Glyburide Micro 6mg Tablets

Glyburide is a second-generation sulfonylurea that lowers blood glucose by stimulating the release of insulin from the beta cells of the pancreatic islets. It binds to the sulfonylurea receptor (SUR1) on the beta-cell membrane, leading to closure of ATP-sensitive potassium channels, depolarization of the membrane, influx of calcium, and subsequent exocytosis of insulin.

Urgent Side Effects: Seek Medical Help Right Away

While rare, some people may experience severe and potentially life-threatening side effects when taking this medication. If you notice any of the following symptoms, contact your doctor or seek medical attention immediately:

Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Changes in eyesight
Muscle or joint pain
Low blood sugar (hypoglycemia), which may be more likely when this medication is used with other diabetes medications. Symptoms of low blood sugar include:
+ Dizziness
+ Headache
+ Feeling sleepy or weak
+ Shaking
+ Fast heartbeat
+ Confusion
+ Hunger
+ Sweating
Follow your doctor's instructions for managing low blood sugar, which may include taking glucose tablets, liquid glucose, or some fruit juices.

Additionally, be aware of the following potential side effects and seek medical attention if you experience:

Low blood cell counts, which can increase the risk of bleeding problems, infections, or anemia. Symptoms may include:
+ Fever
+ Chills
+ Sore throat
+ Unexplained bruising or bleeding
+ Feeling very tired or weak
Liver problems, which can be indicated by:
+ Dark urine
+ Tiredness
+ Decreased appetite
+ Upset stomach or stomach pain
+ Light-colored stools
+ Vomiting
+ Yellow skin or eyes

Other Possible Side Effects

Most people do not experience significant side effects, but some may occur. If you are bothered by any of the following side effects or if they do not go away, contact your doctor or seek medical attention:

Feeling full
Upset stomach
Heartburn
* Weight gain

This is not an exhaustive list of potential side effects. If you have questions or concerns about side effects, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.

Before Taking This Medication: Important Information to Share with Your Doctor

It is essential to inform your doctor about the following conditions to ensure safe treatment:

Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Describe the allergic reaction you experienced, including the symptoms that occurred.
If you have a condition that affects the acidity of your blood.
If you have type 1 diabetes. Note that this medication is not intended to treat type 1 diabetes.
If you are currently taking bosentan.
* If the patient is a child, as this medication is not suitable for children.

This list is not exhaustive, and it is crucial to discuss all your medications, including prescription and over-the-counter drugs, natural products, and vitamins, with your doctor and pharmacist. They will help you determine if it is safe to take this medication with your existing treatments and health conditions.

Remember, do not start, stop, or change the dose of any medication without first consulting your doctor to ensure your safety.

It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication.

If you have a deficiency of the enzyme glucose-6-phosphate dehydrogenase (G6PD), you may be at a higher risk of developing anemia. This deficiency is more common in individuals of African, South Asian, Middle Eastern, and Mediterranean descent.

Follow your doctor's instructions for monitoring your blood sugar levels. Regular blood tests, as advised by your doctor, are also crucial to ensure your safety while taking this medication. Discuss any concerns or questions you have with your doctor.

Avoid driving if you have experienced low blood sugar, as it can significantly increase your risk of being involved in an accident.

Before consuming alcohol, consult with your doctor to understand the potential risks and how to minimize them.

If you are taking colesevelam, ensure that you take it at least 4 hours after taking this medication to avoid any potential interactions.

Be aware that stress, such as from fever, infection, injury, or surgery, can affect your blood sugar control. Changes in your physical activity, exercise routine, or diet can also impact your blood sugar levels.

This medication can cause low blood sugar, which, if severe, can lead to seizures, loss of consciousness, permanent brain damage, and even death. Discuss the risks and how to manage low blood sugar with your doctor.

There is an increased risk of heart disease-related death associated with this medication. Talk to your doctor about this risk and any concerns you may have.

This medication can make you more susceptible to sunburn. Take precautions when spending time in the sun, and inform your doctor if you experience increased sensitivity to the sun.

If you are 65 years or older, use this medication with caution, as you may be more prone to side effects.

If you are pregnant, planning to become pregnant, or breastfeeding, discuss the benefits and risks of this medication with your doctor. It is crucial to weigh the potential effects on both you and your baby.

Note that infants born to mothers who took a similar medication during pregnancy have experienced low blood sugar. If you are taking this medication and become pregnant, your doctor will advise you on when to stop taking it before your due date to minimize this risk.

