER 500-850 2000 1500-2000
Pioglitazone 15–30 45 45 26 −0.7 to −1.9

  • weight gain

  • fractures
a

MAX: Maximum recommended daily dose.

b

EFF: Most effective daily dose.

c

Range of EFF for all studies.

d

Severe hypoglycemia <50 mg/dL23.

e

IR: Intermediate release.

f

ER: Extended release.

g

CVD: Cardiovascular disease.

h

CI: Contraindicated.

i

RI: Renal insufficiency.