Medications - Diabetes in the Yukon

Transcription

Medications
FOR TYPE 2 DIABETES
DIABETES MEDICATION HANDOUT 2013.indd 1
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table of contents
Medications for Type 2 Diabetes.......................................................................2
Blood sugar medications....................................................................................3
Medications that help your insulin work well....................................................4
METFORMIN.................................................................................................4
ACTOS...........................................................................................................6
Medication that help block some sugars from being taken into the body....7
ACARBOSE...................................................................................................7
Medications that help your body to make more insulin..................................8
GLYBURIDE...................................................................................................8
GLICLAZIDE..................................................................................................9
GLUCONORM.............................................................................................10
JANUVIA......................................................................................................11
VICTOZA......................................................................................................12
Adding more insulin to your body....................................................................13
Remembering to take your medicine..............................................................14
Are my medication costs covered?.................................................................16
Contact and resource information...................................................................18
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MEDICATIONS FOR TYPE 2 DIABETES
Part of staying healthy with diabetes is keeping your blood sugar, blood
pressure and cholesterol (blood fats) on-target. This is the safest way to
delay and hopefully avoid diabetes complications such as heart attacks,
strokes, and damage to your eyes, nerves, and kidneys.
To get and stay on-target may mean taking medications to treat your blood
sugar, your blood pressure and/or your cholesterol. You may even be asked
to take medication just to keep your blood vessels healthy.
People with diabetes take medication to maintain their health and prevent
their condition from getting worse over time. This can be a big shift from
what you’re used to.
Sometimes medications have side effects. This can seem scary because
you certainly don’t want any more problems. Your doctor, nurse, and/or
pharmacist can help you reach a decision that’s right for you when balancing
the prevention of complications and the risk of side-effects.
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BLOOD SUGAR MEDICATIONS
Diabetes prevents your body from properly controlling the level of sugar in
your blood. When you eat, your pancreas releases a hormone called insulin,
which moves sugar out of the blood stream and into your cells for energy.
Without insulin or when insulin doesn’t work well, you can end up with high
blood sugar.
When you have Type 2 Diabetes you may be asked to take one or more
medications to help lower sugar levels in your blood. Sometimes you start a
medication at one dose and then take more until your blood sugar levels are
on-target.
Some medications:
1. Help your own body’s insulin to work well
2. Block some sugars from being taken into the body
3. Help your body to make more insulin
4. Add more insulin into your body
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MEDICATIONS THAT HELP YOUR INSULIN WORK WELL
METFORMIN
Another name for Metformin is Glucophage
How does this medication help diabetes?
• Metformin helps to lower your blood sugar by helping the cells in your
body to use insulin better.
• It lowers the amount of sugar made by your liver.
• Metformin may even help to protect your heart.
• Some people lose weight and a healthy weight helps control blood sugar
levels.
How to take this medication?
Some people get an upset stomach such as gas or diarrhea when they first
start taking Metformin. This usually goes away after a short time. When the
dose is increased an upset stomach can return before it goes away again.
To lower the chances of an upset stomach:
• Metformin can be taken with or after food and
• Metformin can be started at a low dose and slowly increased to the
most effective dose.
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Metformin comes in 500mg and 850mg tablets:
• People can take between 500mg and 2500mg a day.
• Doctors may suggest taking different amounts of
tablets between one and five times a day.
Glumetza is a special form of Metformin that only needs to
be taken once a day and comes in 500mg and 1000mg tablets.
What are the side effects?
• Metformin has few side effects. The most common side effect is an
upset stomach.
• Taking Metformin does not increase the amount of insulin in your body
so it will not cause low blood sugar (hypoglycemia).
• Metformin does not cause weight gain.
• When a person’s kidneys are not working well, they may be asked to
take a lower dose of Metformin or stop altogether.
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ACTOS
Another name for Actos is Pioglitazone
Actos helps the cells in your body accept insulin, which allows sugar to
move out of the blood and into cells. This lowers blood sugar.
How to take this medication?
• Actos is different from other medications because it can take several
weeks before blood sugars start to come down so it is important to take
your medication every day.
• The usual dose of Actos is between 15mg and 45mg, taken once a day.
