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On-line Diabetes Resources

Part 11: Diabetes Medications Web Sites

By David Mendosa

Last Update: June 20, 2011

This Web page brings together in one place descriptions of and links to those Web pages of companies marketing medications for blood glucose control and certain complications of diabetes. In some cases, where company information is particularly sparse, it is augmented by information on other Web sites. A separate Web page describes and links insulin at http://www.mendosa.com/insulin.htm. These pages are also linked to the 15 other On-line Diabetes Resources pages dealing with other Web pages, other parts of the Internet, and other on-line services. Those links that I think are especially valuable are marked in red.

On-line Medication Resources

  • Drugs.com is a new Internet drug information resource. You have to register, but it's free. Drugs.com gets its main database and Care Guide information from Micromedex, a part of the global Thomson Health Care Information group. The Drug Interactions information comes from Multum Information Services, a company that specializes in solutions to the growing problem of adverse drug events. A pharmacist at Drugs.com tells me that the site contains about 24,000 drug names. It unfortunately has an interface that makes entering more than a few items tedious. The URL is
    http://www.drugs.com/

  • Drugstore.com has an excellent and easy-to-use drug interaction tool, albeit one that is hard to find. The URL is Drug Interactions

  • The Express Scripts “Check Interactions” site is http://www.drugdigest.org/DD/Interaction/ChooseDrugs/1,4109,,00.html.

  • Another drug interaction site is the “Drug Interaction Checker.” The URL of this tool is http://www.healthline.com/druginteractions.

  • The Diabetes Monitor: Medications has many links to Web sites about diabetes medications. The URL is
    http://www.diabetesmonitor.com/other-05.htm

  • RxList - The Internet Drug Index is a free, searchable database of more than 4,500 prescription and over-the-counter medications. The search engine uses fuzzy logic, so you can often find a drug even when you misspell its name. The URL is
    http://www.rxlist.com/

  • Healthtouch® Drug Information enables you to find information about more than 10,000 prescription and over-the-counter medications. You can enter either the generic or brand name of the drug, but you have to spell it correctly. While it includes more drugs than RxList, the information it provides is less detailed. The URL is
    http://www.healthtouch.com/level1/p_dri.htm

  • Johns Hopkins IntelliHealth lets you search its U. S. Pharmacopeia database for drug information. The URL is
    http://www.intelihealth.com/email/drugs


Oral Hypoglycemic Agents—"Diabetes Pills"

Oral hypoglycemic agents or "diabetes pills" are used to treat type 2 diabetes. They are not insulin.

This Web page lists the classes of these medications currently available, the brand (and generic names), the companies marketing them in the United States, and the Web sites of those companies. The classes are listed in order of introduction, and within the classes the medications are listed in alphabetical order by generic name:

Sulfonylureas

Sulfonylureas help the body release more insulin.

First Generation Sulfonylureas (marketed before 1984)
  • Dymelor (acetohexamide)
    Rarely prescribed
    Eli Lilly and Company

  • Diabinese (chlorpropamide)
    A generic name product is available.

  • Orinase (tolbutamide)
    Pharmacia & Upjohn Inc.
    Pharmacia & Upjohn advises that the company stopped making Orinase in 2000.
    A generic name product is available.

    Tolbutamide was discovered in Germany in 1954 and in November 1955 began clinical trials in the United States, according to an article by William L. Laurence in the February 24, 1957, issue of The New York Times ("Science in Review: Drug for the Treatment of Diabetes Tested And Found of Great Importance," p. 179). "It is being produced in this country by the Upjohn Company of Kalamazoo, Mich., under the trade name Orinase."

  • Tolinase (tolazamide)
    Pharmacia & Upjohn Inc.
    http://pharmacia.com/prescription/PDF_Current/Tolinase.pdf has full prescribing information as of January 2000.
    A generic name product is also available.

Second Generation Sulfonylureas (i.e., marketed since 1984)

  • Amaryl (glimepiride)
    Sanofi-Aventis S.A.
    The Amaryl site is
    http://www.amaryl.com/ A generic name product also became available in October 2005.

