Classifications: hormone; sulfonylurea; antidiabetic agent; Therapeutic: antidiabetic; sulfonylurea
Pregnancy Category: C
250 mg, 500 mg tablets
Lowers blood glucose by stimulating pancreatic beta cells to secrete insulin.
Promotes increased effectiveness of endogenous insulin in type 2 diabetes mellitus.
Mild to moderately severe stable type 2 diabetes mellitus. Preferred by some clinicians for patients who also have gout.
Hypersensitivity to sulfonylureas; severe impairment of hepatic, renal, thyroid, or other endocrine function; type 1 diabetics,
diabetic ketoacidosis; renal failure, renal impairment; pregnancy (category C), lactation. Safety and effectiveness in children
have not been established.
Renal insufficiency, hepatic impairment, history of hepatic porphyria, elderly.
Route & Dosage
Adult: PO 250 mg/d before breakfast, may be increased by 250500 mg q57d (max: 1.5 g/d); may be dosed b.i.d.
- Administer daily dose before breakfast.
- Divided doses are given before breakfast and dinner.
- Store at 15°30° C (59°86° F), unless otherwise directed.
Adverse Effects (≥1%)Body as a Whole:
Generally dose-related. Erythema
, urticaria, pruritus, rash, photosensitivity. GI:
Nausea, vomiting, epigastric fullness, anorexia, stomach pain or discomfort, heartburn, diarrhea
. Hematologic: Agranulocytosis, aplastic anemia, severe hypoglycemia, thrombocytopenia
Diagnostic Test Interference
Serum uric acid levels may be appreciably reduced.
may elicit disulfiram
reaction; warfarin, aspirin
and other salicylates
, chloramphenicol, clofibrate, fenfluramine, guanethidine, mao inhibitors
, oxytetracycline, phenylbutazone, probenecid, sulfinpyrazone,
may enhance hypoglycemic effects; with diazoxide
there is mutual antagonism and effects of both drugs are reduced; thiazide diuretics
may exacerbate hyperglycemia, resulting in need for increased acetohexamide doses; phenytoin
may decrease effects of acetohexamide; beta-adrenergic blockers
may mask symptoms
. Herbal: Garlic, ginseng
may increase hypoglycemic effects.
Rapidly from GI tract. Onset:
1 h. Peak:
24 h. Duration:
1224 h. Distribution:
Breast milk. Metabolism:
In liver to active metabolite
8095% in urine; 15% in bile. Half-Life:
Assessment & Drug Effects
- Monitor blood glucose levels closely during first 2448 h after therapy is initiated or the dose is changed.
- Monitor for S&S of hypoglycemia/exaggerated hypoglycemic response, particularly in older adults, malnourished, and debilitated
patients or those with impaired hepatic, renal function, adrenal, or pituitary insufficiency.
- Lab tests: Periodic blood glucose, HbA1C, and liver functions.
Patient & Family Education
- Ingest some form of sugar (e.g., orange juice, dissolved table sugar, corn syrup, honey) if symptoms of hypoglycemia develop,
and seek medical assistance.
- Check blood glucose as prescribed.
- Do not take any other medication unless approved by physician.
- Alcoholic beverages may produce a disulfiram-type reaction (see Appendix F).
- Avoid prolonged direct exposure to sun to prevent photosensitivity reaction.
- Report dermatologic reactions such as rash or itching.