• You can take the tablets with or without food.
• Actos is sometimes used together with Metformin.
• People with certain heart conditions cannot take this medication.
• Actos can sometimes cause weight gain.
• Taking Actos does not increase the amount of insulin in your body so it
will not cause low blood sugar (hypoglycemia).
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MEDICATION THAT HELP BLOCK
SOME SUGARS FROM BEING
TAKEN INTO THE BODY
ACARBOSE
Another name for Acarbose is Glucobay.
Acarbose prevents some of the
sugars, from the food you eat,
being absorbed into the blood.
How to take this medication
• Acarbose is taken with
meals.
SMALL INTESTINE
• It should be taken with your
first mouthful of food to make
sure it is in your stomach with
the meal that you eat.
LARGE INTESTINE
• Acarbose can cause gas, stomach cramping, and/or diarrhea
because the sugar that is not going into your blood stays in your
bowel (intestine).
• Taking Acarbose does not increase the amount of insulin in your
body so the chance of having a low blood sugar (hypoglycemia)
is very low. If you are already on insulin or another medication
that adds more insulin to the blood and you are also prescribed
Acarbose, you may be at risk for low blood sugar (hypoglycemia).
You will need to treat the low blood sugar with dextrose, not table
sugar, because Acarbose blocks some of the table sugar from being
absorbed into the blood.
• Some people lose a little bit of weight taking Acarbose.
B L O C K
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MEDICATIONS THAT HELP YOUR BODY TO MAKE
MORE INSULIN
GLYBURIDE
Another name for Glyburide is Diabeta.
Glyburide helps your pancreas to make more insulin. This extra insulin helps
move sugar out of the blood and into the cells.
• Glyburide needs to be taken 30 minutes before eating so that it has time
to start working.
• The dose of tablets may change over time depending on your blood
sugar results.
• Glyburide comes in 2.5mg, 5mg and 10mg tablets.
• The amount of Glyburide people can take each day is between 1.25mg
and 20mg.
• Doctors may suggest taking different amounts of Glyburide once or
twice a day, usually breakfast and supper.
• Taking Glyburide increases the amount of insulin in your body so it can
cause low blood sugar (hypoglycemia).
• People who take Glyburide need to learn how:
• Low blood sugar can affect them
• To treat low blood sugar
• To prevent low blood sugar.
take a lower dose of Glyburide or stop altogether.
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GLICLAZIDE
Another name for Gliclazide is Diamicron.
PANCREAS
Gliclazide helps the pancreas to make more insulin.
This extra insulin helps move sugar out of the blood
and into the cells.
• The usual dose of Gliclazide is between 80mg and
160mg twice daily, usually with breakfast and supper.
• The dose of tablets may change over time
depending on your blood sugar results.
• Gliclazide MR is a special form of Gliclazide that
only needs to be taken once a day. Because the
tablets release the medication slowly over the whole day, you should not
crush or chew these tablets. The usual does is 30mg-120mg once daily.
• In some people Gliclazide can cause a small amount of weight gain,
usually less than 5 pounds.
• Gliclazide can cause your skin to be more sensitive to sunlight. This
means you may burn more easily and/or get a rash when you are in the
sun. You should always wear sunscreen if you are taking Gliclazide.
• Taking Gliclazide increases the amount of insulin in your body so there is
a chance of having a low blood sugar (hypoglycemia). People who take
Gliclazide need to learn how:
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GLUCONORM
Another name for Gluconorm is Repaglanide.
Gluconorm works by helping your body produce more insulin right when you
eat a meal or snack. This helps to lower your blood sugars after eating.
• You should take Gluconorm when you start to eat a meal or snack. If
you miss a meal or snack you should NOT take the tablet meant for that
meal.
• You might be given a lower strength of tablet for when you eat snacks
than the one prescribed at meals.
• Your dose will depend on the times when your blood sugars are highest.
• Gluconorm is available as 0.5mg, 1mg and 2mg tablets.
• Gluconorm lowers your blood sugar by making the body produce more
insulin so it can cause low blood sugar (hypoglycemia). You can avoid
this by making sure you only take Gluconorm if you eat a meal or snack.
