Complete Diabetes Medications Table - Diabetes Educators Calgary

Updated November 13, 2019. To quickly search this medication table hold Ctrl+f (windows) or Cmd+f (mac) and type your search term; hit enter.

Product indications change. Verify at Canada's Health Product Database.
Questions to consider prior medication changes (also note Diabetes Canada's "Therapeutic Considerations for Renal Impairment")
Blue Cross Pharmacy Providers Price Files
Alberta Blue Cross coverage database. The legend used on this page for *Alberta Blue Cross coverage is:
- B - benefit (coverage provided)
- NB - not a benefit (no coverage provided)
- SA - special authorization/step therapy required (The form for SA of GLP-1, DPP-4 or SGLT is here. All other SA forms are on the Blue Cross Forms page).

Diabetes Medication Classes

For quick access, click the medication class:
Alpha-Glucosidase Inhibitor Biguanide (Metformin) DPP-4 Inhibitors	GLP-1 Agonists (Incretin Mimetics) SGLT Inhibitors Secretagogues	Thiazolidinediones -TZDs Combination Medications Insulins Glucagon

Alpha-Glucosidase Inhibitor

Generic name *Brand names (coverage) Cost/Month**	Available Strengths (max daily dose)	Usual Dosing	Health Canada Indications
Acarbose Glucobay® (B) $24-$33	50 or 100 mg	Three times daily (before meals)	Monotherapy or in combination with metformin, sulfonylurea or insulin

Biguanide (Metformin)

Generic name *Brand names (coverage) Cost/Month**	Available Strengths (max daily dose)	Usual Dosing	Health Canada Indications
Metformin Glucophage® (B) $7	500 mg, 850 mg (max 2000-2500 mg/day)	2-3 times daily	Monotherapy or in combination with other antihyperglycemic agents
Metformin extended release Glumetza® (NB) $21- $41	500 mg, 1000 mg (max 2000 mg/day)	Once daily	Monotherapy or in combination with other antihyperglycemic agents

DPP-4 Inhibitors

Generic name *Brand names (coverage) Cost/Month**	Available Strengths (max daily dose)	Usual Dosing	Health Canada Indications
Alogliptin Nesina® (NB) $79	6.25 mg, 12.5 mg, 25 mg (max 25 mg/day)	Once daily	Monotherapy or in combination with metformin, sulfonylurea, pioglitazone or insulin. Use of DPP-4 inhibitors with SGLT-2 inhibitors may not be outlined in the product monograph(s), but is an acceptable combination according to research.
Linagliptin Trajenta® (SA) $77	5 mg (max 5 mg/day)	Once daily	Monotherapy or in combination with metformin , sulfonylurea or with empagliflozin. Use of linagliptin with insulin may not be indicated in the product monograph, but is an acceptable combination according to research. Use of DPP-4 inhibitors with SGLT-2 inhibitors may not be outlined in the product monograph(s), but is an acceptable combination according to research.
Saxagliptin Onglyza® (SA) $72-$86	2.5 mg, 5 mg (max 5 mg/day)	Once daily	In combination with metformin, sulfonylurea, dapagliflozin or insulin. Use of DPP-4 inhibitors with SGLT-2 inhibitors may not be outlined in the product monograph(s), but is an acceptable combination according to research.
Sitagliptin Januvia® (SA) $89	25 mg, 50 mg, 100 mg (max 100 mg/day)	Once daily	Monotherapy or in combination with metformin, sulfonylurea, pioglitazone, dapagliflozin or insulin. Use of DPP-4 inhibitors with SGLT-2 inhibitors may not be outlined in the product monograph(s), but is an acceptable combination according to research. .

GLP-1 Agonists (Incretin Mimetics)

