Medications
With so many different diabetes medications, it can be confusing. Learn more about insulin, generic drug options, and different over-the-counter medications that are best for you. Remember, many OTC (over the counter) medications contain sugar, which could affect your blood glucose level.
Oral Medications
When diet and exercise haven't been enough, Type 2 diabetes can often be treated with an oral medication. These medications all work differently to help control blood glucose levels. The following table outlines the 5 groups of medications, how they work, and some examples of each group.
Oral Medications
Sulfonylureas
Help the pancreas to release more insulin |
Acetohexamide
Chlorpropamide
Glimepiride
Glipizide
Glyburide
Tolazamide
Tolbutamide |
Dymelor®
Diabinese®
Amaryl®
Glucotrol®
Glucotrol® XL
Diabeta®
Micronase®
Glynase® PresTab®
Tolinase®
Orinase® |
Biguanides
Decrease the release of glucose from the liver and increase the body's sensitivity to insulin |
Metformin |
Glucophage®
Glucophage XR® |
Thiazolidinediones
Make the body more sensitive to insulin and decrease glucose production by the liver |
Pioglitazone
Rosiglitazone |
Actos®
Avandia® |
Meglitinides
Help the pancreas to release more insulin |
Nateglinide
Repaglinide |
Starlix®
Prandin® |
Alpha-Glucosidase Inhibitors
Slow the absorption of carbohydrates in the intestine |
Acarbose
Miglitol |
Precose®
Glyset® |
DPP-4 Inhibitors
Increase insulin release and decrease glucose production by liver |
Sitagliptin |
Januvia® |
View chart larger
For more detailed information regarding any of these products visit the “Rite Aid's Rite Advice” patient information counseling area. There you can get a better understanding of medications including how to take the medication, the possible side effects and potential drug interactions. As always, your Rite Aid Pharmacist is ready to help you understand medications and their use.
Insulin
Insulin is a hormone that helps the body use or store blood glucose. People with Type 1 diabetes no longer make insulin, so they must use insulin injections to lower there blood glucose. People with Type 2 diabetes don't make enough insulin or may not respond to the insulin they do make. Over time, people with Type 2 diabetes make less and less insulin and, therefore, may also need to use insulin injections to reach their glucose goals.
There are 4 main types of insulin. They differ in how quickly they work, when they reach their most effective peak, and how long they work. Combinations of some of these types are also available. The values in the follow table are only approximate time frames. Variation may occur based on injection site, injection technique, exercise, temperature, dosage amount, etc.
Rapid-acting |
Glulisine |
10-15 minutes |
1-1.5 hours |
3-5 hours |
Rapid-acting |
Aspart |
10-20 minutes |
1-3 hours |
3-5 hours |
Rapid-acting |
Lispro |
15-30 minutes |
0.5-1.5 hours |
3-6 hours |
Short-acting |
Regular |
30-60 minutes |
1-5 hours |
6-10 hours |
Intermediate-acting |
NPH |
1-2 hours |
6-14 hours |
16-24 hours |
Long-acting |
Glargine |
1 hour |
No peak |
24 hours |
Long-acting |
Detemir |
1-2 hours |
No peak |
12-24 hours |
View chart larger
Injecting Insulin
At the present time, insulin can only be given through an injection. It comes either dissolved (clear) or suspended (cloudy) in a liquid, depending on the type. Many people use a syringe to inject insulin, but it can also be delivered with a pump, a pen or a needle-free device. People with diabetes must work with their health care team to find the right doses and combinations of insulin to help them reach their blood glucose goals and prevent complications. People with Type 1 diabetes may need to take up to 3 to 4 injections daily to keep their blood glucose levels close to normal. People with Type 2 diabetes that are not meeting their blood glucose goals on oral medication, generally need 1 to 2 injections daily of insulin to start, but in time may need to inject insulin 3 to 4 times daily.
Rapid-acting insulin is usually taken right before a meal and short-acting insulin is usually taken 30 minutes before a meal. These insulin types help to lower your blood glucose levels following meals.
Intermediate- and long-acting insulin are most frequently taken in the morning and/or at night and provide "basal" or "all day" coverage. A combination of meal time and basal insulin coverage is often required to meet your blood glucose goals. Some pre-mixed combinations are available. If you inject insulin with a syringe, you may be able to mix your rapid- or short-acting insulin with your intermediate or long-acting insulin before injection. Discuss this with your physician or Rite Aid Pharmacist first, as some insulin types should not be mixed together.