  • Diamicron (Gliclazide)
    Not commercially available in the U.S., but for sale in Canada, Australia, New Zealand, South Africa, etc. Other brand names include Ziclin and Glucomed. No product-specific Web site.

  • Glucotrol XL (glipizide)
    Pfizer Inc.
    The Pfizer site has prescribing information at
    http://www.pfizer.com/pfizer/download/uspi_glucotrol_xl.pdf
    A generic name product is also available.

  • Diaßeta (glyburide in the U.S. and Canada; glibenclamide in most of the rest of the world)
    Aventis S.A.
    http://www.aventis-us.com/PIs/diabeta_TXT.html has prescribing information as of April 2004.
    A generic name product is also available.

  • Glynase PresTab (glyburide in the U.S. and Canada; glibenclamide in most of the rest of the world)
    Pharmacia & Upjohn Inc.
    http://pharmacia.com/prescription/PDF_Current/Glynase.pdf has prescribing information as of January 2000.
    A generic name product is also available.

  • Micronase (glyburide in the U.S. and Canada; glibenclamide in most of the rest of the world)
    Pharmacia & Upjohn Inc.
    http://pharmacia.com/prescription/PDF_Current/Micronas.pdf has prescribing information as of January 2000.
    A generic name product is also available.

Biguanides

Biguanides make the insulin the body is producing work better.

  • Glucophage (metformin HCI tablets)
    The U.S. Food and Drug Administration approved the marketing of metformin in May 1995. Bristol-Myers Squibb Company
    Glucophage

  • Glucophage XR (metformin HCl extended release tablets)
    Bristol-Myers Squibb Company
    Glucophage XR is a once-daily dosage form of Glucophage.
    Glucophage XR

    Generic metformin is now also available, including Glumetza XR, an extended release formula. 

Alpha-Glucosidase

Alpha-Glucosidase inhibitors delay the digestion of sugars and starches.

  • Precose (acarbose)
    The U.S. Food and Drug Administration approved the marketing of Precose in September 1995. Known as Prandase in Canada
    Bayer Corporation's Pharmaceutical Division, North America
    http://www.bayerpharma-na.com/products/co03precose.asp
    Prescribing Information: http://www.univgraph.com/Bayer/inserts/Precose.pdf

  • Glyset (miglitol)
    Pharmacia & Upjohn Inc. has been granted marketing rights to Bayer's miglitol for marketing in the United States, Canada, Australia, and New Zealand under the tradename Glyset. The U.S. Food and Drug Administration approved the marketing of Glyset in December 1996. Sanofi holds the European rights to miglitol and has launched it in Germany as Diastabol. Bayer recently granted Sanwa Kagaku Japanese development rights to the product.
    http://pharmacia.com/prescription/PDF_Current/Glyset.pdf has full prescribing information as of September 1999.

Thiazolidinedione

Thiazolidinedione makes the insulin the body is producing work better.

  • Avandia (rosiglitazone maleate)
    Avandia is a treatment for type 2 diabetes developed by GlaxoSmithKline that the U.S. Food and Drug Administration approved in May 1999. By reducing insulin resistance Avandia significantly improves blood sugar control. The company's Web site is
    http://www.avandia.com/

  • Actos (pioglitazone hydrochloride)
    Developed by Japan's Takeda Chemicals Industries Ltd. and marketed in the United States by Eli Lilly, Actos was approved by the U.S. Food and Drug Administration in July 1999. The URL is
    http://www.actos.com/

Meglitinide

Meglitinide stimulates insulin secretion from the beta cells of the pancreas.

Amino acid D-phenylalanine Derivative

This drug restores early insulin secretion.

Amylinomimetics

This new class of drugs enhances glucose-dependent insulin secretion by the pancreatic beta-cell, suppresses inappropriately elevated glucagon secretion, and slows gastric emptying.

