What is Glyburide?

Glyburide is in a class of drugs called sulfonylureas. It is used to help control blood sugar levels.

Moreover, glyburide is used to treat type 2 (noninsulin-dependent) diabetes (formerly known as 'adult-onset'), particularly in people whose diabetes cannot be controlled by diet alone.
 
Glyburide manages to lower blood sugar levels by stimulating the pancreas to secrete insulin and helping the body use insulin efficiently. The pancreas must produce insulin for this medication to work. Glyburide is not used to treat type 1 (insulin-dependent) diabetes (formerly 'juvenile-onset').

Uses For Glyburide

Glyburide is used to treat high blood sugar levels caused by a type of diabetes mellitus (sugar diabetes) called type 2 diabetes. In type 2 diabetes, your body does not work properly to store excess sugar and the sugar remains in your bloodstream. Chronic high blood sugar can lead to serious health problems in the future.

Proper diet is the first step in managing type 2 diabetes, but often medicines are needed to help your body. Glyburide belongs to a class of medicines called sulfonylureas. It causes your pancreas to release more insulin into the blood stream. This medicine may be used alone or with another oral medicine such as metformin.

This medicine is available only with your doctor's prescription.

Proper Use of glyburide

This section provides information on the proper use of a number of products that contain glyburide. It may not be specific to Diabeta. Please read with care.

Follow carefully the special meal plan your doctor gave you. This is the most important part of controlling your condition, and is necessary if the medicine is to work properly. Also, exercise regularly and test for sugar in your blood or urine as directed.

Use only the brand of this medicine that your doctor prescribed. Different brands may not work the same way.

Dosing
The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For type 2 diabetes:
  
• For oral dosage form (tablets):
  Adults—At first, 2.5 to 5 milligrams (mg) once a day taken with breakfast or the first main meal. Your doctor may adjust your dose if needed. However, the dose is usually not more than 20 mg per day.
  Children—Use and dose must be determined by your doctor.

• For oral dosage form (micronized tablets):
  Adults—At first, 1.5 to 3 milligrams (mg) once a day taken with breakfast or the first main meal. Your doctor may adjust your dose if needed. The dose is usually not more than 12 mg per day.
  Children—Use and dose must be determined by your doctor.

Missed Dose
If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage
Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using Diabeta

It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly. Blood tests may be needed to check for unwanted effects.

It is very important to follow carefully any instructions from your health care team about:

Alcohol—Drinking alcohol may cause severe low blood sugar. Discuss this with your health care team.
Counseling—Other family members need to learn how to prevent side effects or help with side effects if they occur. Also, patients with diabetes may need special counseling about diabetes medicine dosing changes that might occur because of lifestyle changes, such as changes in exercise and diet. Furthermore, counseling on contraception and pregnancy may be needed because of the problems that can occur in patients with diabetes during pregnancy.
Travel—Keep your recent prescription and your medical history with you. Be prepared for an emergency as you would normally. Make allowances for changing time zones and keep your meal times as close as possible to your usual meal times.
In case of emergency—There may be a time when you need emergency help for a problem caused by your diabetes. You need to be prepared for these emergencies. It is a good idea to wear a medical identification (ID) bracelet or neck chain at all times. Also, carry an ID card in your wallet or purse that says you have diabetes and a list of all of your medicines.
Check with your doctor right away if you start having chest pain or discomfort; nausea; pain or discomfort in arms, jaw, back, or neck; shortness of breath; sweating; or vomiting while you are using this medicine. These may be symptoms of a serious heart problem, including a heart attack.

Too much glyburide can cause low blood sugar (hypoglycemia) when it is used under certain conditions. Symptoms of low blood sugar must be treated before they lead to unconsciousness (passing out). Different people may feel different symptoms of low blood sugar. It is important that you learn which symptoms of low blood sugar you usually have so that you can treat it quickly and call someone on your health care team right away when you need advice.

Symptoms of hypoglycemia (low blood sugar) include anxiety; behavior change similar to being drunk; blurred vision; cold sweats; confusion; cool, pale skin; difficulty in thinking; drowsiness; excessive hunger; fast heartbeat; headache (continuing); nausea; nervousness; nightmares; restless sleep; shakiness; slurred speech; or unusual tiredness or weakness.

