Glyburide

Brand names

• Albert -Glyburide
• Apo-Glyburide
• Diabeta
• Euglucon
• Gen-Glybe
• Glubate
• Glynase Prestab
• Micronase
• Novo-Glyburide
• Nu-Glyburide
• PMS-Glyburide

Usage

To help control adult-onset (non-insulin-dependent or type 2) diabetes. Sometimes used in conjunction with other oral antidiabetic agents.

How it works

Glyburide stimulates the release of insulin by the pancreas and decreases sugar production in the liver.

Side effects

Serious

Serious side effects are related to hypoglycemia, or low blood sugar, whose symptoms include perspiration or a cold sweat, restlessness, rapid pulse, anxious feeling, nausea, feelings of dizziness, weakness, or lightheadedness, poor coordination, slurred speech, confusion, sleepiness, seizures, weakness of an arm, leg, or an entire side of the body, and fainting. Seek emergency assistance. Administer sugar-containing substances only if the patient is conscious and alert. Other serious but less common side effects include bone marrow suppression, hemolytic anemia, and elevation of liver-associated enzymes; these problems can be detected by your doctor.

Common

Bloating, heartburn, nausea, indigestion.

Less common

Blurred vision, changes in taste, itching, hives, joint or muscle pain.

Possible interactions

Other medicaments:

The following medicaments may increase the effects of glyburide:

• acarbose (Precose).
• aspirin and other salicylates (aspirin may also block disulfiram effect).
• chloramphenicol (Chloromycetin).
• cimetidine (Tagamet).
• ciprofloxacin (Cipro).
• clofibrate (Atromid-S).
• cotrimoxazole (various).
• fenfluramine (Pondimin).
• gemfibrozil (Lopid).
• monoamine oxidase (MAO) type A inhibitors.
• phenylbutazone (Butazolidin).
• ranitidine (Zantac).
• ritonavir (Norvir).
• sulfa medicaments such as trimethoprim/sulfamethoxazole (Septra) or erythromycin/sulfisoxazole (Pediazole).

The following medicaments may decrease the effects of glyburide:

• beta-blocker medicaments.
• bumetanide (Bumex).
• diazoxide (Proglycem).
• ethacrynic acid (Edecrin).
• furosemide (Lasix).
• phenytoin (Dilantin).
• rifampin (Rifadin, others).
• thiazide diuretics.
• thyroid hormones.

Glyburide taken concurrently with:

• antacids (containing magnesium hydroxide) or magnesium supplements may result in increased risk of excessively lowered blood sugar.
• antifungal agents (such as itraconazole or other azoles) may result in severe lowering of blood sugar.
• cyclosporine (Sandimmune) may increase cyclosporine levels by up to 57%.
• enalapril (Vasotec) may enhance blood sugar lowering effect.
• MAO inhibitors may increase risk of hyperglycemia.
• steroids (betamethasone, prednisone, others) blunts glyburide benefits.
• warfarin (Coumadin) may result in bleeding; more frequent INR (prothrombin time) testing is needed.

Foods:

Follow the diabetic diet prescribed by your physician.

Herbal medicines or minerals:

Using chromium may change the way your body is able to use sugar. Some health food stores advocate vanadium as mimicking the actions of insulin, but possible toxicity and need for rigorous studies presently preclude recommending it. Caution: St. John's wort may cause photosensitivity, and this medicament may too.
DHEA may change sensitivity to insulin or insulin resistance. Hawthorn, ginger, garlic, ginseng and licorice, nettle and yohimbe may change blood sugar. Since this may require adjustment of hypoglycemic medicine dosing, talk to your doctor before combining any of these herbal medicines with this medicine. Echinacea pupurea (injectable) and blonde psyllium seed or husk should not be taken by people living with diabetes.

Beverages:

As directed in the diabetic diet.

Alcohol:

Use with extreme caution-alcohol can exaggerate this medicament's hypoglycemic effect. This medicament can cause a disulfiramlike reaction: facial flushing, sweating, palpitation.

Exposure to sun:

Use caution until sensitivity has been determined. Some medicaments of this class can cause photosensitivity.

Occurrence of unrelated illness:

Acute infections, vomiting or diarrhea, serious injuries and surgical procedures can worsen diabetic control and may require insulin. If any of these conditions occur, consult your physician promptly.

Discontinuation:

Because of the possibility of secondary failure, it is advisable to evaluate the continued benefit of this medicament every 6 months.

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