glyburide (Rx)

Brand and Other Names:Diabeta, Glynase, more...Glynase PresTab
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Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

tablet

  • 1.25mg
  • 2.5mg
  • 5mg

tablet, micronized

  • 1.5mg
  • 3mg
  • 5mg
  • 6mg

Type 2 Diabetes Mellitus

Regular tablets

  • Initial: 2.5-5 mg PO qDay
  • Maintenance: 1.25-20 mg PO qDay or q12hr
  • Not to exceed 20 mg/day
  • Consider administering q12hr for doses >10 mg/day

Micronized tablets

  • Initial: 1.5-3 mg PO qDay
  • Maintenance: 0.75-12 mg PO qDay
  • Not to exceed 12 mg/day
  • Patients at risk for hypoglycemia: 0.75 mg PO qDay initially

Transferring from insulin therapy to glyburide

  • Current insulin dose <20 units: Discontinue insulin and initiate glyburide dose at 2.5-5 mg/day (regular) or 1.5-3 mg/day (micronized)
  • Current insulin dose 20-40 units: Discontinue insulin and initiate glyburide dose at 5 mg/day (regular) or 3 mg/day (micronized)
  • Current insulin dose >40 units: Decrease insulin dose by 50% and initiate glyburide dose at 5 mg/day (regular) or 3 mg/day (micronized); increase glyburide dose by 1.25-2.5 mg (regular) or 0.75-1.5 mg/day (micronized); decrease insulin dose gradually, based on patient’s response as glyburide dose increased

Dosage Modifications

Renal impairment: If CrCl <50 mL/min; caution advised

Hepatic impairment: Use conservative initial and maintenance doses; avoid use in severe liver disease

Orphan Designations

Acute spinal cord injury

Acute subarachnoid hemorrhage

Acute ischemic stroke

Sponsor

  • Remedy Pharmaceuticals, Inc; 122 W. 27th Street 10th Floor; New York, NY 10001

Safety and efficacy not established

Type 2 Diabetes

Initial: 1.25 mg/day if nonmicronized tablets or 0.75 mg/day of micronized tablets

Depending on glucose response, may increase dose by no more than 1.25-2.5 mg (regular) or 0.75-1.5 mg (micronized) every week

May administer maintenance dose of 1.25-20 mg/day (regular) or 0.75-12 mg/day (micronized); for better satisfactory response may divide dose q12hr for patients taking >10 mg/day (regular) or >6 mg/day (micronized)

Dosing considerations

Because the elderly are susceptible to the hypoglycemic effects of glucose-lowering drugs, the question of how tightly glucose levels should be controlled is controversial

Recognizing hypoglycemia in the elderly may be challenging

Monitoring other parameters associated with cardiovascular disease, such as blood pressure and cholesterol, may be more important than normalized glycemic control

Initial and maintenance dosing should be conservative

Use caution in patients with renal insufficiency

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Interactions

Interaction Checker

and glyburide

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            Contraindicated (1)

            • bosentan

              bosentan, glyburide. Either decreases levels of the other by increasing metabolism. Contraindicated.

              bosentan, glyburide. Either increases toxicity of the other by Other (see comment). Contraindicated. Comment: Coadministration increases risk of liver enzyme elevations; alternative hypoglycemic agents should be considered.

            Serious - Use Alternative (11)

            • aminolevulinic acid oral

              aminolevulinic acid oral, glyburide. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid administering other phototoxic drugs with aminolevulinic acid oral for 24 hr during perioperative period.

            • aminolevulinic acid topical

              glyburide increases toxicity of aminolevulinic acid topical by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration of photosensitizing drugs may enhance the phototoxic reaction to photodynamic therapy with aminolevulinic acid.

            • darolutamide

              darolutamide will increase the level or effect of glyburide by Other (see comment). Avoid or Use Alternate Drug. Darolutamide is a BCRP inhibitor. Avoid coadministration with BCRP inhibitors. If use is unavoidable, closely monitor for adverse reactions and consider dose reduction of BCRP substrate drug (refer BCRP substrate prescribing information).

            • eluxadoline

              glyburide increases levels of eluxadoline by decreasing metabolism. Avoid or Use Alternate Drug. Decrease eluxadoline dose to 75 mg PO BID if coadministered with OATP1B1 inhibitors. .

            • ethanol

              ethanol, glyburide. Other (see comment). Contraindicated. Comment: Excessive EtOH consumption may alter glycemic control. Some sulfonylureas may produce a disulfiram like rxn.

            • fluvastatin

              fluvastatin increases levels of glyburide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug.

            • ivosidenib

              ivosidenib will decrease the level or effect of glyburide by affecting hepatic enzyme CYP2C9/10 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP2C9 substrates with ivosidenib or replace with alternate therapies. If coadministration is unavoidable, monitor patients for loss of therapeutic effect of these drugs.

            • lasmiditan

              lasmiditan increases levels of glyburide by Other (see comment). Avoid or Use Alternate Drug. Comment: Lasmiditan inhibits BCRP in vitro. Avoid coadministration of lasmiditan with BCRP substrates.

            • lonafarnib

              glyburide will increase the level or effect of lonafarnib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration of lonafarnib (a sensitive CYP3A substrate) with weak CYP3A inhibitors is unavoidable, reduce to, or continue lonafarnib at starting dose. Closely monitor for arrhythmias and events (eg, syncope, heart palpitations) since lonafarnib effect on QT interval is unknown.

            • lumacaftor/ivacaftor

              lumacaftor/ivacaftor will decrease the level or effect of glyburide by affecting hepatic enzyme CYP2C9/10 metabolism. Avoid or Use Alternate Drug. Sulfonylureas are CYP2C9 substrates. Lumacaftor/ivacaftor has the potential to induce CYP2C9.

            • methyl aminolevulinate

              glyburide, methyl aminolevulinate. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Each drug may increase the photosensitizing effect of the other.

            Monitor Closely (206)

            • acalabrutinib

              acalabrutinib increases levels of glyburide by Other (see comment). Use Caution/Monitor. Comment: Acalabrutinib may increase exposure to coadministered BCRP substrates by inhibition of intestinal BCRP.

            • aceclofenac

              aceclofenac increases effects of glyburide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

            • acemetacin

              acemetacin increases effects of glyburide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

            • albiglutide

              albiglutide, glyburide. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Serious hypoglycemia may occur when insulin secretagogues and GLP-1 agonists are concurrently administered. Consider lowering the dose of insulin secretagogue to reduce the risk of hypoglycemia. .

            • alogliptin

              alogliptin, glyburide. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration of alogliptin with insulin and/or insulin secretagogues (eg, sulfonylureas, meglitinide derivatives) may increase risk for hypoglycemia; may require lower dose of insulin or insulin secretagogue .

            • alpelisib

              alpelisib will decrease the level or effect of glyburide by affecting hepatic enzyme CYP2C9/10 metabolism. Modify Therapy/Monitor Closely.

            • aluminum hydroxide

              aluminum hydroxide will increase the level or effect of glyburide by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

            • apalutamide

              apalutamide will decrease the level or effect of glyburide by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Coadministration of apalutamide, a weak CYP2C9 inducer, with drugs that are CYP2C9 substrates can result in lower exposure to these medications. Evaluate for loss of therapeutic effect if medication must be coadministered.

              apalutamide will decrease the level or effect of glyburide by increasing elimination. Use Caution/Monitor. Apalutamide weakly induces BCRP and may decrease systemic exposure of drugs that are BCRP substrates.

