Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS AND MECHANISM: Glyburide is an oral glucose lowering-drug
in a class of diabetic drugs called sulfonylureas. Other sulfonylureas include
glipizide (Glucotrol), glimepiride (Amaryl), tolbutamide (Orinase), tolazamide,
and chlorpropamide
(Diabinese). Insulin is a hormone that is made in the pancreas. When
released into the blood, insulin reduces the formation of glucose by the liver
and causes cells in the body to remove sugar (glucose) from the blood. Patients
with type 2 diabetes have high glucose levels in their blood because the cells
in their bodies are resistant to the effect of insulin. Their liver produces too
much glucose. In addition, the pancreas cannot produce enough insulin to
overcome the insulin resistance of the body's cells. Glyburide reduces blood
glucose by stimulating the pancreas to produce more insulin. Glyburide is not a
cure for diabetes. The FDA approved glyburide in May 1984.
STORAGE: Glyburide should be stored at room temperature, 15-30 C
(59-86 F).
PRESCRIBED FOR: Glyburide is used in combination with
diet and
exercise to reduce blood glucose in patients with type 2 diabetes. It may be
used alone or combined with other medications for treating type 2 diabetes.
DOSING: The recommended starting dose is 2.5 to 5 mg daily of regular
tablets or 1.5-3 mg daily of micronized tablets. The maximum dose is 1.25 to 20
mg of regular tablets and 0.75 to 12 mg of micronized tablets. Glyburide usually
is administered with the first main meal of the day.
DRUG INTERACTIONS:Bosentan (Tracleer) and glyburide should not be
used together because blood levels of both drugs decrease, potentially reducing
their effect, and there is an increase in liver toxicity. Bosentan may increase
the breakdown of glyburide in the liver.
There have been reports of changes in blood sugar (increase or decrease) in
patients treated with fluoroquinolone type antibiotics, for example,
levofloxacin (Levaquin) and ciprofloxacin (Cipro) and antidiabetic agents such
as glyburide.
Thiazide diuretics, for example, hydrochlorothiazide (Hydrodiuril) increase
blood glucose levels, reducing the effect of glucose reducing medications such
as glyburide.
PREGNANCY: There are no adequate studies of glyburide in
pregnant
women. Prolonged and severe hypoglycemia (low blood glucose) has occurred in
infants whose mothers were receiving other sulfonylurea drugs.
NURSING MOTHERS: It is not known whether glyburide is excreted in
breast milk. Since many sulfonylureas are excreted in breast milk and
potentially may harm the infant, alternative diabetic therapies should be
considered or breast feeding should be discontinued.
SIDE EFFECTS: Common side effects include nausea,
heartburn,
rashes,
low blood sugar, blurred vision and weight gain. Rare but serious side effects
include hepatitis, jaundice, and low blood sodium levels (hyponatremia).
Diabetes mellitus is a chronic condition characterized by high levels of sugar (glucose) in the blood. The two types of diabetes are referred to as type 1 (insulin dependent) and type 2 (non-insulin dependent). Symptoms of diabetes include increased urine output, thirst, hunger, and fatigue. Treatment of diabetes depends on the type.
The major goal in treating diabetes is controlling elevated blood sugar without causing abnormally low levels of blood sugar. Treatment for type 1 diabetes is with insulin, exercise, and a diabetic diet. Treatment for type 2 diabetes is first treated with weight reduction, a diabetic diet, and exercise. When these measures fail to control the elevated blood sugar, oral medications are used. If oral medications are still insufficient, insulin medications are considered.
A diabetic diet, or diabetes diet helps keep blood glucose levels in the target range for patients. Exercise and medication may also help stabilize blood glucose levels. Keeping track of when you take your diabetic medicine, keeping track of food choices, eating the proper amount of fruits, vegetables, carbohydrates, and fats will also help maintain proper blood glucose levels.
Managing your diabetes is important. The goal of diabetic therapy is to control blood glucose levels and prevent the complications of diabetes. Information about exercise, diet diet, and medication will help you manage your diabetes better. Blood glucose reagent strips, blood glucose meters, urine glucose tests, tests for urinary ketones, continuous glucose sensors, and Hemoglobin A1C testing information is also provided in this article.
Diabetes mellitus is a condition in
which the body does not produce enough insulin or the
insulin that is produced is ineffective. Insulin is produced and secreted by the
pancreas and is needed for the proper storage and
utilization of nutrients (glucose, proteins, and fat) by the cells of the body.
Insulin allows nutrients to enter the cells of the body. For example, insulin
allows cells to remove glucose from the blood, and the glucose is used to
generate the energy that is necessary to fuel the activities of the cells. When
insulin is absent or ineffective and the cells receive inadequate amounts of
glucose, the body releases more glucose into the blood in an attempt to overcome
the block to glucose entering the cells. The additional glucose cannot penetrate
the cells, of course, and the glucose levels in the blood rise. High levels of
blood and urine glucose is what causes the symptoms and signs of diabetes. For more, please re...
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