GLIBENCLAMIDE

Glibenclamide (also known as glyburide) belongs to a class of anti-diabetes medications called sulfonylureas, which act by increasing insulin release from the beta cells in the pancreas. Glibenclamide was developed in 1966 in a cooperative study between Boehringer Mannheim (now part of Roche) and Hoechst (now part of Sanofi-Aventis).

Glibenclamide lowers blood glucose concentration principally by stimulating secretion of endogenous insulin from the pancreatic beta cells and reduction of the liver’s glucose production and enhancement of peripheral insulin action at target sites.

Glibenclamide should not be given to patients with kidney and liver impairment. It should be taken with food, usually before breakfast.

Nausea, epigastric fullness, heartburn, pruritus, erythema, urticaria, morbilliform or maculopapular eruptions, angioedema, arthralgia, myalgia, and vasculitis. Rarely, cholestatic jaundice, leucopenia, thrombocytopenia, pancytopenia, agranulocytosis, aplastic anaemia, and haemolytic anaemia.

Potentially Fatal: Hypoglycemia.

Precautions

Give with caution to pregnant and lactating women; elderly, debilitated and malnourished patients; and patients with hypersensitivity to other sulfonamide derivatives, autonomic neuropathy, G6PD deficiency, severe endocrine disorders and adrenal or pituitary insufficiency, mild to moderate renal or hepatic impairment.

 

Interactions

Serum levels may be reduced by colesevelam. May increase hypoglycemic effect with MAOIs, chloramphenicol, fluoroquinolones (e.g. ciprofloxacin), probenecid, NSAIDs, ACE inhibitors, fluoxetine, disopyramide, clarithromycin, salicylates, sulfonamides, β-blockers. Increased serum levels with antifungal antibiotics (e.g. miconazole, fluconazole). May decrease hypoglycemic effect with nonthiazide (e.g. furosemide) and thiazide diuretics, corticosteroids, phenothiazines, thyroid agents, estrogens, OC, phenytoin, nicotinic acid, sympathomimetic agents, rifampicin, calcium channel blockers, isoniazid.

 

Potentially Fatal: May increase hepatotoxic effect of bosentan.

Overdose of glibenclamide can cause severe hypoglycemia or low blood sugar. Symptoms include:

  • Weakness, faintness or hunger
  • Confusion and irrational behavior
  • Sweating with cold, clammy skin
  • Rapid pulse
  • Trembling
  • Deteriorating level of response

Help the victim sit down. If they have their own glucose gel, help them take it. If not, you need to give them something sugary like fruit juice, softdrinks, two teaspoons of sugar, candy or sugary sweets. If they improve quickly, give them more sugary food or drink and let them rest. If they have their glucose testing kit with them, help them use it to check their glucose level. Stay with them until they feel completely better.

If the victim’s condition does not improve, bring them to the hospital immediately.

 

Available brands:

  • Allase (Interphil)
  • Euglotab (ACME)
  • Euglucon (Roche)
  • Lodulce (Littman)
  • Daonil (SanofiAventis)

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