Glyburide
Brand Name: Micronase, Diabeta
Generic Available
Common Dosage Forms:
Tablets: 1.25 mg, 2.5 mg, 5 mg
FDA Indications/Dosages:
As an adjunct to diet in the treatment of non-insulin dependent stable of maturity onset type on mild to moderately severe diabetes mellitus: Usual initial dose is 1.25 mg to 5 mg, given with breakfast. Normal dosage range is 2.5 mg to 5 mg given once or twice daily. Make dosage increases in increments of 1.25 mg to 2.5 mg every 5-7 days. If a single dose proves to be unsatisfactory, divide daily dose and give twice a day. Daily dosages above 10 mg should be divided into two equal doses. Maximum recommended daily dosage is 20 mg.
*Patient receiving less than 20 units of insulin per day may be switched to 2.5 mg or 5 mg tablets and their insulin discontinued. Patients receiving between 20-40 units of insulin per day may be switched to 5 mg tablets and their insulin dose decreased by 50% per day. Further reductions in insulin dosage may be applied dependent upon results. No transition period is needed when transferring patients from other hypoglycemic agents.
Monitor: BG, HbA1C
Pharmacology/Pharmacokinetics: Glyburide stimulates insulin synthesis and release from beta cells in the pancreatic islets. May also improve binding between insulin and insulin receptors and increase the number of insulin receptors in the periphery. Peak plasma levels are reached in 4 hours with a half-life of 10 hours. Effects last for 24 hours. Glyburide is excreted in the urine and feces as metabolites.
Drug Interactions: Dicumarol, chloramphenicol, alcohol, monoamine oxidase inhibitors, phenylbutanamide, salicylates, sulfinpyrazone, and sulfonamides may increase effects. Diazoxide, rifampin, and thiazide diuretics may decrease effects.
Contraindications/Precautions: Contraindicated in juvenile, unstable (labile), or complicated diabetes mellitus as the sole therapy, and in diabetic ketoacidosis with or without coma. Use with caution in patients with serious impairment of renal, hepatic, or thyroid function and in pregnant and nursing women. In patients with severe burns, infections, or trauma, glyburide may need to be discontinued and insulin given. Pregnancy Category B.
Adverse Effects: Nausea, heartburn, pruritus, and urticaria. Mild hypoglycemic reactions (headache, dizziness, or confusion) may occur rarely and should be treated with oral glucose.
Patient Consultation:
Store in a cool, dry place away from sunlight and children.
If a dose is missed, take it as soon as possible. If it is closer to the time if your next dose than the dose you missed, skip the missed dose and return to your dosing schedule. Do not double doses.
Contact a physician if the above side effects are severe or persistent.
Take with breakfast or the first main meal.
Compliance with therapy is essential for optimum effect.
Follow prescribed diet closely.
Avoid excessive use of alcohol.
Patient should be aware of the signs of hypoglycemia including sweating, tremor, blurred vision, weakness, hunger, and confusion. When two or more of these effects are seen, treat with oral glucose or contact a physician.