| Class |
drugs |
Other therapeutic considerations |
coverage |
SA criteria |
| Biguanide |
metformin |
covered |
| Alpha-glucosidase inhibitor (acarbose) |
acarbose |
Improved postprandial control, GI side-effects |
delisted |
| Incretin agent: DPP-4 Inhibitors |
linagliptin (Trajenta) |
SA |
same as onglyza |
| sitagliptin (Januvia) |
delisted |
| saxagliptin (Onglyza) |
SA |
As part of a combination treatment for type 2 diabetes mellitus, 1) When insulin NPH is not an option
AND
2) After inadequate glycemic control on maximum tolerated doses of dual therapy of metformin AND a sulfonylurea. |
| Incretin agent: GLP-1 receptor agonists |
liraglutide (Victoza) |
GI side-effects |
not listed |
| Insulin |
rapid acting (Humalog, novorapid, apidra) |
No dose ceiling, flexible regiments |
partial coverage |
| short acting (Humulin R, Novolin Toronto) |
covered |
| NPH |
covered |
| Premixed (Humulin 30/70, Novolin 30/70, 40/60, 50/50) |
covered |
| Premixed (Humalog mix 25, mix 50, Novomix 30) |
partial coverage |
| glargine (Lantus) |
SA |
A) Type 1 DM or B) Type 2 DM > 17 years old, and 1) requiring insulin and is currently taking insulin NPH and/or pre-mix insulin daily at optimal dosing
AND
2) Has experienced unexplained nocturnal hypoglycemia at least once a month despite optimal management
OR
3) Has experienced or continues to experience severe, systemic or local allergic reaction to existing insulin treatment. |
| detemir (Levemir) |
SA |
same as Lantus |
| new glargine (Toujeo) |
not listed |
| Insulin secretagogue: Meglitinide |
repaglinide (gluconorm) |
Less hypoglycemia in context of missed meals but usually requires TID to QID dosing |
not listed |
| Insulin secretagogue: Sulfonylurea |
glyburide |
Gliclazide and glimepiride associated with less hypoglycemia than glyburide |
covered |
| gliclazide |
SA (listed everywhere else in Canada) |
Treatment failure or intolerance to at least one other sulfonylurea drug (e.g., glyburide, tolbutamide) at adequate doses. |
| SGLT2 inhibitors |
canagliflozin (Invokana) |
UTI, genital infections, hypotension, hyperlipidemia, caution with renal dysfunction and loop diuretics, dapagliflozin not to be used if bladder cancer, rare diabetic ketoacidosis (may occur with no hyperglycemia) |
1 year manufacturer coverage with special plan |
| dapagliflozin (Forxiga) |
1 year manufacturer coverage with special plan |
| empagliflozin (Jardiance) |
not listed |
| TZD |
rosiglitazone |
CHF, edema, fractures, rare bladder cancer (pioglitazone), cardiovascular controversy (rosiglitazone), 6-12 weeks required for maximal effect |
delisted |
| pioglitazone |
SA |
same as onglyza |
| Weight loss agent (orlistat) |
orlistat |
GI side effects |
not listed |
| Combination Drugs |
sitagliptin and metformin (Janumet) |
delisted |
| linagliptin and metformin (Jentadueto) |
SA |
same as onglyza |
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