Non-insulin therapy dosing Flashcards
metformin initial dose
500mg BID or 850mg QD (w/ meals)
metformin titration
weekly or bi-monthly. increase by 250-500mg daily
metformin max dose
2gm/day
metformin dosing eGFR greater than/equal to 60
-no contraindication
-monitor Scr annually
metformin dosing eGFR 45-60
-safe to start
-continue if already taking
-monitor Scr 3-6 months
metformin dosing eGFR 30-45
-do not start
-reduce by 50% if already taking
-monitor every 3 month
metformin dosing eGFR < 30
-do not start
-stop immediately
-may restart/hold until numbers improve
canagliflozin dosing eGFR > 60
100mg QD
max: 300mg QD
canagliflozin dosing eGFR 30-60
max: 100mg QD if no albuminuria present
canagliflozin dosing eGFR < 30
-do not start
-if already on, then 100mg QD if albumin > 300
dapagliflozin dosing eGFR > 45
-5mg QD
-max: 10mg QD
dapagliflozin dosing eGFR < 30
-do not start
-if already on, the monitor
empagliflozin dosing eGFR > 30
-10mg daily
-max: 25mg QD
empagliflozin dosing eGFR < 30
-do not start
-if on monitor
dosing of SGLT2 inhibitors for ESRD or HD
do not use