• People who take Gluconorm need to learn how:
• If you have liver disease you may need to have a lower dose of
Gluconorm or stop taking it altogether.
• Talk to your doctor before changing the amount of Gluconorm you take.
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JANUVIA
Another name for Januvia is Sitagliptin.
PANCREAS
• Januvia works on hormones in the
stomach that help the body make
more insulin.
• Januvia also lowers the amount of
sugar made by the liver.
• Januvia should be taken
SMALL INTESTINE
once a day with breakfast.
• If you forget to take Januvia,
take it as soon as you remember
but do not take two doses in the same day.
• Januvia is available as 25mg, 50mg or 100mg tablets
LARGE INTESTINE
• Januvia does not cause any changes in weight.
• The most common side effect is an upset stomach.
• Taking Januvia will not cause low blood sugar.
take a lower dose of Januvia or stop altogether.
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VICTOZA
Another name for Victoza is Liraglutide.
PANCREAS
• Victoza helps the body make more insulin
when blood sugar rises after a meal.
• It also keeps you feeling full longer after
eating.
• Some people lose weight and a
healthy weight helps control
blood sugar levels.
SMALL INTESTINE
LARGE INTESTINE
• Victoza is only available as an
injection (but is not insulin).
• You should inject Victoza once daily.
• Victoza needs to be stored in the fridge. Once you take the injection out
of the fridge write the date on it. Victoza is only usable for 30 days once
it reaches room temperature.
• The starting dose is 0.6mg daily. This can be increased weekly up to
1.8mg daily.
• Your diabetes educator, nurse, pharmacist, or doctor will show you how
to give an injection.
• The most common side effects are an upset stomach like diarrhea,
feeling sick and even throwing up.
• Very rarely it can cause pancreatitis (which is an inflamed/swollen
pancreas).
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ADDING MORE INSULIN TO YOUR BODY
Taking Insulin brings blood sugar levels down by moving sugar from the
blood into cells. There are different types of insulin available and you may be
prescribed one or more types depending on what works best for you.
1. Some insulin starts working right now and is gone in a few hours. These
types of insulin are known as rapid acting or fast acting/meal-time
insulin.
• Humalog, NovoRapid and Apidra are names of rapid acting insulins.
• Humulin R and Toronto are names of fast acting insulins. 2. Some insulin starts working more slowly and stays in your body for most
of the day. These types of insulin are known as long acting or very long
acting insulin.
• Humulin N and Novolin NPH are names of long acting insulins.
• Lantus and Levemir are names of very long acting insulins.
3. Some insulin is a blend of more than one type of insulin.
• For example, 30/70 insulin is a blend of fast and long acting insulin. • There are different mixtures available such as Humalog 25 and Novomix.
How do I take insulin?
• Insulin is only available as an injection.
• Your diabetes educator, nurse, pharmacist, or doctor will provide training for you when you need to start using insulin.
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REMEMBERING TO TAKE YOUR MEDICINE
No matter what medication is prescribed, it won’t do you any good if you
don’t take it! If you are having trouble taking your medications, ask yourself the
following questions and discuss the answers with your nurse, pharmacist, or
doctor.
•
•
•
•
•
Do you tend to be forgetful?
Are you confused about the instructions?
Do your medications have bothersome side effects?
Is your medicine too expensive?
Do you feel your diabetes is not serious or bothersome enough to need
regular medications? (People with diabetes often do not feel symptoms.)
• Have you, or someone you know, had a bad experience with the
medication?
• Are you afraid of becoming addicted or dependent on the medication?
• Are you embarrassed about taking the medication, view it as a failure or
weakness, or fear you’ll be judged negatively if people know about it?
When living with a chronic illness these are some of the common
challenges with taking medications and often simple changes can make
it easier. Organizing all the details needed to get every dose, each day is
part of managing your diabetes.
If forgetting to take your medications is a major problem, here are some
ideas that may help:
• Place the medication or a reminder note next to your toothbrush, on the
meal table, in your lunch box, or in some other place where you’re likely to
“stumble over” it.
• Make a medication chart listing each medication you are taking and when
you take it, or put a check on a calendar each time you take a dose.