Insulin can be injected into a number of different sites, including the abdomen, thigh, upper arm, and buttocks. Insulin is absorbed differently depending on the site. Since insulin works the fastest when injected into the abdomen, that site is usually preferred. You should use the same general area for your injections at a particular time of day. Within an area, however, you should rotate your injection sites. Talk to your physician or Rite Aid Pharmacist to learn more about injecting insulin.
What's New in Diabetes Care?
Keeping tight control of your blood sugar when you have diabetes can be very challenging. Planning healthy meals, exercising, taking medications, and regularly monitoring your blood sugar aren't easy additions to any lifestyle. Fortunately, new medications and improved devices are becoming more readily available to assist you in managing your diabetes.
Incretin Mimetics
Victoza® (liraglutide [rDNA origin]) Injection is the newest incretin mimetic agent on the market. It is indicated to improve glycemic control in adults with type 2 diabetes mellitus along with diet and exercise. GLP-1 receptor agonists help the pancreas to make more insulin after eating a meal. Victoza is administered once daily at any time, independently of meals.
Victoza is not recommended as first-line therapy for patients inadequately controlled on diet and exercise and should be used cautiously in patients with a history of pancreatitis. This product is not for the treatment of type 1 diabetes mellitus or diabetic ketoacidosis and has not been studied in combination with insulin.
To ensure the safe and effective use of this product, Victoza was approved with a Risk Evaluation and Mitigation Strategy consisting of a Medication Guide and a Communication Plan to help patients and providers understand the risks of Victoza and to ensure that the benefits of the drug outweigh the risk of acute pancreatitis and the potential risk of medullary thyroid cancer.
Byetta™ (exenatide) Injection is an incretin mimetic for people with type 2 diabetes who have not been able to reach their blood sugar goals taking other oral medications, such as metformin and/or a sulfonylurea. Byetta stimulates the pancreas to secrete insulin only when blood glucose levels are high and particularly right after meals. Byetta may also contribute to weight loss. Byetta can only be administered by injection and should be given within 1 hour prior to the morning and evening meal.
Symlin® (pramlintide acetate) Injection is the first drug in a completely new class of diabetes medications. Symlin is very similar to a hormone the body produces called amylin. Amylin is produced by the body in the beta cells in the pancreas, just like insulin, but just in response to the food you eat. Symlin works by increasing the amount of time it takes your stomach to digest food thereby affecting how fast sugar enters your blood after eating. It also makes you feel satisfied from your meals sooner, which could lead you to eat less and lose weight. Symlin also tells your liver to release less sugar. It is indicated for people with type 1 and type 2 diabetes who are also taking mealtime insulin (regular, lispro, or aspart) but still not meeting their blood sugar goals. Symlin should be injected with insulin before meals. Taking Symlin with insulin may increase your risk for hypoglycemia or low blood sugar reactions. It is therefore very important that you are able to recognize when your blood sugar levels are dropping too low and that you know how to treat hypoglycemia.
For more information on these new diabetes medications, speak with your physician or Ask the Pharmacist.
Insulin Pens
Insulin pens allow people with diabetes to administer insulin doses with ease and convenience. Insulin pens are compact, portable and discreet. They typically contain 150 or 300 units 
of insulin and provide another option to the vial and syringe for administering most insulin formulations. They are available as both prefilled and reusable. The reusable pen requires the patient to load an insulin cartridge into the device and attach a pen needle, whereas the prefilled pen only requires that a needle be attached before injecting. A dose can be accurately selected by simply turning a dial. Depending on the pen, doses can be adjusted for half or full unit increments. Refer to the patient instructions for your particular product for specific injection and storage recommendations. You usually need to wait 5-6 seconds before removing the needle to assure the entire dose has been administered. The pen you are currently using can be carried with you, though extra pens should be stored in the refrigerator.
Injex™
For people with diabetes who need insulin, but aren't comfortable using a needle in any form, there is another option. Injex is a needle free system that propels the insulin at a very high rate of speed through the skin. The jet injector may be less painful, though you will feel a pressure with injections. Five to 30 units of a single formulation or mixed insulin can be drawn from a typical insulin vial into the Injex ampule. The device is then placed on the skin and a trigger is pushed to deliver the injection. Insulin can be administered in all of the same sites on the body as with other insulin delivery systems and normal rotation of injection sites is still important.
