Glyburide (Micronase) Risks, Warnings, and Complications
Glyburide can cause severe health problems, especially in certain high-risk patients. Some of the risks of glyburide use include:
SEVERE HYPOGLYCEMIA: Glyburide can cause a dangerous drop in blood sugar to life-threatening levels. Signs and symptoms of low blood glucose include pale skin, sweating, shakiness, irritability, confusion, and a fast heartbeat. To protect yourself against low blood sugar, always carry some fast-acting form of sugar like glucose tablets, hard candy, non-diet soda, or fruit juice with you at all times while on glyburide. You can use fast-acting sugars to raise your blood sugar levels quickly if you experience mild hypoglycemia. Talk to your healthcare provider or pharmacist about how to recognize signs of low blood sugar. The risk of severe hypoglycemia (dangerously low blood sugar) is higher after changes in diet and exercise, in older adults (age 65 and above), in people who drink alcohol, in people who take other medications for diabetes, and in people with pre-existing kidney or liver problems.
HEART PROBLEMS: Some studies have shown that glyburide can increase the risk of death from heart problems compared to other methods of blood sugar control such as diet and insulin. A specific warning has been issued for another medication, tolbutamide, which belongs to the same class of drugs (sulfonylureas) as glyburide. Talk to your healthcare provider about the benefits versus risks of taking glyburide.
Precautions Before Starting Glyburide (Micronase)
Tell your doctor if you have ever had an allergic reaction to glyburide, any of the active or inactive ingredients in glyburide tablets, or any other drugs. Your pharmacy can give you a list of ingredients.
Give your healthcare provider a complete medical history. Glyburide may not be right for people with certain medical conditions, such as hormone disorders, heart disease, renal insufficiency (kidney disease), hepatic impairment (liver disease), or an inherited condition called glucose 6 phosphate dehydrogenase (G6PD) deficiency that can lead to hemolytic anemia from the destruction of red blood cells.
Give your doctor a complete list of all your medications, including prescription and nonprescription drugs, vitamins, dietary supplements, and herbal products. This can help avoid serious interactions between glyburide and your other medications.
Talk to your doctor about the safety of drinking alcohol while on glyburide. Alcohol can make some of the side effects of this medicine worse. Rarely, consuming alcohol while taking glyburide can lead to symptoms such as headache, facial flushing, nausea, vomiting, blurred vision, weakness, chest pain, confusion, breathing difficulty and anxiety.
Tell your doctor if you are pregnant, could be pregnant, plan to get pregnant, or are breastfeeding.
Talk to your doctor about the safety of taking glyburide if you are an older adult (age 65 or above). You may be at increased risk of certain glyburide side effects. There may be other safer medications available to treat your high blood sugar.
Precautions During Use of Glyburide (Micronase)
Keep all your doctors’ appointments while on glyburide. Your doctor may want to perform dosage adjustments. For example, they may initiate a glyburide dose at a lower level and increase the dose gradually based on glucose response. If you show a satisfactory response and good blood sugar control on glyburide, your doctor may decrease your insulin dose or even discontinue insulin.
Avoid drinking alcohol while on this medicine.
Glyburide can make your skin more sensitive to sunlight. Avoid unnecessary sun exposure to the sun and wear protective clothing when outdoors.
Talk to your doctor about what to do for blood sugar control in case you are sick with an infection, have suffered an injury, or are experiencing high levels of mental stress. These conditions can lead to fluctuations in blood glucose levels. Your doctor may want to give you lower or higher doses of glyburide to maintain glycemic control.
Tell all your doctors you are on glyburide before any surgery, including dental procedures.
Glyburide (Micronase) Drug Interactions
Taking glyburide with other drugs can affect glyburide metabolism and how the medications work. Possible drug interactions between glyburide and your other medicines can also increase the risk of serious side effects. Your healthcare professional may choose a different medication for you, change the dose or frequency of your medications, and/or closely monitor you for side effects if there are known interactions between glyburide and your other drugs.
You should not take glyburide with a medication called bosentan (Tracleer) which is used to treat pulmonary arterial hypertension (high blood pressure in the lungs).
There can also be possible drug interactions between glyburide and other drugs such as:
- Medications used to treat high blood pressure, including angiotensin-converting enzyme (ACE) inhibitors such as captopril (Capoten), benazepril (Lotensin), enalapril (Vasotec), lisinopril (Prinivil, Zestril), fosinopril (Monopril), moexipril (Univasc), quinapril (Accupril), perindopril (Aceon), trandolapril (Mavik), and ramipril (Altace); beta blockers such as labetalol (Normodyne), atenolol (Tenormin), metoprolol (Lopressor, Toprol XL), propranolol (Inderal), and nadolol (Corgard); and calcium channel blockers such as diltiazem (Dilacor, Tiazac, Cardizem, others), amlodipine (Norvasc), felodipine (Plendil), nicardipine (Cardene), isradipine (DynaCirc), nimodipine (Nimotop), nifedipine (Adalat, Procardia), verapamil (Calan, Verelan, Isoptin), and nisoldipine (Sular)
- Aspirin and other nonsteroidal anti-inflammatory medications (NSAIDs) such as naproxen (Aleve, Naprosyn) and ibuprofen (Advil, Motrin)
- Blood thinners or anticoagulants such as warfarin (Coumadin)
- Antibiotics such as clarithromycin (Biaxin), chloramphenicol, quinolones and fluoroquinolones like ciprofloxacin (Cipro), cinoxacin (Cinobac), enoxacin (Penetrex), levofloxacin (Levaquin), gatifloxacin (Tequin), lomefloxacin (Maxaquin), nalidixic acid (NegGram), moxifloxacin (Avelox), norfloxacin (Noroxin), sparfloxacin (Zagam), ofloxacin (Floxin), trovafloxacin and alatrofloxacin combination (Trovan), and sulfa antibiotics like co-trimoxazole (Septra, Bactrim) and sulfasalazine (Azulfidine)
- Immunosuppressants like cyclosporine (Neoral, Sandimmune)
- Diuretics or water pills
- Antiarrhythmic medications like disopyramide (Norpace)
- Antifungal drugs like fluconazole (Diflucan) and miconazole (Monistat)
- Antidepressant medications like fluoxetine (Prozac, Sarafem)
- MAO inhibitors such as phenelzine (Nardil), isocarboxazid (Marplan), tranylcypromine (Parnate), and selegiline (Emsam, Eldepryl, Zelapar),
- Cholesterol lowering drugs like gemfibrozil (Lopid)
- Hormonal contraceptives (birth control pills, rings, patches, injections, and implants) and hormone replacement therapy
- Insulin or other glucose lowering drugs used to treat high blood glucose or diabetes
- Tuberculosis medications like isoniazid (INH) and rifampin
- Medications used for colds and asthma
- Medications prescribed for mental illness and nausea
- Oral steroid medicines like methylprednisolone (Medrol), prednisone (Deltasone), and dexamethasone (Decadron, Dexone)
- Vitamin B3 or niacin
- Anti-seizure drugs like phenytoin (Dilantin)
- Gout medications like probenecid (Benemid)
- Salicylate pain relievers like choline salicylate (Arthropan), choline magnesium trisalicylate, diflunisal (Dolobid), salsalate (Disalcid, Argesic, Salgesic), and magnesium salicylate (Doan's, others)
- Thyroid medications
Give your doctor or pharmacist a complete list of your medications, including prescription drugs, over-the-counter medicines, vitamins, dietary supplements, and herbal products.
Also tell your doctor if you smoke, drink alcohol, or use illegal drugs because some of these substances can cause serious health complications when used with prescription drugs.