  • Symlin (pramlintide acetate)
    Symlin injection is a synthetic analog of human amylin. It is the first member of a new class of amylinomimetic compounds. The U.S. Food and Drug Aministration approved it in March 2005.
    http://www.symlin.com/

Incretin Mimetics

This new class of drugs enhances glucose-dependent insulin secretion by the pancreatic beta-cell, suppresses inappropriately elevated glucagon secretion, and slows gastric emptying.

DPP-4 Inhibitors

  • Januvia (sitagliptin phosphate)
      The Food and Drug Administration approved Januvia for type 2 diabetes on October 17, 2006, as both monotherapy and as add-on therapy to either of two other types of oral diabetes medications, metformin or thiazolidinediones. Januvia doesn't help people with type 1 diabetes or diabetic ketoacidosis. Merck & Co. markets Januvia in the United States.
      Prescribing Information: http://www.merck.com/product/usa/pi_circulars/j/januvia/januvia_pi.pdf
  • Onglyza (Saxagliptin)
  • Tradjenta™ (linagliptin)

      The U.S. Food and Drug Administration approved Tradjenta™ (linagliptin), a new once-daily oral treatment for type 2 diabetes in January 2011. Tradjenta is indicated as an add-on therapy to diet and exercise to to lower blood sugar in adults with type 2 diabetes. It is the first member of the medicine class known as DPP-4 inhibitors to be approved at one dosage strength (5 mg) regardless of kidney or liver impairment. Tradjenta should not be used in patients with type 1 diabetes or for the treatment of diabetic ketoacidosis (increased ketones in the blood or urine). It has not been studied in combination with insulin. Prescribing Information: Click Here

    Colesevelam HCl

  • Welchol (colesevelam HCl)
      The Food and Drug Administration approved Welchol for type 2 diabetes in January 2008. The FDA had previously approved it in 2000 for controlling high LDL cholesterol. Welchol is the only approved medication for both conditions. It is also one of the few approved diabetes drugs that doesn't generally cause weight gain.
      Prescribing Information: http://welchol.com/pdf/Welchol_PI.pdf

    Combinations

    These drugs combine two oral medications.

    Other Resources

    NovoMedLink Diabetes Patient Care has diabetes patient care information and resources for health care professionals. The URL is
    http://www.novomedlink.com/diabetes/

    An excellent (albeit not completely up to date) website about forthcoming drugs is maintained by the Pharmaceutical Research and Manufacturers of America (the trade or lobbying group) at
    http://www.phrma.org/newmedicines/

    World-wide sales of oral diabetes medications reached $7.8 billion in 2003, according to analysts from SG Cowen Securities Corporation, a U.S. securities and investment banking firm focused on the emerging growth sectors of health care and other markets. This includes glitazones, $3.6 billion; sulfonylureas, $1.0 billion, and other, $3.7 billion (meanwhile insulin sales totalled $4.7 billion). They reported this at a March 2004 investment conference in Boston last week, according to Kelly Close in Diabetes Close Up, V3, #6 March 17, 2004. Her website is http://www.closeconcerns.com.

    Please also refer to my article in the September 2000 issue of Diabetes Wellness Letter, "Smart Drugs: Are We Ready For Them?" This article is online at http://www.mendosa.com/starlix.htm.

    The May 1998 issue of Diabetes Wellness Letter, included another article about new hypoglycemic agents, "Beyond Sulfonylureas: The New Drugs for Blood Glucose Control." This article is online at http://www.mendosa.com/newdrugs.htm

    Good sources for additional information about several of these drugs are PharmInfoNet, Medications, http://www.pharmacytimes.com/diabetesce.html, and Oral Diabetes Medication Information.