Generic name *Brand names (coverage) Cost/Month**	Available Strengths (max daily dose)	Usual Dosing	Health Canada Indications
Dulaglutide Trulicity® (NB) $225	0.75 mg, 1.5 mg (max 1.5 mg/week)	Once weekly injection	Monotherapy or in combination with metformin, sulfonylurea or insulin.
Exenatide ER (Extended Release) Bydureon® (NB) $225	2 mg (max 2 mg/week)	Once weekly injection	Monotherapy or in combination with metformin, sulfonylurea or basal insulin.
Exenatide ER (Extended Release) Bydureon BCise® (NB); not yet marketed	2 mg (max 2 mg/week)	Once weekly injection	Combination with metformin or sulfonylurea.
Exenatide Byetta® (NB) $150	5 mcg, 10 mcg (max 20 mcg/day)	Twice daily injection	Add-on to metformin or sulfonylurea or glargine.
Liraglutide Victoza® (NB) $175- $263	0.6 mg, 1.2 mg, 1.8 mg (max 1.8 mg/day)	Once daily injection	Monotherapy or in combination with metformin, sulfonylurea or basal insulin. There is limited experience with prandial insulin.
Lixisenatide Adlyxine® (NB) $120	10 ug, 20 ug (max 20 ug/day)	Once daily injection	Monotherapy or use with metformin, sulfonylurea, pioglitazone or basal insulin
Semaglutide Ozempic® (SA) $98 - $195 (NIHB Coverage -Non-insured health benefits for First Nations and Inuit)	0.25, 0.5 mg, 1 mg (max 1 mg/week)	Once weekly injection	Monotherapy or in combination with metformin, sulfonylurea or basal insulin. Prandial insulin has not been studied.

Secretagogues (Sulfonylureas and Meglitinides)

Generic name *Brand names (coverage) Cost/Month**	Available Strengths (max daily dose)	Usual Dosing	Health Canada Indications
Gliclazide Diamicron® (B) $3 - $11	80 mg (max 320 mg/day)	Twice daily	"Non- ketosis prone, maturity onset or adult type" diabetes
Gliclazide modified release Diamicron MR® (B) $3 - $14	30 mg, 60 mg (max 120 mg/day)	Once daily	"Non- ketosis prone, maturity onset or adult type" diabetes
Glimepiride Amaryl® (NB) $30	1 mg, 2 mg, 4 mg (max 8 mg/day)	Once daily	Monotherapy or with metformin or insulin
Glyburide Diabeta® (B) $2-$8	2.5 mg, 5 mg (max 20 mg/day)	Twice daily	Type 2 Diabetes
Repaglinide Gluconorm® (B) $10	0.5 mg, 1 mg, 2 mg (max 4 mg/meal; 16 mg/day)	At meals (optional HS snack)	Monotherapy or with metformin or rosiglitazone

SGLT Inhibitors (SGLT-1 and SGLT-2 Inhibitors)

Generic name *Brand names (coverage) Cost/Month**	Available Strengths (max daily dose)	Usual Dosing	Health Canada Indications
Canagliflozin (SGLT 2) Invokana® (SA) $81	100 mg, 300 mg (max 300 mg/day)	Once daily	Monotherapy or in combination with metformin, sulfonylurea, pioglitazone, sitagliptin or insulin or as add-on combination in patients with established cardiovascular disease. Use of other DPP-4 inhibitors with SGLT-2 inhibitors may not be outlined in the product monograph(s), but is an acceptable combination according to research.
Dapagliflozin (SGLT 2) Forxiga® (SA) $85	5 mg, 10 mg (max 10 mg/day)	Once daily	Monotherapy or in combination with metformin, sulfonylurea, sitagliptin or insulin. Use of other DPP-4 inhibitors with SGLT-2 inhibitors may not be outlined in the product monograph(s), but is an acceptable combination according to research.
Empagliflozin (SGLT 2) Jardiance® (SA) $80	10 mg, 25 mg (max 25 mg/day)	Once daily	Monotherapy or in combination with metformin, sulfonylurea, pioglitazone, linagliptin or insulin or as add-on combination in patients with established cardiovascular disease. Use of other DPP-4 inhibitors with SGLT-2 inhibitors may not be outlined in the product monograph(s), but is an acceptable combination according to research.
Ertugliflozin (SGLT 2) Steglatro® (NB) cost not available	5 mg, 15 mg (max 15 mg/day)	Once daily (morning)	Monotherapy or in combination with metformin, sitagliptin. Use of DPP-4 inhibitors with SGLT-2 inhibitors may not be outlined in the product monograph(s), but is an acceptable combination according to research.
Sotagliflozin (SGLT 1 & 2 Inhibitor) Zynquista® Not yet approved by Health Canada	Not yet approved by Health Canada		Not yet approved by Health Canada Indications are expected to be with type 1 diabetes first. (Consideration for type 2 diabetes requires completion of cardiovascular outcome trials.) Use of DPP-4 inhibitors with SGLT-2 inhibitors may not be outlined in the product monograph(s), but is an acceptable combination according to research.

