Approximate Cost Reference List i for Antihyperglycemic Agents

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1 Alpha Glucosidase Inhibitor Acarbose (Glucobay ) Biguanides Metformin (Glucophage, generic) Metformin ER (Glumetza ) Approximate Cost Reference List i for Antihyperglycemic Agents Incretin Agents - DPP-4 inhibitors Alogliptin (Nesina ) 100 mg $ 0.41/Tab mg three times a day 50 mg $ 0.29/Tab mg per day in divided doses $ 0.05/Tab mg per day in divided doses $ 0.06/Tab mg per day $ 0.63/Tab mg per day $ 1.27/Tab 6.25 mg 6.25 mg once daily (depending on renal function) $ 2.84/Tab 12.5 mg 12.5 mg once daily (depending on renal function) $ 2.84/Tab 25 mg 25 mg once daily (depending on renal function) $ 2.84/Tab Linagliptin (Trajenta ) 5 mg 5 mg once daily $ 2.60/Tab Saxagliptin (Onglyza ) Sitagliptin (Januvia ) Incretin Agents GLP-1 receptor agonists 2.5 mg mg once daily $ 2.57/Tab 5 mg mg once daily $ 3.09/Tab 25 mg 25 mg once daily (depending on renal function) $ 3.20/Tab 50 mg 50 mg once daily (depending on renal function) $ 3.20/Tab 100 mg 100 mg once daily $ 3.20/Tab Albiglutide (Eperzan ) N/A N/A N/A Exenatide (Byetta ) 5 mcg prefilled pen (250 µg/ml) 10 mcg prefilled pen (250 µg/ml) 10 mcg twice a day 10 mcg twice a day $ 2.50/5 mcg dose (supplied as prefilled pen) $ 2.50/10 mcg dose (supplied as prefilled pen) Liraglutide (Victoza ) 6 mg/ml mg once daily $ 2.98/0.6 mg dose $ 5.96/1.2 mg dose $ 8.95/1.8 mg dose (supplied as prefilled pens)

2 Insulin Secretagogues Sulfonylureas Gliclazide (Diamicron, generic) Gliclazide (Diamicron MR, generic) Glimepiride (Amaryl, generic) Glyburide (Diabeta, generic) 80 mg mg per day (doses > 160mg should be twice a day) $ 0.09/Tab 30 mg mg once daily $ 0.09/Tab 60 mg mg once daily $ 0.21/Tab 1 mg 2 mg 4 mg 2.5 mg mg once daily $ 0.04/Tab 5 mg mg once daily $ 0.06/Tab Note: chlorpropamide and tolbutamide are still available in Canada, but rarely used Insulin Secretagogues Meglitinides Nateglinide (Starlix) (Discontinued) Repaglinide (Gluconorm, generic) 60 mg 120 mg three times a day $ 0.60/Tab 120 mg 120 mg three times a day $ 0.63/Tab 0.5 mg 1 mg 2 mg $ 0.15/Tab $ 0.16/Tab $ 0.18/Tab Sodium Glucose co-transporter 2 inhibitors (SGLT2) Canagliflozin(Invokana ) 100 mg mg once daily $ 2.84/Tab 300 mg mg once daily $ 2.84/Tab Dapagliflozin(Forxiga ) 5 mg 5-10 mg once daily $ 2.84/Tab 10 mg 5-10 mg once daily $ 2.84/Tab Empagliflozin (Jardiance ) Thiazolidinediones Pioglitazone (Actos) generic Rosiglitazone (Avandia ) 10 mg mg once daily $ 2.84/Tab 25 mg mg once daily $ 2.84/Tab 15 mg mg once daily $ 1.29/Tab 30 mg mg once daily $ 1.81/Tab 45 mg Maximum daily dose $ 2.72/Tab 2 mg 4-8 mg daily as a single or as a divided dose 4 mg 4-8 mg daily as a single or as a divided dose $ 2.34/Tab 8 mg 4-8 mg daily as a single or as a divided dose $ 3.35/Tab