            • aripiprazole

              aripiprazole, glyburide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

            • asenapine

              asenapine, glyburide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

            • aspirin

              aspirin increases effects of glyburide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

            • aspirin rectal

              aspirin rectal increases effects of glyburide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

            • aspirin/citric acid/sodium bicarbonate

              aspirin/citric acid/sodium bicarbonate increases effects of glyburide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

            • atazanavir

              atazanavir decreases effects of glyburide by Other (see comment). Use Caution/Monitor. Comment: Reports of hyperglycemia due to insulin resistance with protease inhibitors. .

            • atorvastatin

              glyburide increases toxicity of atorvastatin by Other (see comment). Use Caution/Monitor. Comment: OATP1B1 inhibitors may increase risk of myopathy.

            • axitinib

              glyburide increases levels of axitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • benazepril

              benazepril increases effects of glyburide by pharmacodynamic synergism. Use Caution/Monitor. Additive hypoglycemic effects.

            • bexarotene

              bexarotene increases effects of glyburide by pharmacodynamic synergism. Use Caution/Monitor. Based on the mechanism of action, bexarotene capsules may increase the action of insulin enhancing agents, resulting in hypoglycemia. Hypoglycemia has not been associated with bexarotene monotherapy.

            • bitter melon

              bitter melon increases effects of glyburide by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypoglycemia.

            • bosentan

              bosentan decreases levels of glyburide by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Strong CYP2C9 inducers may increase glyburide metabolism.

            • calcium carbonate

              calcium carbonate will increase the level or effect of glyburide by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

            • canagliflozin

              glyburide, canagliflozin. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Consider a lower dose of insulin or insulin secretagogue to avoid hypoglycemia when coadministered with canagliflozin.

            • cannabidiol

              cannabidiol will increase the level or effect of glyburide by decreasing metabolism. Modify Therapy/Monitor Closely. Cannabidiol may potentially inhibit CYP2C9 activity. Consider reducing the dose when concomitantly using CYP2C9 substrates.

            • capecitabine

              capecitabine increases levels of glyburide by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Strong CYP2C9 inhibitors may decrease glyburide metabolism.

            • captopril

              captopril increases effects of glyburide by pharmacodynamic synergism. Use Caution/Monitor. Both drugs lower blood glucose. Monitor blood glucose.

            • carbamazepine

              carbamazepine decreases levels of glyburide by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Strong CYP2C9 inducers may increase glyburide metabolism.

            • celecoxib

              celecoxib increases effects of glyburide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

            • cholic acid

              glyburide increases toxicity of cholic acid by decreasing elimination. Modify Therapy/Monitor Closely. Avoid concomitant use of inhibitors of the bile salt efflux pump (BSEP). May exacerbate accumulation of conjugated bile salts in the liver and result in clinical symptoms. If concomitant use is necessary, monitor serum transaminases and bilirubin.

            • choline magnesium trisalicylate

              choline magnesium trisalicylate increases effects of glyburide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

            • cimetidine

              cimetidine will increase the level or effect of glyburide by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

            • cinnamon

              cinnamon increases effects of glyburide by pharmacodynamic synergism. Use Caution/Monitor. Potential for hypoglycemia.

            • ciprofibrate

              ciprofibrate increases effects of glyburide by plasma protein binding competition. Use Caution/Monitor. Hypoglycemia; increased risk in hypoalbuminemia.

            • ciprofloxacin

              ciprofloxacin increases effects of glyburide by pharmacodynamic synergism. Use Caution/Monitor. Hyper and hypoglycemia have been reported in patients treated concomitantly with quinolones and antidiabetic agents. Careful monitoring of blood glucose is recommended.

            • clarithromycin

              clarithromycin increases levels of glyburide by plasma protein binding competition. Use Caution/Monitor. Risk of hypoglycemia.

            • clotrimazole

              clotrimazole increases levels of glyburide by decreasing metabolism. Use Caution/Monitor.

            • clozapine

              clozapine, glyburide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

            • colesevelam

              colesevelam decreases levels of glyburide by drug binding in GI tract. Use Caution/Monitor. Concomitant administration decreases glyburide absorption; however, absorption is not reduced when glyburide is administered 4 hr before colesevelam.

            • cyclosporine

              glyburide, cyclosporine. unknown mechanism. Use Caution/Monitor. Cyclosporine may decrease the effects of sulfonylureas. Sulfonylureas may increase the effects of cyclosporine.

            • dapagliflozin

              glyburide, dapagliflozin. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Consider a lower dose of insulin or insulin secretagogue to avoid hypoglycemia when coadministered with dapagliflozin.

            • darunavir

              darunavir decreases effects of glyburide by Other (see comment). Use Caution/Monitor. Comment: Reports of hyperglycemia due to insulin resistance with protease inhibitors. .

            • diclofenac

              diclofenac increases effects of glyburide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

            • diflunisal

              diflunisal increases effects of glyburide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

            • disopyramide

              disopyramide increases effects of glyburide by unspecified interaction mechanism. Use Caution/Monitor. Risk of hypoglycemia.

            • dulaglutide

              dulaglutide, glyburide. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

            • eliglustat

              eliglustat increases levels of glyburide by P-glycoprotein (MDR1) efflux transporter. Modify Therapy/Monitor Closely. Monitor therapeutic drug concentrations, as indicated, or consider reducing the dosage of the P-gp substrate and titrate to clinical effect.

            • eluxadoline

              eluxadoline increases levels of glyburide by decreasing metabolism. Use Caution/Monitor. Eluxadoline may increase the systemic exposure of coadministered BCRP substrates.

            • elvitegravir/cobicistat/emtricitabine/tenofovir DF

              elvitegravir/cobicistat/emtricitabine/tenofovir DF decreases levels of glyburide by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Elvitegravir is a moderate CYP2C9 inducer.

            • empagliflozin

              empagliflozin, glyburide. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Consider a lower dose of insulin or insulin secretagogue to avoid hypoglycemia when coadministered with SGLT2 inhibitors.

            • enalapril

              enalapril increases effects of glyburide by pharmacodynamic synergism. Use Caution/Monitor.

            • ertugliflozin

              ertugliflozin, glyburide. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Consider a lower dose of insulin or insulin secretagogue to avoid hypoglycemia when coadministered with ertugliflozin.

            • esomeprazole

              esomeprazole will increase the level or effect of glyburide by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

            • etodolac

              etodolac increases effects of glyburide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

            • exenatide injectable solution

              exenatide injectable solution, glyburide. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of hypoglycemia when exenatide is used in combination with agents that induce hypoglycemia. Consider lowering dose of sulfonylureas to reduce risk of hypoglycemia. .

            • exenatide injectable suspension

              exenatide injectable suspension, glyburide. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of hypoglycemia when exenatide is used in combination with agents that induce hypoglycemia. Consider lowering dose of sulfonylureas to reduce risk of hypoglycemia.

            • famotidine

              famotidine will increase the level or effect of glyburide by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

            • fenofibrate

              fenofibrate increases effects of glyburide by plasma protein binding competition. Use Caution/Monitor. Hypoglycemia; increased risk in hypoalbuminemia.

            • fenofibrate micronized

              fenofibrate micronized increases effects of glyburide by plasma protein binding competition. Use Caution/Monitor. Hypoglycemia; increased risk in hypoalbuminemia.