Thiazolidinediones (TZDs)

Generic name *Brand names (coverage) Cost/Month**	Available Strengths (max daily dose)	Usual Dosing	Health Canada Indications
Rosiglitazone Avandia® (SA) $41 - $93	2 mg, 4 mg, 8 mg (max 8 mg/day)	Once daily	In combination with metformin or sulfonylurea. Prior to prescribing AVANDIA, physicians must: Document the eligibility of patients to meet the above criteria; Counsel each patient on the risks and benefits of AVANDIA, including the cardiovascular risks; and Obtain the patient’s written informed consent to take the drug.
Pioglitazone Actos® (SA) $11- $23	15 mg, 30 mg, 45 mg (max 45 mg/day)	Once daily	Monotherapy or in combination with metformin or sulfonylurea.

Combination Medications

Generic name (class) *Brand names (coverage) Cost/Month**	Available Strengths (max daily dose)	Usual Dosing	Health Canada Indications
Alogliptin (DPP-4) + Metformin Kazano® (NB) $82	12.5 mg / 500 mg 12.5 mg / 850 mg 12.5 mg / 1000 mg (max 25 mg + 2000 mg/day)	Twice daily	Alone or in combination with pioglitazone or insulin
Linagliptin (DPP-4) + Metformin Jentadueto® (SA) $160	2.5 mg + 500 mg 2.5 mg + 850 mg 2.5 mg + 1000 mg (max 5 mg + 2000 mg/day)	Twice daily	Alone or in combination with sulfonylurea or empagliflozin.
Sitagliptin (DPP-4) + Metformin Janumet® (SA) $96	50 mg / 500 mg 50 mg / 850 mg 50 mg / 1000 mg (max 100 mg + 2000 mg/day)	Twice daily	Alone or in combination with sulfonylurea, pioglitazone or insulin.
Sitagliptin (DPP-4) + Metformin modified release Janumet XR® (SA) $49 - $98	50 mg / 500 mg 50 mg / 1000 mg 100 mg / 1000 mg (max 100 mg + 2000 mg/day)	Once daily with a meal preferably in the evening	Alone or in combination with sulfonylurea, pioglitazone or insulin.
Sitagliptin (DPP-4) + Ertugliflozin (SGLT-2) Steglujan® (NB)	100 mg / 5 mg 100 mg / 15 mg	Once daily	Metformin
Saxagliptin (DPP-4) + Metformin Komboglyze® (SA) $82	2.5 mg + 500 mg 2.5 mg + 850 mg 2.5 mg + 1000 mg (max 5 mg + 2000 mg/day)	Twice daily	Alone or in combination with sulfonylurea or insulin.
Saxagliptin (DPP-4) + Dapagliflozin (SGLT-2) QTERN® (NB) $ - cost not available; not yet marketed	5 mg / 5 mg 5 mg / 10 mg (max 5 mg / 10 mg/day)	Once daily	On metformin and saxagliptin alone or already controlled with metformin, saxagliptin and dapagliflozin. Can be used with insulin.
Canagliflozin (SGLT-2) + Metformin Invokamet® (NB) $99	50 mg / 500 mg 50 mg / 850 mg 50 mg / 1000 mg 150 mg / 500 mg 150 mg / 850 mg 150 mg / 1000 mg (max 300 mg + 2000 mg/day)	Twice daily	Alone or in combination with sulfonylurea, pioglitazone or insulin.
Canagliflozin (SGLT-2) + Metformin modified release Invokamet XR® (NB); not yet marketed	50 mg / 500 mg 50 mg / 1000 mg 150 mg / 500 mg 150 mg / 1000 mg (max 300 mg + 2000 mg/day)	Once daily	Alone or in combination with sulfonylurea, pioglitazone or insulin.
Dapagliflozin (SGLT-2) + Metformin Xigduo® (SA) $85	5 mg / 850 mg 5 mg / 1000 mg (max 10 mg + 2000 mg/day)	Twice daily	Alone or in combination with sulfonylurea, sitagliptin or insulin.
Empagliflozin (SGLT-2) + Metformin Synjardy® (NB) $88	5 mg / 500 mg 5 mg / 850 mg 5 mg / 1000 mg 12.5 mg / 500 mg 12.5 mg / 850 mg 12.5 mg / 1000 mg (max 25 mg + 2000 mg/day)	Twice daily	Alone or in combination with sulfonylurea, pioglitazone or insulin (not premix).
Empagliflozin (SGLT-2) + Linagliptin (DPP-4) Glyxambi® (NB) $75	10 mg / 5 mg 25 mg / 5 mg (max 25 mg + 5 mg/day)	Once daily	Metformin
Ertugliflozin (SGLT-2) + Metformin Segluromet® (NB)	2.5 mg / 500 mg 2.5 mg / 1000 mg 7.5 mg / 500 mg 7.5 mg / 1000 mg (max 15 mg / 2000 mg )	Twice daily	Sitagliptin
Insulin degludec + liraglutide (GLP-1) Xultophy® (NB) $ - cost not available	1 unit of Xultophy contains 1 unit of degludec and 0.04 mg liraglutide (fixed ratio) Starting dose: 16 units Maximum dose: 50 units	Once daily injection	Type 2 diabetes in combination with metformin, with or without sulfonylurea, when these combined with basal insulin (< 50 units daily) or liraglutide (less than or equal to 1.8 mg daily), do not provide adequate glycemic control.
Insulin glargine + lixisenatide (GLP-1) Soliqua® (NB) $244 at max dose	1 unit of SOLIQUA contains 1 unit of insulin glargine and 0.33 mcg lixisenatide (fixed ratio) Starting dose: 15 units/day or 30 units/day Maximum dose: 60 units/day	Once daily injection	Type 2 diabetes on basal insulin (< 60 units daily and > 15 units per day) alone or in combination with metformin Taken before the first meal. Starting Doses: 15 units Soliqua (if current glargine dose < 30 units); 30 units Soliqua (if current glargine dose 30 to <60 units.) Take oral contraceptives at least 1 hour before or at least 11 hours after the dose of SOLIQUA. Suggested adjustments by fasting glucose of past 3 days: > 7.8 mmol/L add 4 units > 5.6 to < 7.8 mmol/L add 2 units 4.4 to 5.6 mmol/L, no change < 4.4 mmol/L subtract 2 units