3 Weight Loss Agent Orlistst (Xenical ) 120 mg tab 120 mg three times a day $ 1.78/Tab Combination Products Alogliptin/Metformin (Kazano ) $ 1.28/Tab Linagliptin/Metformin (Jentadueto ) Rosiglitazone/Metformin (AvandaMet ) Saxagliptin/Metformin (Komboglyze ) Sitagliptin/Metformin (Janumet ) Sitagliptan/Metformin Extended Release Formula (Janumet XR ) 2 mg/ 2 mg/ 4 mg/ 4 mg/ Starting dose of 2 mg/ may increase to a Starting dose of 2 mg/ may increase to a Starting dose of 2 mg/ may increase to a Starting dose of 2 mg/ may increase to a Usual dose 2 tablets once daily Usual dose 2 tablets once daily $ 1.28/Tab $ 1.28/Tab $ 1.26/Tab $ 1.73/Tab $ 1.83/Tab 100 mg/ Usual dose 2 tablets once daily

4 PRANDIAL (BOLUS) INSULINS Rapid-Acting Insulin Analogues Aspart (NovoRapid ) Glulisine (Apidra ) Lispro (Humalog ) Lispro 200 units/ml (Humalog ) Short-Acting Insulin regular (Humulin - R) Insulin regular (Novolin ge Toronto) Approximate Cost Reference for Insulins ii 200 units/ml (600 units/prefilled pen) USUAL MAINTENANCE DOSE OR USUAL DOSAGE RANGE FOR PEN CARTRIDGE FOR PRE- FILLED PEN $ 0.043/unit $ 0.044/unit $ 0.036/unit $ 0.036/unit $ 0.041/unit $ 0.040/unit N/A $ 0.033/unit N/A $ 0.037/unit Note: Pork regular insulin (Hypurin Regular Insulin Pork) and pork isophane insulin (Hypurin NPH Insulin Isophane) are available but rarely used. BASAL INSULINS Intermediate-acting Insulin NPH (Humulin - N) Insulin NPH (Novolin ge NPH) Long-acting Basal Insulin Analogues Determir (Levemir ) Glargine (Lantus ) Glargine 300 units/ml (Toujeo ) 300 units/ml (450 units/prefilled pen) $ 0.033/unit $ 0.033/unit $ 0.075/unit $ 0.078/unit $ 0.067/unit $ 0.067/unit N/A $ 0.064/unit Note: Pork regular insulin (Hypurin Regular Insulin Pork) and pork isophane insulin (Hypurin NPH Insulin Isophane) are available but rarely used.

5 PREMIXED INSULINS Premixed Regular Insulin NPH Insulin regular/nph (Humulin 30/70) Insulin regular/nph (Novolin ge 30/70, 40/60, 50/50) Premixed Insulin Analogues USUAL MAINTENANCE DOSE OR USUAL DOSAGE RANGE FOR PEN CARTRIDGE $ 0.028/unit N/A FOR PRE- FILLED PEN Aspart 30%/aspart protamine 70% (NovoMix 30) $ 0.040/unit N/A Lispro 25%/lispro protamine 75% (Humalog Mix25 ) $ 0.041/unit $ 0.040/unit Lispro 50%/lispro protamine 50% (Humalog Mix50 ) $ 0.040/unit $ 0.040/unit * Approximate unit drug cost not including dispensing/professional fee and pharmacy mark-up. Approximate Canadian Cost average is the weighted wholesale cost (including a wholesale mark-up charge) to the pharmacy before dispensing. i The listed medications represent both the classes and the agents that are most commonly used in primary care practices. It is not meant to be an exhaustive list, and is intended only as a guide for the family physician. ii Insulin prices are based on the pen cartridge price and corresponding vial price would be marginally less Updated October 2015 guidelines.diabetes.ca diabetes.ca BANTING ( )

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