            • fenofibric acid

              fenofibric acid increases effects of glyburide by plasma protein binding competition. Use Caution/Monitor. Hypoglycemia; increased risk in hypoalbuminemia.

            • fenoprofen

              fenoprofen increases effects of glyburide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

            • finerenone

              glyburide will increase the level or effect of finerenone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Monitor serum potassium during initiation and dosage adjustment of either finererone or weak CYP3A4 inhibitors. Adjust finererone dosage as needed.

            • fleroxacin

              fleroxacin increases effects of glyburide by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.

            • flibanserin

              glyburide will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Increased flibanserin adverse effects may occur if coadministered with multiple weak CYP3A4 inhibitors.

            • fluconazole

              fluconazole increases levels of glyburide by decreasing metabolism. Use Caution/Monitor.

              fluconazole increases levels of glyburide by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Strong CYP2C9 inhibitors may decrease glyburide metabolism.

            • fluorouracil

              fluorouracil increases levels of glyburide by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Strong CYP2C9 inhibitors may decrease glyburide metabolism.

            • fluoxetine

              fluoxetine increases effects of glyburide by unspecified interaction mechanism. Use Caution/Monitor. Risk of hypoglycemia.

            • flurbiprofen

              flurbiprofen increases effects of glyburide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

              flurbiprofen increases levels of glyburide by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Strong CYP2C9 inhibitors may decrease glyburide metabolism.

            • fluvastatin

              glyburide increases toxicity of fluvastatin by Other (see comment). Use Caution/Monitor. Comment: OATP1B1 inhibitors may increase risk of myopathy.

            • fosamprenavir

              fosamprenavir decreases effects of glyburide by Other (see comment). Use Caution/Monitor. Comment: Reports of hyperglycemia due to insulin resistance with protease inhibitors. .

            • fosinopril

              fosinopril increases effects of glyburide by pharmacodynamic synergism. Use Caution/Monitor.

            • fosphenytoin

              fosphenytoin decreases levels of glyburide by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Strong CYP2C9 inducers may increase glyburide metabolism.

            • fostemsavir

              fostemsavir will increase the level or effect of glyburide by Other (see comment). Modify Therapy/Monitor Closely. Fostemsavir inhibits OATP1B1/3 and BCRP transporters. If possible, avoid coadministration or modify dose of OATP1B1/3 or BCRP substrates coadministered with fostemsavir.

            • gemfibrozil

              gemfibrozil increases effects of glyburide by plasma protein binding competition. Use Caution/Monitor. Hypoglycemia; increased risk in hypoalbuminemia.

              gemfibrozil increases levels of glyburide by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Strong CYP2C9 inhibitors may decrease glyburide metabolism.

            • gemifloxacin

              gemifloxacin increases effects of glyburide by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.

            • glecaprevir/pibrentasvir

              glyburide will increase the level or effect of glecaprevir/pibrentasvir by decreasing metabolism. Use Caution/Monitor. Caution when coadministering glecaprevir/pibrentasvir with OATP1B1/OATP1B3 inhibitors

              glecaprevir/pibrentasvir will increase the level or effect of glyburide by Other (see comment). Use Caution/Monitor. Glecaprevir/pibrentasvir may increase plasma concentration of P-gp and BCRP substrates.

            • ibuprofen

              ibuprofen increases effects of glyburide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

              ibuprofen increases levels of glyburide by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Strong CYP2C9 inhibitors may decrease glyburide metabolism.

            • ibuprofen IV

              ibuprofen IV increases levels of glyburide by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Strong CYP2C9 inhibitors may decrease glyburide metabolism.

              ibuprofen IV increases effects of glyburide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

            • ibuprofen/famotidine

              ibuprofen/famotidine will increase the level or effect of glyburide by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

            • iloperidone

              iloperidone, glyburide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

            • imidapril

              imidapril increases effects of glyburide by pharmacodynamic synergism. Use Caution/Monitor.

            • indinavir

              indinavir decreases effects of glyburide by Other (see comment). Use Caution/Monitor. Comment: Reports of hyperglycemia due to insulin resistance with protease inhibitors. .

            • indomethacin

              indomethacin increases effects of glyburide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

              indomethacin increases levels of glyburide by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Strong CYP2C9 inhibitors may decrease glyburide metabolism.

            • insulin aspart

              glyburide, insulin aspart. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

            • insulin aspart protamine/insulin aspart

              glyburide, insulin aspart protamine/insulin aspart. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

            • insulin degludec

              glyburide, insulin degludec. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

            • insulin degludec/insulin aspart

              glyburide, insulin degludec/insulin aspart. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

            • insulin detemir

              glyburide, insulin detemir. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

            • insulin glargine

              glyburide, insulin glargine. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

            • insulin glulisine

              glyburide, insulin glulisine. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

            • insulin inhaled

              glyburide, insulin inhaled. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

            • insulin isophane human/insulin regular human

              glyburide, insulin isophane human/insulin regular human. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

            • insulin lispro

              glyburide, insulin lispro. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

            • insulin lispro protamine/insulin lispro

              glyburide, insulin lispro protamine/insulin lispro. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

            • insulin NPH

              glyburide, insulin NPH. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

            • insulin regular human

              glyburide, insulin regular human. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

            • isavuconazonium sulfate

              glyburide will increase the level or effect of isavuconazonium sulfate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • isocarboxazid

              isocarboxazid increases effects of glyburide by unknown mechanism. Use Caution/Monitor.

            • ivacaftor

              ivacaftor increases levels of glyburide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor. Ivacaftor and its M1 metabolite has the potential to inhibit P-gp; may significantly increase systemic exposure to sensitive P-gp substrates with a narrow therapeutic index.

              glyburide increases levels of ivacaftor by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Monitor when coadministered with weak CYP3A4 inhibitors .

            • ketoconazole

              ketoconazole increases levels of glyburide by decreasing metabolism. Use Caution/Monitor.

              ketoconazole increases levels of glyburide by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Strong CYP2C9 inhibitors may decrease glyburide metabolism.

            • ketoprofen

              ketoprofen increases effects of glyburide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

            • ketorolac

              ketorolac increases effects of glyburide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

            • ketorolac intranasal

              ketorolac intranasal increases effects of glyburide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

            • ketotifen, ophthalmic

              ketotifen, ophthalmic, glyburide. Other (see comment). Use Caution/Monitor. Comment: Combination may result in thrombocytopenia (rare). Monitor CBC.

            • lemborexant

              glyburide will increase the level or effect of lemborexant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Lower nightly dose of lemborexant recommended if coadministered with weak CYP3A4 inhibitors. See drug monograph for specific dosage modification.

            • letermovir

              letermovir, glyburide. Either increases levels of the other by Other (see comment). Use Caution/Monitor. Comment: Monitor glucose concentrations.

            • levofloxacin

              levofloxacin increases effects of glyburide by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.

            • linagliptin

              glyburide, linagliptin. Other (see comment). Use Caution/Monitor. Comment: When linagliptin is used in combination with sulfonylureas, a lower dose of the sulfonylurea may be required to reduce risk of hypoglycemia.

            • linezolid

              linezolid increases effects of glyburide by unknown mechanism. Use Caution/Monitor.

            • liraglutide

              liraglutide, glyburide. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Serious hypoglycemia may occur when insulin secretagogues and GLP-1 agonists are concurrently administered. Consider lowering the dose of insulin secretagogue to reduce the risk of hypoglycemia. .