• Bosentan (increased risk of hepatotoxicity)
• Miconazole (oral, systemic - significantly increases glyburide levels and risk of severe hypoglycemia)

• Alcohol (increased risk of hypoglycemia, disulfiram-like reaction)
• Beta-blockers (mask hypoglycemia symptoms, impair glucose recovery)
• Fluconazole (CYP2C9 inhibitor, increases glyburide levels)
• NSAIDs (e.g., ibuprofen, naproxen - may enhance hypoglycemic effect)
• Sulfonamides (e.g., sulfamethoxazole/trimethoprim - may enhance hypoglycemic effect)
• Chloramphenicol (may enhance hypoglycemic effect)
• Coumarin derivatives (e.g., warfarin - altered anticoagulant effect, increased hypoglycemia risk)
• MAOIs (may enhance hypoglycemic effect)
• Probenecid (may enhance hypoglycemic effect)
• Salicylates (high doses, may enhance hypoglycemic effect)
• Corticosteroids (decrease hypoglycemic effect)
• Thiazide diuretics (decrease hypoglycemic effect)
• Thyroid hormones (decrease hypoglycemic effect)
• Estrogens/Oral Contraceptives (decrease hypoglycemic effect)
• Phenothiazines (decrease hypoglycemic effect)
• Phenytoin (decrease hypoglycemic effect)
• Sympathomimetics (decrease hypoglycemic effect)
• Calcium channel blockers (decrease hypoglycemic effect)
• Isoniazid (decrease hypoglycemic effect)
• Rifampin (CYP2C9 inducer, decreases glyburide levels)

• Chromium (may enhance hypoglycemic effect)
• Garlic (may enhance hypoglycemic effect)

• Symptoms of hypoglycemia: sweating, tremor, dizziness, confusion, hunger, irritability, rapid heartbeat, blurred vision, weakness, headache, slurred speech, anxiety.
• Symptoms of hyperglycemia (less common with sulfonylureas alone): increased thirst, increased urination, fatigue, blurred vision.

Glyburide is Pregnancy Category B. While some studies suggest it may be used in gestational diabetes, insulin is generally the preferred treatment for diabetes during pregnancy due to its established safety profile and lack of placental transfer. If used, careful monitoring of maternal and fetal glucose is essential.

Glyburide is excreted into breast milk. The American Academy of Pediatrics considers it compatible with breastfeeding, but there is a potential risk of hypoglycemia in the breastfed infant. Monitor the infant for signs of hypoglycemia (e.g., lethargy, poor feeding, jitteriness). Insulin is generally preferred during lactation.

Safety and efficacy have not been established in pediatric patients. Glyburide is generally not recommended for use in children or adolescents with Type 2 diabetes; metformin or insulin are typically preferred.

Elderly patients are at increased risk of hypoglycemia due to age-related decline in renal function, reduced hepatic metabolism, and potential for irregular meal patterns or polypharmacy. Start with the lowest effective dose (e.g., 0.75 mg) and titrate slowly. Monitor closely for signs of hypoglycemia, which may be atypical or masked in older adults.

• Glyburide Micro (micronized glyburide) has different pharmacokinetic properties and dosing compared to non-micronized glyburide. Doses are not interchangeable mg-for-mg.
• Always take glyburide with breakfast or the first main meal of the day to minimize gastrointestinal upset and reduce the risk of hypoglycemia.
• Patients should be educated on the signs and symptoms of hypoglycemia and how to treat it immediately.
• Due to the risk of prolonged hypoglycemia, especially in elderly patients or those with renal/hepatic impairment, glyburide is often considered a less favorable choice compared to newer antidiabetic agents (e.g., DPP-4 inhibitors, SGLT2 inhibitors, GLP-1 receptor agonists) or even other sulfonylureas (e.g., glipizide, gliclazide) which may have a shorter half-life or less active metabolites.
• Avoid in patients with severe renal or hepatic impairment due to high risk of severe, prolonged hypoglycemia.

• Other Sulfonylureas (e.g., Glipizide, Glimepiride)
• Metformin (Biguanide)
• DPP-4 Inhibitors (e.g., Sitagliptin, Saxagliptin)
• SGLT2 Inhibitors (e.g., Canagliflozin, Dapagliflozin)
• GLP-1 Receptor Agonists (e.g., Liraglutide, Semaglutide)
• Thiazolidinediones (e.g., Pioglitazone, Rosiglitazone)
• Insulin
• Alpha-glucosidase Inhibitors (e.g., Acarbose, Miglitol)
• Meglitinides (e.g., Repaglinide, Nateglinide)

If your symptoms or health issues persist or worsen, it is essential to contact your doctor promptly. To ensure safe and effective treatment, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so it's a good idea to check with your pharmacist. If you have any questions or concerns about this medication, don't hesitate to discuss them with your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek emergency medical attention. When seeking help, be prepared to provide detailed information about the overdose, including the medication taken, the amount, and the time it occurred.