If symptoms of low blood sugar occur, eat glucose tablets or gel, corn syrup, honey, or sugar cubes; or drink fruit juice, non-diet soft drink, or sugar dissolved in water. Also, check your blood for low blood sugar. Glucagon is used in emergency situations when severe symptoms such as seizures (convulsions) or unconsciousness occur. Have a glucagon kit available, along with a syringe or needle, and know how to use it. Members of your household also should know how to use it.

Do not take this medicine if you are also using bosentan (Tracleer®). Also, make sure your doctor knows about all other medicines you are using for diabetes, including insulin.

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部分中文参考信息：

通用名:格列本脲

药品类别:胰岛素及其他影响血糖药

性状:本品为白色片。

药理毒理:本品为降血糖药。 1. 刺激胰腺胰岛β细胞分泌胰岛素，先决条件是胰岛β细胞还有一定的合成和分泌胰岛素的功能； 2. 通过增加门静脉胰岛素水平或对肝脏直接作用，抑制肝糖原分解和糖原异生作用，肝生成和输出葡萄糖减少； 3. 也可能增加胰外组织对胰岛素的敏感性和糖的利用（可能主要通过受体后作用），因此，总的作用是降低空腹血糖和餐后血糖。
药代动力学 口服吸收快，蛋白结合率很高，为95%，口服后2-5小时血药浓度达峰值，持续作用24小时。半衰期为10小时。在肝内代谢，由肝和肾排出各约50%。

适应症:适用于单用饮食控制疗效不满意的轻、中度Ⅱ型糖尿病，病人胰岛 β细胞有一定的分泌胰岛素功能，并且无严重的并发症。

用法用量:口服 开始2.5mg，早餐前或早餐及午餐前各一次，轻症者1.25mg，一日三次，三餐前服，7日后递增每日2.5mg。一般用量为每日5-10mg，最大用量每日不超过15mg。
 
不良反应:1. 可有腹泻、恶心、呕吐、头痛、胃痛或不适； 2. 较少见的有皮疹； 3. 少见而严重的有黄疸、肝功能损害、骨髓抑制、粒细胞减少（表现为咽痛、发热、感染）、血小板减少症（表现为出血、紫癜）等。

禁忌症:下列情况应禁用：1.Ⅰ型糖尿病人；2.Ⅱ型糖尿病人伴有酮症酸中毒、昏迷、严重烧伤、感染、外伤和重大手术等应激情况；3.肝、肾功能不全者；4.对磺胺药过敏者；5.白细胞减少的病人。

注意事项:1. 下列情况应慎用：体质虚弱、高热、恶心和呕吐、甲状腺功能亢进、老年人。 2. 用药期间应定期测血糖、尿糖、尿酮体、尿蛋白和肝、肾功能，并进行眼科检查等。

孕妇及哺乳期妇女用药: 1. 动物试验和临床观察证明磺酰脲类降血糖药物可造成死胎和胎儿畸形，孕妇不宜服用。 2. 本类药物可由乳汁排出，乳母不宜服用，以免婴儿发生低血糖。
 
老年患者用药:老年病人及有肾功能不全者对本类药的代谢和排泄能力下降，本品降血糖作用相对较强，不宜用本品，可用其他作用时间较短的磺酰脲类降糖药。

药物相互作用:1. 与酒精同服时，可以引起腹部绞痛、恶心、呕吐、头痛、面部潮红和低血糖。 2. 与β受体阻滞剂合用，可增加低血糖的危险，而且可掩盖低血糖的症状，如脉率增快、血压升高；小量用选择性β受体阻滞剂如阿替洛尔（atenolol）和美托洛尔（metoprolol）造成此种情况的可能性较小。 3. 氯霉素、胍乙啶、胰岛素、单胺氧化酶抑制剂、保泰松、羟保泰松、丙磺舒、水杨酸盐、磺胺类与本品同时用，可加强降血糖作用。 4. 肾上腺皮质激素、肾上腺素、苯妥英钠、噻嗪类利尿剂、甲状腺素可增加血糖水平，与本类药同用时，可能需增加本类药的用量。 5. 香豆素类抗凝剂与本类药同用时，最初彼此血浆浓度皆升高，但以后彼此血浆浓度皆减少，故需要调整两者的用量。

于2010年2月8日更新