            • lisinopril

              lisinopril increases effects of glyburide by pharmacodynamic synergism. Use Caution/Monitor.

            • lixisenatide

              lixisenatide, glyburide. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Risk of hypoglycemia increased when coadministered with sulfonylureas. Sulfonylurea dosage reduction may be required.

            • lomitapide

              glyburide increases levels of lomitapide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Lomitapide dose should not exceed 30 mg/day.

            • lopinavir

              lopinavir decreases effects of glyburide by Other (see comment). Use Caution/Monitor. Comment: Reports of hyperglycemia due to insulin resistance with protease inhibitors. .

            • lornoxicam

              lornoxicam increases effects of glyburide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

            • lurasidone

              lurasidone, glyburide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

            • marijuana

              marijuana decreases effects of glyburide by pharmacodynamic antagonism. Use Caution/Monitor.

            • mecasermin

              mecasermin increases effects of glyburide by pharmacodynamic synergism. Use Caution/Monitor. Additive hypoglycemic effects.

            • meclofenamate

              meclofenamate increases effects of glyburide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

            • mefenamic acid

              mefenamic acid increases effects of glyburide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

              mefenamic acid increases levels of glyburide by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Strong CYP2C9 inhibitors may decrease glyburide metabolism.

            • meloxicam

              meloxicam increases effects of glyburide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

            • metreleptin

              glyburide, metreleptin. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration of metreleptin with insulin and/or insulin secretagogues (eg, sulfonylureas, meglitinide derivatives) may increase risk for hypoglycemia; may require lower dose of insulin or insulin secretagogue.

            • miconazole vaginal

              miconazole vaginal increases levels of glyburide by decreasing metabolism. Use Caution/Monitor.

            • midazolam intranasal

              glyburide will increase the level or effect of midazolam intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration of mild CYP3A4 inhibitors with midazolam intranasal may cause higher midazolam systemic exposure, which may prolong sedation.

            • mipomersen

              mipomersen, glyburide. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Both drugs have potential to increase hepatic enzymes; monitor LFTs.

            • moexipril

              moexipril increases effects of glyburide by pharmacodynamic synergism. Use Caution/Monitor.

            • moxifloxacin

              moxifloxacin increases effects of glyburide by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.

            • nabumetone

              nabumetone increases effects of glyburide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

            • nadolol

              nadolol decreases effects of glyburide by pharmacodynamic antagonism. Use Caution/Monitor. Non selective beta blockers may also mask the symptoms of hypoglycemia.

            • naproxen

              naproxen increases effects of glyburide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

            • nelfinavir

              nelfinavir decreases effects of glyburide by Other (see comment). Use Caution/Monitor. Comment: Reports of hyperglycemia due to insulin resistance with protease inhibitors. .

            • nicardipine

              nicardipine increases levels of glyburide by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Strong CYP2C9 inhibitors may decrease glyburide metabolism.

            • nitazoxanide

              nitazoxanide, glyburide. Either increases levels of the other by Mechanism: plasma protein binding competition. Use Caution/Monitor.

            • nitisinone

              nitisinone will increase the level or effect of glyburide by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Nitisinone inhibits CYP2C9. Caution if CYP2C9 substrate coadministered, particularly those with a narrow therapeutic index.

            • ofloxacin

              ofloxacin increases effects of glyburide by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.

            • olanzapine

              olanzapine, glyburide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

            • omeprazole

              omeprazole will increase the level or effect of glyburide by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor.

            • opuntia ficus indica

              opuntia ficus indica increases effects of glyburide by pharmacodynamic synergism. Use Caution/Monitor.

            • osimertinib

              osimertinib will increase the level or effect of glyburide by Other (see comment). Modify Therapy/Monitor Closely. Osimertinib is an inhibitor of BCRP transport. Caution if coadministered with sensitive BCRP substrates.

            • ospemifene

              glyburide, ospemifene. Either increases levels of the other by plasma protein binding competition. Modify Therapy/Monitor Closely.

            • oxaprozin

              oxaprozin increases effects of glyburide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

            • paliperidone

              paliperidone, glyburide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

            • parecoxib

              parecoxib increases effects of glyburide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

            • peginterferon alfa 2b

              peginterferon alfa 2b decreases levels of glyburide by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. When patients are administered peginterferon alpha-2b with CYP2C9 substrates, the therapeutic effect of these drugs may be altered. .

            • perindopril

              perindopril increases effects of glyburide by pharmacodynamic synergism. Use Caution/Monitor.

            • phenelzine

              phenelzine increases effects of glyburide by unknown mechanism. Use Caution/Monitor.

            • phenobarbital

              phenobarbital decreases levels of glyburide by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Strong CYP2C9 inducers may increase glyburide metabolism.

            • phenytoin

              phenytoin decreases levels of glyburide by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Strong CYP2C9 inducers may increase glyburide metabolism.

            • pindolol

              pindolol decreases effects of glyburide by pharmacodynamic antagonism. Use Caution/Monitor. Non selective beta blockers may also mask the symptoms of hypoglycemia.

            • piroxicam

              piroxicam increases effects of glyburide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

              piroxicam increases levels of glyburide by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Strong CYP2C9 inhibitors may decrease glyburide metabolism.

            • pitavastatin

              glyburide increases toxicity of pitavastatin by Other (see comment). Use Caution/Monitor. Comment: OATP1B1 inhibitors may increase risk of myopathy.

            • ponatinib

              ponatinib increases levels of glyburide by P-glycoprotein (MDR1) efflux transporter. Use Caution/Monitor.

              ponatinib increases levels of glyburide by Other (see comment). Use Caution/Monitor.

            • posaconazole

              posaconazole increases levels of glyburide by decreasing metabolism. Use Caution/Monitor.

            • pravastatin

              glyburide increases toxicity of pravastatin by Other (see comment). Use Caution/Monitor. Comment: OATP1B1 inhibitors may increase risk of myopathy.

            • primidone

              primidone decreases levels of glyburide by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Strong CYP2C9 inducers may increase glyburide metabolism.

            • probenecid

              probenecid increases levels of glyburide by unspecified interaction mechanism. Use Caution/Monitor. Risk of hypoglycemia.

            • propranolol

              propranolol decreases effects of glyburide by pharmacodynamic antagonism. Use Caution/Monitor. Non selective beta blockers may also mask the symptoms of hypoglycemia.

            • quetiapine

              quetiapine, glyburide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

            • quinapril

              quinapril increases effects of glyburide by pharmacodynamic synergism. Use Caution/Monitor.

            • ramipril

              ramipril increases effects of glyburide by pharmacodynamic synergism. Use Caution/Monitor.

            • regorafenib

              regorafenib will increase the level or effect of glyburide by Other (see comment). Modify Therapy/Monitor Closely. Regorafenib likely inhibits BCRP (ABCG2) transport. Coadministration with a BCRP substrate may increase systemic exposure to the substrate and related toxicity.

            • rifabutin

              rifabutin decreases levels of glyburide by increasing metabolism. Use Caution/Monitor.

            • rifampin

              rifampin decreases levels of glyburide by increasing metabolism. Use Caution/Monitor.

              rifampin decreases levels of glyburide by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Strong CYP2C9 inducers may increase glyburide metabolism.

