Glyburide
Brand: DiaBeta, Glynase (both discontinued; generic only)
No boxed warning on the current FDA label. On the ISMP high-alert list.
- Caution
- Prolonged hypoglycemia, especially in older adults and kidney impairment; avoided in older adults (Beers list).
- Pregnancy
- Has been used in gestational diabetes but insulin is generally preferred.
Common side effects
- Low blood sugar
- Weight gain
- Nausea
- Rash
Key interactions
- Alcohol can trigger low blood sugar
- Beta blockers mask the warning signs
- Additive effect with other glucose-lowering drugs
Counseling points
- Carry a fast-acting sugar source at all times
- Do not skip meals
- Low blood sugar can recur hours later: longer-acting than glipizide
- Higher risk in older adults and kidney impairment
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