The document summarizes the mode of action, average dose details, and maximum daily doses of several common oral anti-diabetic drugs according to the British National Formulary from March 2010. Metformin works by decreasing glucose production and increasing glucose uptake in the body, with an average dose of 1500 mg per day. Glibenclamide and gliclazide work by stimulating insulin secretion, with average doses of 10 mg and 60 mg respectively. Glipizide also stimulates insulin release, with an average dose of 10 mg. Glimerpride works similarly at an average dose of 3 mg. Repaglinide and natiglinide stimulate rapid, short-acting insulin

1. Mode of Action & Dose of Oral Anti-Diabetic Drugs
( Accordinf to the British National Formulary BNF March 2010)
Active Avr. Dose
Mode of Action Dose Details mg
Principle
Decreasing gluconeogenesis &
increasing peripheral utilization of Adult and Child over 10 years 500 mg with breakfast > one week > 500 mg with
Metformin 1500
glucose. Only if there is residual breakfast & dinner > one week > 500 mg with 3 meals
pancreatic function
Initially 5 rng daily with or immediately after break-fast, dose adjusted according
Glibenclamide 10
to response ; max. 15 mg daily
Initially 30 mg daily with breakfast, adjusted according to response every 4 weeks ;
Gliclazide(MR) 60
Augmentig Insulin secreation. During max. 120 mg daily
long term adminestration they have
extrapanceatic action Initially 2.5—5 mg daily shortly before breakfast or lunch, adjusted according to
Glipizide 10
response; max. 20 mg daily.Up to 15 mg (Sigle dose), higher doses divided.
Initially 1 mg daily, adjusted according to response at 1-2 week intervals; max. 4 mg
Glimerpride 3
daily taken shortly before or with first main meal
> 18 years, initially 500 micrograms within 30 minutes before main meals ; up to 4
Repaglinide 3
Stimulate insulin release. Both drugs mg may be given as a single dose, max. 16 mg daily
have a rapid onset of action and short
duration of activity > 18 years, initially 60 mg 3 times daily within 30 minutes before main meals, up
Natiglinide 180
to max. 180 mg 3 times daily
Inhibits intestinal glucosidase , delays > 18 years, initially 50 mg daily increased to 50 mg 3 times daily, max. 200 mg 3
Acarbose the digestion & absorption of starch & times daily Tablets should be chewed with first mouthful of food or swallowed 150
sucrose whole with a little liquid immediately before food
Reduce peripheral insulin resistance,
> 18 years, initially 15-30 mg once daily increased to 45 mg once daily according to
Pioglitazone leading to a reduction of blood-glucose 30
response
concentration
Inhibits dipeptidylpeptidase-4 so
Sitagliptin increases insulin secreation and > 18 years, 100 mg once daily 100
lowers glucagon secretion