    The Geriatric Drug Review: Diabetes by Alan Lukazewski, Registered Pharmacist and Certified Diabetes Educator, is a valuable resource for anyone over 50 who has diabetes. This is probably the most important Web page about diabetes on AgeNet, which provides resources for older adults and caregivers. The site also has an "Ask a Pharmacist" area where visitors can e-mail a pharmacist and Certified Diabetes Educator about drugs specific to the aging population. The URL is
    http://www.agenet.com/drug_review_diabetes.html


    Selected Medications for Diabetic Complications

    Diabetes can lead to several complications. The best starting point for the various complications is the Diabetes Monitor's Web page Complications and their Prevention

    Medications for three of the most common complications include:

      Intermittent Claudication

      • Pletal (cilostazol)
         Otsuka America Pharmaceutical Inc.
        Pletal (cilostazol) is a new medicine for intermittent claudication, which is a symptom of peripheral arterial disease. PAD is one of the most significant health problems affecting older people with diabetes. Most people know PAD as "hardening of the arteries." You also may have heard it called atherosclerosis.

      Diabetic Nephropathy

      Foot Ulcers

      • Regranex® (becaplermin)
        Ortho-McNeil Pharmaceutical Inc.
        REGRANEX (becaplermin) Gel 0.01%

      • Apligraf® (Graftskin)
        Organogenesis Inc.
        Organogenesis Inc. in Canton, Massachusetts, had developed Apligraf (Graftskin), a manufactured skin construct. In June 2000 the Food and Drug Administration has approved Apligraf for use with conventional diabetic foot ulcer care in the treatment of diabetic foot ulcers of greater than 3 weeks duration. Novartis Pharma AG has global marketing rights for Apligraf.

      • Dermagraft®
        Advanced Tissue Sciences Inc.
        Advanced Tissue Sciences Inc. in La Jolla, California, sells Dermagraft in Canada, the United Kingdom, several other European countries, Australia, and New Zealand. The FDA in October 2001 approved the Premarket Approval Application (PMA) for Dermagraft in the treatment of chronic foot ulcers in patients with diabetes in the United States.

    Clinical Trials

    The pre-clinical trials for most drugs average about 18 months, according to the FDA or 5 years, according to Zeke Ashton on The Motley Fool. Clinical trials normally take another 2 to 10 years, according to the FDA and 5 to 9 years, according to Zeke Ashton. The FDA review process takes 2 months to 7 years, averaging 24 months, the FDA says.

    The current costs of bringing a new medicine to market are estimated to be as high as $0.8 to 1.7 billion.

    The The Food and Drug Administration says that of 100 drugs for which developers submit investigational new drug applications are submitted to it, about 70 will successfully complete phase 1 trials and go on to phase 2. About 33 of the original 100 will complete phase 2 and go to phase 3. And 25 to 30 of the original 100 will clear phase 3. Therefore, on average, about 20 of the original 100 will ultimately be approved for marketing.

    There has been an explosion of Web sites matching patients with manufacturers who are testing proposed drugs in clinical trials. I wrote about some of them for my ADA column "About the Internet" in May 2000 at: http://www.mendosa.com/clinicaltrials.htm, but there are now several more:

    • Acurian Inc. in Horsham, Pennsylvania, lists hundreds of clinicial trials for diabetes. Much of that information, according to the site, is licensed from CenterWatch (see below). The URL is
      http://www.acurian.com/index.jsp

    • Diabetes Clinical Trials is an Aventis Pharmaceuticals site for their drugs. The URL is
      https://clinicaltrials.aventis-us.com/ct/

    • Bari 2D, the Bypass Angioplasty Revascularization Investigation (BARI) 2 Diabetes, is a program to study whether, in patients with type 2 diabetes, initial treatment with angioplasty or bypass surgery is better than initial treatment with a medical program. At the same time, BARI 2D will compare two approaches to control blood sugar: providing insulin stimulating medication or providing medication that sensitizes the body to the available insulin. The URL is
      http://www.bari2d.org/

    • CenterWatch in Boston, Massachusetts, was probably the first clinical trials site and still one of the largest. When searched most recently, this site showed 466 trials in progress for types 1 and 2 diabetes, but many are duplicates at different places. The URL is
      http://www.centerwatch.com.

