DiaBeta, Euglucon , Glynase, Micronase
Classifications: hormone; antidiabetic agent; sulfonylurea; Therapeutic: antidiabetic; sulfonylurea
Pregnancy Category: C
1.25 mg, 2.5 mg, 5 mg tablets; 1.5 mg, 3 mg, 4.5 mg, 6 mg micronized tablets
One of the most potent of the second-generation sulfonylurea hypoglycemic agents. Potency is enhanced by as much as 200-fold
over first-generation agents. Appears to lower blood sugar concentration in both diabetic and nondiabetic individuals by sensitizing
functioning pancreatic beta cells to release insulin in the presence of elevated serum glucose levels.
Blood glucose-lowering effect persists during long-term glyburide treatment, but there is a gradual decline in meal-stimulated
secretion of endogenous insulin toward pretreatment levels.
Adjunct to diet to lower blood glucose in patients with type 2 diabetes mellitus; after dietary control alone has failed.
Hypersensitivity to glyburide or sulfonylureas; diabetic ketoacidosis; as sole therapy for type 2 diabetes mellitus; moderate
or severe renal impairment (Clcr <50 mL/min) or renal failure; pregnancy (category C); withhold 14 d before labor and delivery; lactation. Safe use in children
is not established.
Limit use in patients with cardiovascular disease; thyroid disease; mild renal impairment or hepatic disease; older adults,
debilitated, or malnourished patients; adrenal or pituitary insufficiency.
Route & Dosage
|Control of Hyperglycemia
Adult: PO 1.255 mg/d with breakfast, may increase by 2.55 mg q12wk; >15 mg/d should be given in divided doses with
morning and evening meal (max: 20 mg/d); Micronized 1.53 mg/d (max: 12 mg/d)
- Give once daily in the morning with breakfast or with first main meal.
- Store in tightly closed, light-resistant container at 15°30° C (59°86° F).
Adverse Effects (≥1%)Metabolic: Hypoglycemia
Epigastric fullness, heartburn, nausea, vomiting. Skin:
, urticarial or cholestatic jaundice
(rare) morbilliform eruptions. Special Senses:
Interactions Drug: Alcohol
causes disulfiram-like reaction in some patients; oral anticoagulants
, chloramphenicol, clofibrate, phenylbutazone, mao inhibitors
, probenecid, sulfonamides
may potentiate hypoglycemic actions; thiazides
may antagonize hypoglycemic effects; cimetidine
may increase glyburide levels, causing hypoglycemia
. Herbal: Ginseng, garlic
may increase hypoglycemic effects.
Readily absorbed from GI tract. Onset:
1560 min. Peak:
12 h. Duration:
Up to 24 h. Distribution:
Distributed in highest concentrations in liver, kidneys, and intestines; crosses placenta. Metabolism:
Extensively in liver. Elimination:
Equally in urine and feces. Half-Life:
Assessment & Drug Effects
- Monitor blood glucose levels carefully during the dangerous early treatment period when dosage is being individualized. Older
adults are especially vulnerable to glyburide-induced hypoglycemia (see Appendix F) because the antidiabetic agent is long-acting.
- Note: The first signs of hypoglycemia may be hard to detect when the patient is also receiving a beta blocker or is an older adult.
- Lab tests: Monitor at regular intervals: Blood and urine glucose, HbA1c, urine ketones, and liver function tests.
Patient & Family Education
- Eat or drink some form of sugar (e.g., corn syrup, orange juice with 2 or 3 tsp of table sugar) when symptoms of hypoglycemia
occur. Report reaction to physician promptly.
- Remember that loss of control of diabetes may result from stress such as fever, surgery, trauma, or infection. Check blood
glucose and urine for ketones more frequently during stress periods; transfer from the sulfonylurea to insulin may be necessary.
- Keep all follow-up medical appointments and adhere to dietary instructions, regular exercise program, and scheduled urine
and blood testing.
- Report blurred vision to physician.