• Set a watch or alarm (like the one on a cell phone) to beep at the times you
take each dose.
• Ask another person (like family/co-workers) to help remind you.
• Use a reusable daily or weekly medication container or ask the pharmacy to
package (blister pack) your medications. You can then see if you have taken
that day’s doses.
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If running out of medications is the challenge, then here is some information
that may help:
• Even if there are refills on a medication prescription, the pharmacy
cannot fill them one year after the prescription date.
• Don’t wait until your last pill or dose before refilling your prescription –
make an appointment with your Doctor once you pick up that last refill.
• Keep track of how many refills you have left by making a note on your
calendar to remind you when you should be running out.
• Check how much medication you have left before all doctor
appointments – it’s better to get a refill even if it’s a little early, instead of
waiting until you run out.
• Book an appointment specifically to review and refill all medications on
a regular basis.
• Allow time for the pharmacy to fill the prescription – they may be out of
your medication and need to order it in so don’t wait until the last day.
• Utilize delivery options if getting to the pharmacy is a problem for you.
• Make an appointment with yourself every few months to review your
medications, refills, and book needed doctor/nurse visits. If you are concerned about the side effects of your medication, confused
about the instructions, or even if you think your diabetes is not serious
enough for taking medication, it is very important that you speak with your
doctor, diabetes nurse or your pharmacist so that you have all of the correct
information before making a decision about your medications. There may
be simple solutions to other challenges or concerns, so don’t hesitate to ask
your health care provider.
(Adapted from the: “Living a Healthy Life with Chronic Conditions” manual, third
edition, Kate Lorig et al, 2006).
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ARE MY MEDICATION COSTS COVERED?
Sometimes the cost of diabetes medications can be covered by a
government or private health insurance program.
If you have Yukon Health Care and you are diagnosed with diabetes, your
doctor can refer you to the Chronic Disease Program to help cover the costs
of your diabetes medications and supplies.
If you have Yukon Health Care and are a senior your medication costs may
be covered by Pharmacare.
Status First Nation’s people may be covered under the national health care
plan called Non-Insured Health Benefits (NIHB).
If you have private insurance some of your medication costs may be
covered.
Pharmacists are a great resource to help you explore options for covering
your medication costs. In addition, you can visit: www.hss.gov.yk.ca/
drugformulary.php for a complete list of Chronic Disease Program and
Pharmacare medication coverage, or www.hc-sc.gc.ca, First Nation & Inuit
Health – Non-Insured Health Benefits, for the most up to date “Drug Benefit
List”.
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MEDICATION
CHRONIC PHARMACARE
NIHB
DISEASE
PROGRAM
Metformin
Glumetza
Actos
Yes
Yes
Yes
No
No
No
Requires Prior
Approval
Requires Prior
Requires Prior
Approval
Approval
Acarbose
Yes
Yes
Yes
Glyburide
Gliclazide
Yes
Yes
Yes
Yes
Yes
Yes
Gliclazide MR
Gluconorm
Yes
Yes
Yes
Yes
Yes
Yes
Januvia
Victoza
Humalog, Novorapid & Apidra
Requires Prior
Approval
Requires Prior
Requires Prior
Approval
Approval
No
No
No
Yes
Yes
Yes
Humulin R &
Toronto
Yes
Yes
Yes
Humulin N &
Novolin NPH
Yes
Yes
Yes
Lantus
Requires Prior Approval
Requires Prior
Approval
Yes
Levemir
Requires Prior Approval
Requires Prior
Approval
Yes
Humalog 25
Novomix
Yes
Yes
No
No
No
No
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CONTACT AND RESOURCE INFORMATION
For more information on diabetes management contact:
• The Government of Yukon • Chronic Conditions Support Program
867-393-7487 • [email protected]
• The Canadian Diabetes Association
www.diabetes.ca
•www.yukondiabetes.ca
• Online Chronic Disease Self-Management Program
www.selfmanage.org/onlinebc
1-866-902-3767
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NOTES
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NOTES
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C HR ONIC
C ONDITIONS
SUPPOR T
Health and Social Services
PR OGR AM
January 2014
1/16/14 4:56 PM

Medications - Diabetes in the Yukon

Transcription

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