            • rifapentine

              rifapentine decreases levels of glyburide by increasing metabolism. Use Caution/Monitor.

              rifapentine decreases levels of glyburide by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Strong CYP2C9 inducers may increase glyburide metabolism.

            • risperidone

              risperidone, glyburide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

            • ritonavir

              ritonavir, glyburide. Other (see comment). Use Caution/Monitor. Comment: Ritonavir may increase or decrease levels of glyburide. Use alternatives if available. Reports of hyperglycemia due to insulin resistance with protease inhibitors. .

            • rosuvastatin

              glyburide increases toxicity of rosuvastatin by Other (see comment). Use Caution/Monitor. Comment: Coadministration of rosuvastatin with OATP1B1 inhibitors may increase rosuvastatin levels and risk for myopathy.

            • rucaparib

              rucaparib will increase the level or effect of glyburide by affecting hepatic enzyme CYP2C9/10 metabolism. Modify Therapy/Monitor Closely. Adjust dosage of CYP2C9 substrates, if clinically indicated.

            • sacubitril/valsartan

              glyburide will increase the level or effect of sacubitril/valsartan by Other (see comment). Use Caution/Monitor. The results from an in vitro study with human liver tissue indicate that valsartan is a substrate of the hepatic uptake transporter OATP1B1; coadministration with OATP1B1 inhibitors may increase valsartan systemic exposure

            • safinamide

              safinamide will increase the level or effect of glyburide by Other (see comment). Use Caution/Monitor. Safinamide and its major metabolite may inhibit intestinal BCRP. Monitor BCRP substrates for increased pharmacologic or adverse effects.

            • salicylates (non-asa)

              salicylates (non-asa) increases effects of glyburide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

            • salsalate

              salsalate increases effects of glyburide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

            • saquinavir

              saquinavir decreases effects of glyburide by Other (see comment). Use Caution/Monitor. Comment: Reports of hyperglycemia due to insulin resistance with protease inhibitors. .

            • secobarbital

              secobarbital decreases levels of glyburide by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Strong CYP2C9 inducers may increase glyburide metabolism.

            • selegiline

              selegiline increases effects of glyburide by unknown mechanism. Use Caution/Monitor. Serum glucose should be monitored closely when MAOIs are added to any regimen containing antidiabetic medications. Hypoglycemic effects may be increased.

            • selegiline transdermal

              selegiline transdermal increases effects of glyburide by unknown mechanism. Use Caution/Monitor.

            • semaglutide

              semaglutide, glyburide. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of insulin secretagogues with GLP-1 agonists may increase hypoglycemia risk. Lowering the insulin secretagogue dose may reduce hypoglycemia risk. .

            • shark cartilage

              shark cartilage increases effects of glyburide by pharmacodynamic synergism. Use Caution/Monitor. Theoretical interaction.

            • simvastatin

              glyburide increases toxicity of simvastatin by Other (see comment). Use Caution/Monitor. Comment: OATP1B1 inhibitors may increase risk of myopathy.

            • sodium bicarbonate

              sodium bicarbonate will increase the level or effect of glyburide by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

            • sodium citrate/citric acid

              sodium citrate/citric acid will increase the level or effect of glyburide by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

            • sodium zirconium cyclosilicate

              sodium zirconium cyclosilicate will increase the level or effect of glyburide by increasing gastric pH. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Check specific recommendations for drugs that exhibit pH-dependent solubility that may affect their systemic exposure and efficacy. In general, administer drugs at least 2 hr before or after sodium zirconium cyclosilicate.

            • sofosbuvir/velpatasvir

              sofosbuvir/velpatasvir will increase the level or effect of glyburide by Other (see comment). Use Caution/Monitor. Velpatasvir is an inhibitor of the drug transporter BCRP. Coadministration may increase systemic exposure of drugs that are BCRP substrates.

            • somapacitan

              somapacitan decreases effects of glyburide by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Growth hormone products may decrease insulin sensitivity, particularly at higher doses. Antidiabetic agents may require dose adjustment after initiating somapacitan. .

            • stiripentol

              stiripentol will increase the level or effect of glyburide by Other (see comment). Modify Therapy/Monitor Closely. Stiripentol is a BCRP transport inhibitor. Consider dosage reduction for BCRP substrates if adverse effects are experienced when coadministered.

            • sulfadiazine

              sulfadiazine increases levels of glyburide by plasma protein binding competition. Use Caution/Monitor.

              sulfadiazine increases levels of glyburide by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Strong CYP2C9 inhibitors may decrease glyburide metabolism.

            • sulfamethoxazole

              sulfamethoxazole increases levels of glyburide by plasma protein binding competition. Use Caution/Monitor.

              sulfamethoxazole increases levels of glyburide by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Strong CYP2C9 inhibitors may decrease glyburide metabolism.

            • sulfamethoxypyridazine

              sulfamethoxypyridazine increases effects of glyburide by unspecified interaction mechanism. Use Caution/Monitor. Risk of hypoglycemia.

            • sulfasalazine

              sulfasalazine increases effects of glyburide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

            • sulfisoxazole

              sulfisoxazole increases levels of glyburide by plasma protein binding competition. Use Caution/Monitor.

            • sulindac

              sulindac increases effects of glyburide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

            • tafamidis

              tafamidis will increase the level or effect of glyburide by Other (see comment). Use Caution/Monitor. Tafamidis inhibits breast cancer resistant protein (BCRP) in vitro and may increase exposure of BCRP substrates following tafamidis or tafamidis meglumine administration. Dosage adjustment of these BCRP substrates may be necessary.

            • tafamidis meglumine

              tafamidis meglumine will increase the level or effect of glyburide by Other (see comment). Use Caution/Monitor. Tafamidis inhibits breast cancer resistant protein (BCRP) in vitro and may increase exposure of BCRP substrates following tafamidis or tafamidis meglumine administration. Dosage adjustment of these BCRP substrates may be necessary.

            • tazemetostat

              glyburide will increase the level or effect of tazemetostat by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • timolol

              timolol decreases effects of glyburide by pharmacodynamic antagonism. Use Caution/Monitor. Non selective beta blockers may also mask the symptoms of hypoglycemia.

            • tinidazole

              glyburide will increase the level or effect of tinidazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

            • tipranavir

              tipranavir decreases effects of glyburide by Other (see comment). Use Caution/Monitor. Comment: Reports of hyperglycemia due to insulin resistance with protease inhibitors. .

            • tolbutamide

              tolbutamide increases levels of glyburide by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Strong CYP2C9 inhibitors may decrease glyburide metabolism.

            • tolfenamic acid

              tolfenamic acid increases effects of glyburide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

            • tolmetin

              tolmetin increases effects of glyburide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

            • trandolapril

              trandolapril increases effects of glyburide by pharmacodynamic synergism. Use Caution/Monitor.

            • tranylcypromine

              tranylcypromine increases effects of glyburide by unknown mechanism. Use Caution/Monitor.

            • triamcinolone acetonide injectable suspension

              triamcinolone acetonide injectable suspension decreases effects of glyburide by pharmacodynamic antagonism. Use Caution/Monitor. Corticosteroids may diminish hypoglycemic effect of antidiabetic agents. Monitor blood glucose levels carefully.