Insulins

For quick access, click the type of insulin. Or, hold Ctrl+f (windows) or Cmd+f (mac) and type your search term; hit enter.

Bolus
Basal
Mixed

Bolus Insulins

Generic name *Brand names (coverage) Cost/box**	Pharmacodynamics Onset/Peak/Duration	Discard after room temp	Dosing Considerations
Aspart Novorapid® (B) vial $29; cartridges $59; prefills $61	10-20 min / 1-3 hrs / 3-5 hrs	28 days	May inject up to 10 minutes before a meal
Faster Insulin Aspart Fiasp® (coverage under review) vial $48, cartridges $85, prefills $88	5-15 min / 1-3 hrs / 3-5 hrs	28 days	May inject 2 mins before meal and up to 20 mins after starting meal Should not be mixed with other insulins Onset is 5 mins earlier than insulin aspart Time to peak is 11mins faster than insulin aspart Offset of effect occurs 12-14 mins earlier than insuilin aspart
Lispro 100 u/mL Admelog® (NB) - approved not yet marketed vial $NA; cartridges $NA; prefills $NA	30-45 min/ 1-3 hr / 3-5 hr	28 days
Lispro 100 u/mL Humalog® (B) vial $28; cartridges $56; prefills $56	30-45 min / 1-3 hr / 3-5 hrs	28 days
Lispro 200 u/mL Humalog® (B) prefills $102	Same as Lispro 100 u/mL 30-45 min / 1-3 hr / 3-5 hrs	28 days	Reserved for patients using > 20 units per day of rapid insulin. Not to be mixed with other insulins Not to be administered via SC infusion pump (not tested)
Glulisine Apidra® (B) vial $25; cartridges $50; prefills $50	10-15 min / 1-1.5 hrs / 3-5 hrs	28 days	Must not be refrigerated once opened
Regular Insulin Humulin R® (B) vial $22; cartridges $44	Refer to "regular insulin" line in the image Pharmacodynamic Action Profiles of Bolus Insulins 30-60 min / 2-4 hrs / 6-8 hrs	28 days
Regular Insulin Novolin ge Toronto® (B) vial $22; cartridges $42	Refer to "regular insulin" line in the image Pharmacodynamic Action Profiles of Bolus Insulins 30-60 min / 2-4 hrs / 6-8 hrs	One month
Insulin, human biosynthetic Entuzity® (NB) 500 u/mL - acts as bolus and basal. See in the Basal Insulin Chart below.	See in basal chart below	28 days

