Diabetes meds - safety concerns, meds that affect BGs

Metformin

Severe renal impairment (eGFR <30 mL/min)

SGLT2i

• Recurrent vaginal candidiasis or UTI

• ESRD (on dialysis) - eGFR cutoffs:

HF 20 mL/min (Jardiance), 25 mL/min (Farxiga)

DM2 30 mL/min (Jardiance), 45 mL/min (Farxiga)

GLP-1 agonists

• Gastroparesis or severe GI disorder

• Pancreatitis

• Thyroid cancer

DPP-4 inhibitors

• pancreatitis

• heart failure (alogliptin, saxagliptin

Sulfonylureas

• renal impairment (glyburide)

• sulfa allergy

Thiazolidinediones

• heart failure

• bladder cancer (pioglitazone)

thiazide/loop diuretics

Increase BG

tacrolimus, cyclosporine

Increase BG

Protease inhibitors

Increase BG

Antipsychotics

Increase BG

Statins

Increase BG

Steroids (systemic)

Increase BG

cough syrups

Increase BG

Niacin

Increase BG

Quinolones

Increase or decrease BG

Beta-blockers

Mask hypoglycemia (decrease BG)

Tramadol

Decrease BG

GLP - DPP4 - PP

Avoid PP (pancreatitis)