            • trimagnesium citrate anhydrous

              trimagnesium citrate anhydrous increases levels of glyburide by enhancing GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

            • valsartan

              glyburide will increase the level or effect of valsartan by Other (see comment). Use Caution/Monitor. The results from an in vitro study with human liver tissue indicate that valsartan is a substrate of the hepatic uptake transporter OATP1B1; coadministration with OATP1B1 inhibitors may increase valsartan systemic exposure

            • voriconazole

              voriconazole increases levels of glyburide by decreasing metabolism. Use Caution/Monitor.

              voriconazole increases levels of glyburide by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Strong CYP2C9 inhibitors may decrease glyburide metabolism.

            • xipamide

              xipamide decreases levels of glyburide by increasing renal clearance. Use Caution/Monitor.

            • ziprasidone

              ziprasidone, glyburide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

            Minor (101)

            • agrimony

              agrimony increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown.

            • American ginseng

              American ginseng increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown.

            • amitriptyline

              amitriptyline increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown.

            • amoxapine

              amoxapine increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown.

            • anamu

              anamu increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown. Theoretical interaction.

            • antithrombin alfa

              glyburide increases effects of antithrombin alfa by unspecified interaction mechanism. Minor/Significance Unknown.

            • antithrombin III

              glyburide increases effects of antithrombin III by unspecified interaction mechanism. Minor/Significance Unknown.

            • argatroban

              glyburide increases effects of argatroban by unspecified interaction mechanism. Minor/Significance Unknown.

            • aspirin

              aspirin increases effects of glyburide by plasma protein binding competition. Minor/Significance Unknown. Large dose of salicylate.

            • aspirin rectal

              aspirin rectal increases effects of glyburide by plasma protein binding competition. Minor/Significance Unknown. Large dose of salicylate.

            • aspirin/citric acid/sodium bicarbonate

              aspirin/citric acid/sodium bicarbonate increases effects of glyburide by plasma protein binding competition. Minor/Significance Unknown. Large dose of salicylate.

            • balsalazide

              balsalazide increases effects of glyburide by plasma protein binding competition. Minor/Significance Unknown. Large dose of salicylate.

            • bemiparin

              glyburide increases effects of bemiparin by unspecified interaction mechanism. Minor/Significance Unknown.

            • bendroflumethiazide

              bendroflumethiazide decreases effects of glyburide by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.

            • bivalirudin

              glyburide increases effects of bivalirudin by unspecified interaction mechanism. Minor/Significance Unknown.

            • budesonide

              budesonide decreases effects of glyburide by pharmacodynamic antagonism. Minor/Significance Unknown.

            • chloramphenicol

              chloramphenicol increases levels of glyburide by decreasing metabolism. Minor/Significance Unknown.

            • chlorothiazide

              chlorothiazide decreases effects of glyburide by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.

            • chlorthalidone

              chlorthalidone decreases effects of glyburide by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.

            • choline magnesium trisalicylate

              choline magnesium trisalicylate increases effects of glyburide by plasma protein binding competition. Minor/Significance Unknown. Large dose of salicylate.

            • chromium

              chromium increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown.

            • clomipramine

              clomipramine increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown.

            • clonidine

              clonidine decreases effects of glyburide by pharmacodynamic antagonism. Minor/Significance Unknown. Diminished symptoms of hypoglycemia.

              clonidine, glyburide. Other (see comment). Minor/Significance Unknown. Comment: Decreased symptoms of hypoglycemia. Mechanism: decreased hypoglycemia induced catecholamine production.

            • coenzyme Q10

              glyburide decreases levels of coenzyme Q10 by unspecified interaction mechanism. Minor/Significance Unknown.

            • cornsilk

              cornsilk increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of hypoglycemia (theoretical interaction).

            • cortisone

              cortisone decreases effects of glyburide by pharmacodynamic antagonism. Minor/Significance Unknown.

            • cyclopenthiazide

              cyclopenthiazide decreases effects of glyburide by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.

            • dalteparin

              glyburide increases effects of dalteparin by unspecified interaction mechanism. Minor/Significance Unknown.

            • damiana

              damiana decreases effects of glyburide by pharmacodynamic antagonism. Minor/Significance Unknown. Theoretical interaction.

            • danazol

              danazol increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown.

            • deflazacort

              deflazacort decreases effects of glyburide by pharmacodynamic antagonism. Minor/Significance Unknown.

            • desipramine

              desipramine increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown.

            • devil's claw

              devil's claw increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown.

            • dexamethasone

              dexamethasone decreases effects of glyburide by pharmacodynamic antagonism. Minor/Significance Unknown.

            • diflunisal

              diflunisal increases effects of glyburide by plasma protein binding competition. Minor/Significance Unknown. Large dose of salicylate.

            • doxepin

              doxepin increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown.

            • elderberry

              elderberry increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of hypoglycemia (in vitro research).

            • enoxaparin

              glyburide increases effects of enoxaparin by unspecified interaction mechanism. Minor/Significance Unknown.

            • eucalyptus

              eucalyptus increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown. Theoretical interaction.

            • fludrocortisone

              fludrocortisone decreases effects of glyburide by pharmacodynamic antagonism. Minor/Significance Unknown.

            • fluoxymesterone

              fluoxymesterone increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown.

            • fo-ti

              fo-ti increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown.

            • fondaparinux

              glyburide increases effects of fondaparinux by unspecified interaction mechanism. Minor/Significance Unknown.

            • forskolin

              forskolin increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown. Colenol, a compound found in Coleus root, may stimulate insulin release.

            • gotu kola

              gotu kola increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown. (Theoretical interaction).

            • guanfacine

              guanfacine decreases effects of glyburide by pharmacodynamic antagonism. Minor/Significance Unknown. Diminished symptoms of hypoglycemia.

              guanfacine, glyburide. Other (see comment). Minor/Significance Unknown. Comment: Decreased symptoms of hypoglycemia. Mechanism: decreased hypoglycemia induced catecholamine production.

            • gymnema

              gymnema increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown.

            • heparin

              glyburide increases effects of heparin by unspecified interaction mechanism. Minor/Significance Unknown.

            • horse chestnut seed

              horse chestnut seed increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown.

            • hydrochlorothiazide

              hydrochlorothiazide decreases effects of glyburide by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.

            • hydrocortisone

              hydrocortisone decreases effects of glyburide by pharmacodynamic antagonism. Minor/Significance Unknown.

            • imipramine

              imipramine increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown.

            • indapamide

              indapamide decreases effects of glyburide by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.

            • isoniazid

              isoniazid decreases effects of glyburide by unspecified interaction mechanism. Minor/Significance Unknown.

            • juniper

              juniper increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of hypoglycemia (theoretical interaction).

            • lofepramine

              lofepramine increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown.

            • lycopus

              lycopus increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of hypoglycemia (theoretical interaction).

            • maitake

              maitake increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of hypoglycemia (animal research).

            • maprotiline

              maprotiline increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown.

            • mesalamine

              mesalamine increases effects of glyburide by plasma protein binding competition. Minor/Significance Unknown. Large dose of salicylate.

            • mesterolone

              mesterolone increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown.

            • methyclothiazide

              methyclothiazide decreases effects of glyburide by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.

            • methylprednisolone

              methylprednisolone decreases effects of glyburide by pharmacodynamic antagonism. Minor/Significance Unknown.

            • methyltestosterone

              methyltestosterone increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown.

            • metolazone

              metolazone decreases effects of glyburide by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.

            • miglitol

              miglitol decreases levels of glyburide by unspecified interaction mechanism. Minor/Significance Unknown.