Insulin Delivery Devices of the Future
All people with Type 1 diabetes and many with Type 2, depend on insulin to manage their diabetes. Though insulin delivery devices have become less complicated, there are still many people with diabetes who find giving themselves multiple daily injections to be burdensome, and even more who avoid beginning insulin therapy due to a fear of injecting themselves. For those people and others with diabetes, there is good news. Research and development continue for additional dosing routes of insulin - including pumps, inhalers, patches and oral pills.
Helpful tips for storing insulin
In addition to some simple "dos" and "do nots" regarding the storage of insulin, there are multiple factors in determining how long insulin products should be kept once in-use. Generally, insulin not in-use (meaning never opened) should be stored in the refrigerator. Insulin vials in-use (or once opened) may be stored in the refrigerator or at room temperature. However, insulin should be at room temperature at the time of administration. Pens and other insulin devices available today are typically stored at room temperature once in-use. The following are more specific recommendations set forth by various organizations and manufacturers.
DO NOT:
- Use insulin beyond the manufacturer’s expiration date stamped on bottle
- Use insulin abnormal in appearance
- Freeze insulin or use product that has been frozen
- Shake insulin excessively
DO:
- Protect insulin from heat and light
- Inspect insulin prior to each use for abnormal appearance
Specific storage guidelines provided by the manufacturer of the particular insulin should always be followed.
Click here for a PDF chart outlining the Maximum Storage Recommendations for Human/Analog Insulin Products. The PDF is bext viewed using Adobe Reader version 6 or higher, which can be obtained from Adobe.
OTC Products
When living with diabetes, you may have questions about the use of nonprescription or over-the-counter (OTC) drugs to treat conditions like the common cold. Your Rite Aid Pharmacist is a valuable resource, and can provide information on the appropriate use of OTCs and how they may affect blood glucose. The more you know about OTC drugs and their effects, the better you can manage your blood glucose levels.
How may OTC products affect your blood glucose?
Many OTC products contain sugar and alcohol. Since sugar can raise your blood glucose, sugar-free products are preferred. Some OTC products may contain small amounts of alcohol. Alcohol may affect your blood glucose; therefore, caution is advised when using these products. Check with your Rite Aid Pharmacist for comparable sugar-free or alcohol-free products.
How do I choose OTC drugs, herbals, or supplements?
There are many choices for the common cold, indigestion, constipation, and other conditions remedied by OTCs. Your Rite Aid Pharmacist can give you good advice on choosing the one that will be best for you.
Here are some tips:
- Read the label and package insert carefully.
- Choose products that contain very little sugar.
- Choose products that contain little or no alcohol.
- Use the same pharmacy and make sure all of your health care providers know what prescription drugs and OTC products you are currently taking.
- Check your blood glucose more frequently while using these products.
OTC Product Recommendations
Cough and Cold
Provide temporary relief from cough |
Diabetic Tussin®, Robitussin Sugar Free®, Halls Sugar Free Cough Drops®, Rite Aid Sugar Free Lozenge |
Allergy
Provide temporary relief from runny nose, sneezing, itching, and watery eyes |
Benadryl®, Rite Aid complete Allergy, Claritin®, Alavert, Rite Aid Loratadine |
Nasal Spray
Provide temporary relief from dry nasal membranes |
Ocean Nasal Spray®
Rite Aid Saline Nasal Spray |
Pain Relief
Provide temporary relief from mild to moderate pain, inflammation, and reduce fever |
Tylenol®, Rite Aid Acetaminophen, Anacin®, Bayer®, Bufferin®, Ecotrin®, St. Joseph Adult Aspirin®, Rite Aid Aspirin, Advil®, Motrin®, Rite Aid Ibuprofen, Aleve®, Rite Aid Naproxen |
Laxative
Provide relief from constipation |
Sugar Free Metamucil®, Rite aid 100% Natural Psyllium Husk Fiber Sugar Free, Colace®, Rite Aid Col-Rite, FiberCon®, Rite Aid Fiber Cap |
Anti-Diarrheal
Help control the symptoms of diarrhea |
Imodium A-D®, Rite Aid Anti-Diarrheal, Pepto-Bismol Sugar Free Caplets® |
Indigestion/Heartburn
Provide temporary relief from heartburn and acid indigestion |
Gaviscon®, Axid®, Pepcid AC®, Rite Aid Famotidine, Tagamet®, Zantac®, Rite Aid Ranitidine, Tums EX Sugar Free®, Prilosec OTC®, Rite Aid Omeprazole |
View chart larger