Basal Insulins

Generic name *Brand names (coverage) Cost/box**	Pharmacodynamics Onset/Peak/Duration	Discard after room temp	Dosing Considerations
Degludec Tresiba® (B) 2 concentrations 100 u/mL: prefills $113 200 u/mL: prefills $136 Also see Combination Medications	1 hr / no peak / 42 hrs	8 weeks	Doses dialed are per one "normal" unit; e,g, 80 units u100 = 80 units u200; the latter is contained in less volume. U100 pen delivers doses in 1 unit increments up to 80 unit per dose U200 pen delivers doses in 2 unit increments up to 160 unit increments Missed doses may be taken when remembered (during waking hrs). Ensure at least 8 hrs between missed dose and the next dose. Steady state serum concentration is reached after 3-4 days. You may wish to use the Tresiba titration handout. Reduce by 20% if patient has type 1 diabetes or if switching from bid basal Also available as the combination medication Xultophy® (degludec + liraglutide). See combination medications section.
Detemir Levemir® (B) cartridges $104; prefills $124	1.5 hrs / no peak / 16-24 hrs	42 days (6 weeks)
Insulin, human biosynthetic (basal and/or bolus) Entuzity® (NB) 500 u/mL prefills 2/box $92 prefills 5/box $unknown (each pen has 1500 units)	15 15 min / 4-8 hrs / 17-24 hrs	28 days	Indicated for those requiring over 200 units insulin/day Onset similar to U-100 Peak slightly lower than Humulin R U100 Time to peak is delayed (vs. Humulin R) Dose 30 minutes before meal Given 2-3 times daily When switching to Entuzity and HbA1c < 8% reduce TDD by 20% Pen delivers 5 unit increments
Insulin, human biosynthetic Humulin N ® (B) vial $30; cartridges $45; prefills $45	1-2 hrs / 5-8 hrs / 14-18 hrs	28 days
Insulin, human biosynthetic Novolin ge NPH® (B) vial $22; cartridges $44; prefills $45	Refer to NPH line in the image Pharmacodynamic Action Profiles of Long-Acting Insulins 1-2 hrs / 5-8 hrs / 14-18 hrs	One month
Glargine Lantus® (B) vial $62; cartridges $93; prefills $93 Also see Combination Medications for Soliqua®	1.5 hrs / no peak / 24 hrs	28 days	Reduce by 20% when switching from Toujeo to Lantus.
Glargine Basaglar® (B) cartridges $69; prefills $69	1.5 hrs / no peak / 24 hrs	28 days
Glargine 300 u/mL Toujeo® (NB) prefilled pens $80	up to 6 hrs / no peak / up to 36 hrs	42 days (6 weeks)	The prescribed dose of TOUJEO should always be expressed in units of insulin. See Toujeo dosing handout.

Mixed Insulins

Generic name *Brand names (coverage) Cost/Month**	Pharmacodynamics Onset/Peak/Duration	Discard after room temp (days)	Dosing Considerations
Lispro insulin (% Humalog)/ lispro protamine Humulin® Mix25 (B) Humulin® Mix50 (B) Cartridges $56, Prefills $56	Per insulins lispro (Humalog) and N	28 days
30% regular insulin (R) / 70% insulin isophane (N), Humulin® 30/70 (B) vial $23, cartridges $35	Per insulins R and N	28 days
Regular insulin (%Toronto) / insulin (%NPH) Novolin® ge 30/70 (B) Novolin® ge 40/60 (B) Novolin® ge 50/50 (B) cartridges $43	Per insulins Toronto and NPH	1 month
30% soluble insulin aspart (rapid)/ 70% insulin aspart protamine crystals (NPH) NovoMix® 30 (NB) cartridges $64	Per insulins aspart (Novorapid) and NPH	1 month

Glucagon

Generic name *Brand names (coverage) Cost/Month**	Storage	Supporting materials and other considerations
glucagon nasal powder BAQSIMI™ cost n/a approved by Health Canada but not yet available	Store BAQSIMI in the shrink wrapped tube at temperatures up to 30°C (86°F).	Lilly BAQSIMI (glucagon nasal powder) Patient Instructions
glucagon injection Glugagon Lilly (B) $89.97 per one kit	Prior to reconstitution, Vials of GLUCAGON and prefilled Hyporets of Diluting Solution may be stored at controlled room temperature, 15° to 30°C	Lilly Glucagon (injected) Instructions Video Lilly Glucagon (injected) Patient Print Instructions
glucagon injection GlucaGen® NovoNordisk (B) $84.41 per one kit	Prior to reconstitution, the shelf life of the product is 3 years. GlucaGen® should be stored at a temperature not exceeding 2-8°C. The sealed container should be protected from light and freezing should be avoided.	NovoNordisk GlucaGen (injected) Patient Instructions

*Verify Alberta Blue Cross coverage through their database.