Micronase 2.5mg 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 pancreatic beta-cell membrane, leading to the closure of ATP-sensitive potassium channels. This depolarization of the beta-cell membrane opens voltage-gated calcium channels, resulting in an influx of calcium and subsequent exocytosis of insulin granules.

Serious Side Effects: Seek Medical Attention Immediately

Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek medical help right away:

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 used with other diabetes medications. Symptoms may 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 serious side effects:

Low blood cell counts, which can increase the risk of bleeding problems, infections, or anemia. If you experience:
+ Signs of infection, such as fever, chills, or sore throat
+ Unexplained bruising or bleeding
+ Feeling very tired or weak
Liver problems. If you notice:
+ 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 serious side effects, and many have only minor or no side effects at all. However, if you notice any of the following side effects or any other unusual symptoms, contact your doctor or seek medical help:

Feeling full
Upset stomach
Heartburn
* Weight gain

This is not an exhaustive list of possible side effects. If you have questions or concerns about side effects, contact 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:

Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction you experienced, including any 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 in combination with your other medications and health conditions. Never start, stop, or adjust the dosage of any medication without first consulting your doctor.

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.

Monitor your blood sugar levels as directed by your doctor. Regular blood tests will also be necessary, as advised by your doctor, to ensure your safety while taking this medication.

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

Before consuming alcohol, consult with your doctor to discuss any potential risks.

If you are also taking colesevelam, take it at least 4 hours after taking this medication to minimize potential interactions.

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

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

Additionally, this medication may increase the risk of death from heart disease. Consult with your doctor to understand this risk and how to mitigate it.

You may be more susceptible to sunburn while taking this medication. Take precautions when exposed to 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, plan to become pregnant, or are breastfeeding, discuss the benefits and risks of this medication with your doctor. It is essential to weigh the potential risks to you and your baby.

It is crucial to note that infants born to mothers who took a similar medication during pregnancy may experience low blood sugar after birth. If you are taking this medication during pregnancy, 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, or topical; severe hypoglycemia)

• Alcohol (increased risk of hypoglycemia)
• Beta-blockers (mask symptoms of hypoglycemia, may prolong hypoglycemia)
• Fluconazole (increased glyburide levels, increased hypoglycemia risk)
• NSAIDs (e.g., ibuprofen, naproxen; increased hypoglycemia risk)
• Salicylates (e.g., aspirin; increased hypoglycemia risk)
• Sulfonamides (increased hypoglycemia risk)
• Chloramphenicol (increased hypoglycemia risk)
• Coumarin derivatives (e.g., warfarin; altered anticoagulant effect)
• MAOIs (increased hypoglycemia risk)
• Probenecid (increased hypoglycemia risk)
• Rifampin (decreased glyburide levels, reduced efficacy)
• Corticosteroids (decreased hypoglycemic effect)
• Thiazide diuretics (decreased hypoglycemic effect)
• Thyroid hormones (decreased hypoglycemic effect)
• Sympathomimetics (e.g., decongestants; decreased hypoglycemic effect)

• Cimetidine (potential for increased glyburide levels)
• Clarithromycin (potential for increased glyburide levels)
• Gemfibrozil (increased hypoglycemia risk)
• Colesevelam (decreased glyburide absorption; administer glyburide 4 hours before colesevelam)
• Phenytoin (altered glucose control)
• Oral contraceptives (potential for decreased hypoglycemic effect)

• Chromium supplements (may enhance glucose lowering)
• Garlic supplements (may enhance glucose lowering)

• Symptoms of hypoglycemia (e.g., sweating, tremor, dizziness, confusion, hunger, irritability, blurred vision, palpitations, headache, slurred speech, weakness)
• Symptoms of hyperglycemia (e.g., increased thirst, increased urination, fatigue, blurred vision)
• Signs of liver dysfunction (e.g., jaundice, dark urine, persistent nausea/vomiting, abdominal pain)
• Unexplained weight gain

Generally not recommended during pregnancy. Insulin is typically the preferred treatment for gestational diabetes or pre-existing diabetes in pregnant women due to better glycemic control and lower risk of neonatal hypoglycemia compared to sulfonylureas. Glyburide is Pregnancy Category C, meaning animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.

Not recommended during breastfeeding. Glyburide is excreted into breast milk and can cause hypoglycemia in the nursing infant. Insulin is generally preferred for glycemic control in lactating mothers.

Safety and efficacy have not been established in pediatric patients. Use is generally not recommended.

Use with caution in elderly patients due to increased risk of hypoglycemia, particularly in those with impaired renal or hepatic function. Start with lower doses (e.g., 1.25 mg/day) and titrate slowly. Elderly patients may be more susceptible to the hypoglycemic effects and may have difficulty recognizing symptoms of hypoglycemia.

• Glyburide is a potent sulfonylurea with a relatively long duration of action, increasing the risk of hypoglycemia, especially in patients with irregular meal patterns, renal/hepatic impairment, or those on interacting medications.
• Always instruct patients to take glyburide with a meal to minimize the risk of hypoglycemia.
• Weight gain is a common side effect associated with sulfonylureas due to increased insulin levels.
• Consider alternative agents in patients prone to hypoglycemia or with significant renal/hepatic dysfunction.
• Micronized glyburide (Glynase PresTab) has higher bioavailability and is not interchangeable on a milligram-for-milligram basis with non-micronized glyburide (Micronase).

• Metformin (first-line for most Type 2 Diabetes patients)
• Other sulfonylureas (e.g., glipizide, glimepiride)
• DPP-4 inhibitors (e.g., sitagliptin, saxagliptin)
• GLP-1 receptor agonists (e.g., liraglutide, semaglutide)
• SGLT2 inhibitors (e.g., empagliflozin, canagliflozin)
• Thiazolidinediones (e.g., pioglitazone)
• Insulin therapy

If your symptoms or health issues persist or worsen, it is essential to contact your doctor promptly. To ensure your safety, 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.