Updated MIMS table helps prescribers adjust doses of diabetes combination products

The expanded MIMS table of dose adjustments for antidiabetic drugs in renal impairment now provides guidance on dosing of the following antidiabetic combinations in patients with kidney disease, based on CrCl or eGFR values:

• Long-acting insulins/GLP-1 agonists
• Dipeptidyl peptidase 4 inhibitors/metformin 
• Dipeptidyl peptidase 4 inhibitors/SGLT2 inhibitors
• Glitazones/metformin
• SGLT2 inhibitors/metformin

The guidance on metformin combination preparations reflects the recommended maximum daily metformin dose of 2g/day in patients with moderate renal impairment stage 3a (GFR 45-59ml/min) and 1g/day in patients with stage 3b (GFR 30-45ml/min). Metformin-containing products are contraindicated in patients with an eGFR less than 30ml/min.

Drug names for all preparations link through to the full MIMS entries for more detailed prescribing information.

Information is summarised from manufacturers' Summaries of Product Characteristics (SPCs), available at medicines.org.uk.