Generic Name and Formulations:
Glyburide 1.25mg, 2.5mg, 5mg; scored tabs.
Adjunct to diet and exercise in type 2 diabetes mellitus.
Initially 2.5–5mg daily with breakfast or first main meal. Elderly or debilitated: initially 1.25mg daily. Increase by 2.5mg at weekly intervals if needed per blood glucose. Maintenance: 1.25–20mg daily in single or divided doses (consider divided doses above 10mg daily); max 20mg daily.
Type 1 diabetes or diabetic ketoacidosis with or without coma. Concomitant bosentan.
Oral hypoglycemic agents may increase risk of cardiovascular mortality. Renal or hepatic impairment. Adrenal or pituitary insufficiency. Stress. Secondary failure may occur with extended therapy. Risk of hemolytic anemia in G6PD deficiency; consider non-sulfonylurea alternative. Monitor urine, fasting blood glucose, and HbA1c levels periodically. Discontinue if jaundice or hepatitis occurs. Sulfonamide allergy. Malnourished. Elderly. Debilitated. Pregnancy (Cat.C): consider using insulin instead. Nursing mothers: not recommended.
See Contraindications. May be potentiated by NSAIDs, ACEIs, disopyramide, fluoxetine, clarithromycin, coumarin, alcohol, highly protein bound drugs, salicylates, sulfonamides, chloramphenicol, probenecid, MAOIs, β-blockers, oral miconazole (possibly), fluroquinolones. Antagonized by diuretics, steroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, niacin, sympathomimetics, calcium channel blockers, isoniazid. Monitor closely for hypoglycemia with concomitant drugs that affect glucose metabolism and upon withdrawal. May increase cyclosporine levels; monitor and adjust cyclosporine dose. Caution with CYP2C9 inhibitors or inducers (eg, rifampin). May be antagonized by topiramate, colesevelam; administer glyburide ≥4hrs prior to colesevelam. Disulfiram-like reaction with alcohol (rare). Monitor for 2 weeks if transferring from chlorpropamide.
Sulfonylurea (2nd generation).
Hypoglycemia, nausea, epigastric fullness, heartburn, allergic skin reactions, photosensitivity, blood dyscrasias; rare: cholestatic jaundice, hepatitis.
Tabs 1.25mg—50; 2.5mg—100; 5mg—100, 1000
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