    • ClinicalTrials.com in Severna Park, Maryland, offers information for current clinical trials being conducted nationwide, with the opportunity for volunteers to register for current and future study information. In addition, it organizes contact information for more than 20,000 health agencies and support groups in more than 1,500 cities. When searched most recently, this site showed about 120 trials in progress for types 1 and 2 diabetes, but many are duplicates at different places. The URL is
      http://www.clinicaltrials.com/.

    • ClinicalTrials.gov is a service of the U.S. National Institutes of Health in Bethesda, Maryland. This site currently contains studies sponsored primarily by the National Institutes of Health, but additional studies from other Federal agencies and the pharmaceutical industry will be included soon. When searched most recently, this site showed 106 studies of diabetes, some of which are not yet recruiting. The URL is
      http://clinicaltrials.gov.

    • ICSL Clinical Studies in Providence, Rhode Island, is a medical research organization that works with pharmaceutical companies to search for safe and effective medications for a wide range of diseases, including diabetes. Presently, ICSL Clinical Studies has approximately 50 research facilities throughout the United States, nearly 30 of which have detailed profiles on the company's Web site. The company is currently conducting 14 different diabetes studies at multiple research locations nationwide. ICSL Clinical Studies' professionals can be contacted directly via the Web site about participation in a currently enrolling study. The URL is
      http://www.icsltd.net/clinicalstudies

    • Lilly has begun recruiting patients for Phase III clinical trials of lidorestat, a correspondent reports on August 27, 2002. "Interestingly, it was not on the list of clinical trials on Lilly's own website," he writes. "But neuropathic diabetics can call Lilly's toll-free number to be pre-screened and to find out if a medical center or doctor near them is participating." The number to call is (800) 545-5979.

    • Radiant Research in Kirkland, Washington, conducts Phase 1 to 4 clinical trials for pharmaceutical and biotechnology companies. "One of our more developed therapeutic specialities is in the area of diabetes research," writes Jeff Jensen, the company's regional ops director. "Currently, Radiant Research is enrolling patients into 31 separate diabetes trials." The URL is
      http://www.radiantresearch.com/

    • GlaxoSmithKline is one of the world's largest pharmaceutical companies. It is conducting a long-term research study to compare the effects of three FDA-approved medications on types 1 and 2 diabetes. The URL is
      http://www.newdiabetes.com.

    • TheHealthExchange in Stamford, Connecticut, is dedicated to connecting people with clinical trials. When searched most recently, this site showed about 50 trials in progress for diabetes. The URL is
      thehealthexchange.org.

    • Veritas Medicine in Cambridge, Massachusetts, provides extensive original content from physicians at hospitals affiliated with Harvard and Tufts universities to help patients choose appropriate clinical trials in which to participate. When searched most recently, this site listed 35 drugs in development for diabetes, but unlike other clinical trials sites it contains extensive information about each drug, including its drug class, approval status, side effects, the pharmaceutical company(ies) marketing it, additional information, and reference articles. The URL is
      http://www.veritasmedicine.com.

      The double-blind placebo-controlled trial is one of the major scientific advances of the 20th century, with consequences of a magnitude greater than is generally understood. Dr. Steven Bratman writes clearly and fully on this important subject and authorizes me to make it available here. The URL is http://www.mendosa.com/bratman.htm.

    [Go to Insulin Web Page] Go to Insulin Resources Page

    [Go to Medline Web Page] Go back to Medline Web Resources Page

    You may quote part of this page in on-line documents and printed publications, but please notify me so I can add a reference and make sure that you add pointers to the places where people can get the latest version.

    Permission to link this site to yours is not needed. Of course, I would be delighted to hear from you, especially if you have a new site that you think should be linked here.

    I have no control over the content or continued existence of any external on-line resources linked here, and I therefore cannot guarantee that they will function as promised. The appearance of a site on this list does not imply any endorsement by me.

    Since this information is constantly changing, readers are urged to email corrections and updates to me at mendosa@mendosa.com.

    If you have a question about your health, please go to either Diabetes Questions & Answers at the Diabetes Monitor, or use the Question Form for the Diabetes Team at Children with Diabetes.

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