            • nettle

              nettle increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown. (Theoretical interaction).

            • nizatidine

              nizatidine will increase the level or effect of glyburide by increasing gastric pH. Applies only to oral form of both agents. Minor/Significance Unknown.

            • nortriptyline

              nortriptyline increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown.

            • ofloxacin

              ofloxacin, glyburide. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Potential dysglycemia.

            • orlistat

              orlistat increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown.

            • oxandrolone

              oxandrolone increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown.

            • oxymetholone

              oxymetholone increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown.

            • pegvisomant

              pegvisomant increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown.

            • phenindione

              glyburide increases effects of phenindione by unspecified interaction mechanism. Minor/Significance Unknown.

            • potassium acid phosphate

              potassium acid phosphate increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown. Interaction especially seen in the treatment of hypokalemia.

            • potassium chloride

              potassium chloride increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown. Interaction especially seen in the treatment of hypokalemia.

            • potassium citrate

              potassium citrate increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown. Interaction especially seen in the treatment of hypokalemia.

            • prednisolone

              prednisolone decreases effects of glyburide by pharmacodynamic antagonism. Minor/Significance Unknown.

            • prednisone

              prednisone decreases effects of glyburide by pharmacodynamic antagonism. Minor/Significance Unknown.

            • protamine

              glyburide increases effects of protamine by unspecified interaction mechanism. Minor/Significance Unknown.

            • protriptyline

              protriptyline increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown.

            • ruxolitinib

              glyburide will increase the level or effect of ruxolitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

            • sage

              sage increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown.

            • salicylates (non-asa)

              salicylates (non-asa) increases effects of glyburide by plasma protein binding competition. Minor/Significance Unknown. Large dose of salicylate.

            • salsalate

              salsalate increases effects of glyburide by plasma protein binding competition. Minor/Significance Unknown. Large dose of salicylate.

            • sitagliptin

              sitagliptin, glyburide. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypoglycemia with combination is unknown.

            • stevia

              stevia increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown.

            • sulfasalazine

              sulfasalazine increases effects of glyburide by plasma protein binding competition. Minor/Significance Unknown. Large dose of salicylate.

            • tacrolimus

              glyburide increases levels of tacrolimus by unknown mechanism. Minor/Significance Unknown.

            • testosterone

              testosterone increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown.

            • testosterone buccal system

              testosterone buccal system increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown.

            • testosterone topical

              testosterone topical increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown.

            • tongkat ali

              tongkat ali increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypoglycemia.

            • topiramate

              topiramate will decrease the level or effect of glyburide by unknown mechanism. Minor/Significance Unknown. Effect in glycemic control is likely small.

            • trazodone

              trazodone increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown.

            • trimipramine

              trimipramine increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown.

            • vanadium

              vanadium increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown.

            • voclosporin

              voclosporin will increase the level or effect of glyburide by Other (see comment). Minor/Significance Unknown. Information suggests voclosporin (an OATP1B1 inhibitor) may increase in the concentration of OATP1B1 substrates is possible. Monitor for adverse reactions of OATP1B1 substrates when coadministered with voclosporin.

            • warfarin

              glyburide increases effects of warfarin by unspecified interaction mechanism. Minor/Significance Unknown.

            • willow bark

              willow bark increases effects of glyburide by plasma protein binding competition. Minor/Significance Unknown. Large dose of salicylate.

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            Adverse Effects

            Frequency Not Defined

            Angioedema

            Urticaria

            Rash

            Morbilliform eruptions

            Pruritus

            Photosensitivity reaction

            Heartburn

            Vasculitis

            Disulfiram-like reaction

            Hyponatremia

            Nocturia

            Agranulocytosis

            Hemolytic anemia

            Pancytopenia

            Thrombocytopenia

            Porphyria cutanea tarda

            Arthralgia

            Paresthesia

            Myalgia

            Blurred vision

            Diuretic effect (minor)

            Hypoglycemia

            Nausea/vomiting

            Cholestatic jaundice and hepatitis, which occur only rarely, may progress to liver failure

            Weight gain

            Bullous reactions, erythema multiforme, and exfoliative dermatitis

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            Warnings

            Contraindications

            Hypersensitivity; sulfa allergy

            Type 1 diabetes

            Diabetic ketoacidosis with or without coma

            Coadministration with bosentan; increased risk of hepatotoxicity

            Cautions

            Risk of hypoglycemia increases when caloric intake is deficient, when more than one glucose-lowering agent used, when ethanol is ingested, or after severe or prolonged exercise; hypoglycemia is also morelikely to occur in elederly patients, malnourished or debilitated patients, and in patients with adrenal and/or pituitary insufficiency, and patients with severe hepatic and hepatic impairment

            Concerns for cross-reactivity between agents containing sulfonamide products has been reported for patients with prior allergic reactions to any compound with the sulfonamide structure SO2NH2; an expanding understanding of allergic mechanisms suggest that cross-reactivity between antibiotic sulfonamides and nonantibiotic sulfonamides may not occur or at the very least the potential is extremely low

            Caution in pregnancy/lactation

            Administration of oral hypoglycemic drugs has been reported to be associated with increased cardiovascular mortality as compared to treatment with diet alone or diet plus insulin; latest studies, however, do not support association

            Hemolytic anemia may occur with glucose 6-phosphate dehydrogenase (G6PD) deficiency when treated with sulfonylurea agents; use caution and consider a nonsulfonylurea alternative in patients with G6PD deficiency

            There are no clinical studies establishing conclusive evidence of macrovascular risk reduction with anti-diabetic drugs

            Use of glyburide not recommended in chronic kidney disease; metabolism and excretion of glyburide may be slowed in aptients with renal impairment and its active metabolites, causing accumulation in advanced renal insufficiency; prolonged hypoglycemia could occur

            It may be necessary to discontinue therapy and administer insulin if patient exposed to stress

            Micronized tablet formulation is not bioequivalent to conventional glyburide tablets; when transferring patient to a different glyburide formulation, retitrate the dose

            Beta cell destruction may occur following prolonged use of therapy, which may result in loss of treatment efficacy in type 2 diabetes mellitus; discontinue therapy if loss of efficacy occurs in patients who were previously responding to treatment and no contributing factors can be identified

            All sulfonylureas are capable of producing severe hypoglycemia

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            Pregnancy & Lactation

            Pregnancy category: C

            Lactation: Not known if crosses into breast milk; avoid use in nursing women

            Pregnancy Categories

            A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA: Information not available.

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            Pharmacology

            Mechanism of Action

            Initial effect is to increase beta-cell insulin secretion

            May also decrease rate of hepatic glucose production and increase insulin receptor sensitivity

            Absorption

            Bioavailability: Variable, depending on oral dosage form

            Onset: 15-60 min after a single dose (increase in serum insulin levels)

            Duration: <24 hr

            Vd: 9-10 L

            Peak serum time: 2-4 hr (adults)

            Distribution

            Protein bound: 99%

            Metabolism

            Metabolized extensively in the liver to less-active metabolites

            Metabolites: 4-trans-hydroxyglyburide, 3-cis-hydroxyglyburide (active)

            Elimination

            Half-life: 10 hr (DiaBeta); 4 hr (Glynase, PresTab)

            Excretion: Urine (50%), feces (50%)

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            Images

            BRAND FORM. UNIT PRICE PILL IMAGE
            glyburide oral
            -
            5 mg tablet
            glyburide oral
            -
            2.5 mg tablet
            glyburide oral
            -
            1.25 mg tablet
            glyburide oral
            -
            5 mg tablet
            glyburide oral
            -
            2.5 mg tablet
            glyburide oral
            -
            1.25 mg tablet
            glyburide oral
            -
            5 mg tablet
            glyburide oral
            -
            2.5 mg tablet
            glyburide oral
            -
            1.25 mg tablet
            glyburide oral
            -
            5 mg tablet
            glyburide oral
            -
            1.25 mg tablet
            glyburide oral
            -
            2.5 mg tablet

            Copyright © 2010 First DataBank, Inc.

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            Patient Handout

            Patient Education
            glyburide oral

            GLYBURIDE - ORAL

            (GLYE-bure-ide)

            COMMON BRAND NAME(S): Diabeta, Glycron, Glynase, Micronase

            USES: Glyburide is used with a proper diet and exercise program to control high blood sugar in people with type 2 diabetes. It may also be used with other diabetes medications. Controlling high blood sugar helps prevent kidney damage, blindness, nerve problems, loss of limbs, and sexual function problems. Proper control of diabetes may also lessen your risk of a heart attack or stroke. Glyburide belongs to the class of drugs known as sulfonylureas. It lowers blood sugar by causing the release of your body's natural insulin.

            HOW TO USE: Read the Patient Information Leaflet if available from your pharmacist before you start taking glyburide and each time you get a refill. If you have any questions, ask your doctor or pharmacist.Glyburide comes in different types of tablets which provide different amounts of the medication. Do not switch between different forms or brands of this medication unless directed by your doctor.Take this medication by mouth with breakfast or the first main meal of the day as directed by your doctor, usually once daily. Some patients, especially those taking higher doses, may be directed to take this drug twice a day. The dosage is based on your medical condition and response to treatment.To reduce your risk of side effects, your doctor may direct you to start this medication at a low dose and gradually increase your dose. Follow your doctor's instructions carefully.If you are already taking another diabetes drug (such as chlorpropamide), follow your doctor's directions carefully for stopping the old drug and starting glyburide.If you are also taking colesevelam, take glyburide at least 4 hours before colesevelam.Use this medication regularly to get the most benefit from it. To help you remember, use it at the same time(s) each day.Tell your doctor if your condition does not improve or if it worsens (your blood sugar is too high or too low).

            SIDE EFFECTS: Nausea, heartburn, stomach fullness, and weight gain may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: signs of infection (such as persistent sore throat, fever), easy bleeding/bruising, stomach pain, yellowing eyes/skin, dark urine, unusual tiredness/weakness, unusual/sudden weight gain, mental/mood changes, swelling of the hands or feet, seizures.This medication can cause low blood sugar (hypoglycemia). This may occur if you do not consume enough calories from food or if you do unusually heavy exercise. Symptoms of low blood sugar include sudden sweating, shaking, fast heartbeat, hunger, blurred vision, dizziness, or tingling hands/feet. It is a good habit to carry glucose tablets or gel to treat low blood sugar. If you don't have these reliable forms of glucose, rapidly raise your blood sugar by eating a quick source of sugar such as table sugar, honey, or candy, or drink fruit juice or non-diet soda. Tell your doctor right away about the reaction and the use of this product. To help prevent low blood sugar, eat meals on a regular schedule, and do not skip meals. Check with your doctor or pharmacist to find out what you should do if you miss a meal.Symptoms of high blood sugar (hyperglycemia) include thirst, increased urination, confusion, drowsiness, flushing, rapid breathing, and fruity breath odor. If these symptoms occur, tell your doctor right away. Your dosage may need to be increased.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

            PRECAUTIONS: Before taking glyburide, tell your doctor or pharmacist if you are allergic to it or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: liver disease, kidney disease, thyroid disease, certain hormonal conditions (adrenal/pituitary insufficiency, syndrome of inappropriate antidiuretic hormone-SIADH), electrolyte imbalance (hyponatremia), a certain nervous system problem (autonomic neuropathy).You may experience blurred vision, dizziness, or drowsiness due to extremely low or high blood sugar. Do not drive, use machinery, or do any activity that requires alertness or clear vision until you are sure you can perform such activities safely.Limit alcohol while taking this medication because it can increase the risk of developing low blood sugar. Rarely, alcohol can interact with glyburide and cause a serious reaction (disulfiram-like reaction) with symptoms such as facial flushing, nausea, vomiting, dizziness, or stomach pain. Consult your doctor or pharmacist about the safe use of alcohol.It may be harder to control your blood sugar when your body is stressed (such as due to fever, infection, injury, or surgery). Consult your doctor because this may require a change in your treatment plan, medications, or blood sugar testing.This medication may make you more sensitive to the sun. Limit your time in the sun. Avoid tanning booths and sunlamps. Use sunscreen and wear protective clothing when outdoors. Tell your doctor right away if you get sunburned or have skin blisters/redness.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Older adults may be more sensitive to the side effects of this drug, especially low blood sugar.During pregnancy, this medication should be used only when clearly needed. Pregnancy may cause or worsen diabetes. Discuss a plan with your doctor for managing your blood sugar while pregnant. Your doctor may substitute insulin for this drug during pregnancy. If glyburide is used, it may be switched to insulin at least 2 weeks before the expected delivery date because of glyburide's risk of causing low blood sugar in your newborn. Discuss the risks and benefits with your doctor.It is unknown if this medication passes into breast milk. However, similar drugs pass into breast milk. Consult your doctor before breast-feeding.

            DRUG INTERACTIONS: See also How To Use section.Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.A product that may interact with this drug is: bosentan.Many drugs can affect your blood sugar, making it harder to control. Before you start, stop, or change any medication, talk with your doctor or pharmacist about how the medication may affect your blood sugar. Check your blood sugar regularly as directed and share the results with your doctor. Tell your doctor right away if you have symptoms of high or low blood sugar. (See also Side Effects section.) Your doctor may need to adjust your diabetes medication, exercise program, or diet.Beta-blocker medications (including metoprolol, propranolol, glaucoma eye drops such as timolol) may prevent the fast/pounding heartbeat you would usually feel when your blood sugar falls too low (hypoglycemia). Other symptoms of low blood sugar such as dizziness, hunger, or sweating are unaffected by these drugs.Check the labels on all your medicines (such as cough-and-cold products) because they may contain ingredients that could affect your blood sugar. Ask your pharmacist about using those products safely.

            OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: shakiness, fast heartbeat, sweating, loss of consciousness.

            NOTES: Do not share this medication with others.Attend a diabetes education program to learn more about how to manage your diabetes with medications, diet, exercise, and regular medical exams.Learn the symptoms of high and low blood sugar and how to treat low blood sugar. Check your blood sugar regularly as directed.Keep all regular medical and laboratory appointments. Laboratory and/or medical tests (such as liver and kidney function tests, fasting blood glucose, hemoglobin A1c, complete blood counts) should be performed periodically to monitor your progress or check for side effects.

            MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

            STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

            MEDICAL ALERT: Your condition can cause complications in a medical emergency. For information about enrolling in MedicAlert, call 1-888-633-4298 (US) or 1-800-668-1507 (Canada).

            Information last revised August 2021. Copyright(c) 2021 First Databank, Inc.

            IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
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            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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            Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.