When patients are transferred to glyburide from another sulfonylurea antidiabetic medication with the exception of chlorpropamide no transition period is required. When transferring patients from chlorpropamide, caution should be exercised during the first 1 to 2 weeks because of the prolonged retention of chlorpropamide in the body and subsequent overlapping of drug effects that could cause hypoglycemia. De Weille JR. Modulation of ATP sensitive potassium channels. Cardiovasc Res 1992; 26: 1017-20. If you don't have these reliable forms of glucose, rapidly raise your 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. cheap tenormin online canada
At first, 5 milligrams mg once a day. Tolbutamide interferes with thyroidal uptake of I 123 and I 131. The results are questionable because negative results were also shown in rats and Chinese hamsters. Long-term studies in rats and mice showed no evidence of carcinogenicity. Neuvonen PJ, Karkainen S. Effects of charcoal, sodium bicarbonate, and ammonium chloride on chlorpropamide kinetics. Clin Pharmacol Ther 1983; 33: 386-93.
Do not take other medicines unless they have been discussed with your doctor. This especially includes nonprescription medicines, such as aspirin, and medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems. Kolterman OG. Glyburide in non-insulin-dependent diabetes: an update. Clin Ther 1992; 142: 196-213. When patients are transferred to tolbutamide from another sulfonylurea antidiabetic medication with the exception of chlorpropamide no transition period is required. When transferring patients from chlorpropamide, caution should be exercised during the first 1 to 2 weeks because of the prolonged retention of chlorpropamide in the body.
Batch J, Ma A, Bird D, et al. The effects of ingestion time of gliclazide in relationship to meals on plasma glucose, insulin and C-peptide levels. Eur J Clin Pharmacol 1990; 385: 465-7. Wilkins; 1990. p. 208-9. If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip themissed dose and resume your usual dosing schedule. Food delays absorption of gliclazide up to 187 minutes; may be best taken 30 minutes before or with a meal.
Halter JB, Morrow LA. Use of sulfonylurea drugs in the elderly patients. Diabetes Care 1990 Feb; 13 Suppl 2: 86-92. Levaquin levofloxacin US prescribing information. When adding a sulfonylurea to an insulin regimen that is poorly controlled with insulin alone, the insulin dose at times may be reduced by 25 to 50%. Connor H, Marks V. Alcohol and diabetes. A position paper prepared by the Nutrition Subcommittee of the British Diabetic Association's Medical Advisory Committe and approved by the Executive Council of the British Diabetic Association. Human Appl Nutr 1985; 39A, 393-9. Diabetes Care 1986; 93: 320-2. Campbell DB, Lavielle R, Nathan C. The mode of action and clinical pharmacology of gliclazide: a review. Diabetes Res Clin Pract 1991; S21-S36. Have a glucagon kit and a syringe and needle available in case severe low blood sugar occurs. Check and replace any expired kits regularly. Loupi E, Descotes J, Lery N, Evreux JC. Interactions medicamenteuses et miconazole. A propos de 10 observations. Therapie 1982; 374: 437-41. When patients are transferred to acetohexamide from another sulfonylurea antidiabetic medication with the exception of chlorpropamide no transition period is required. When transferring patients from chlorpropamide, caution should be exercised during the first 1 to 2 weeks because of the prolonged retention of chlorpropamide in the body. Glyburide Nu-Glyburide, Nu-Pharm. In: Gillis MC, editor. CPS Compendium of pharmaceuticals and specialties. 33rd ed. Ottawa: Canadian Pharmacists Association; 1998. p. 1190. Using some quinolone antibiotics with your diabetes medicine may make your blood sugar too low. Studies in male mice and male and female rats given more than 1700 times and approximately 4000 times, respectively, the maximum recommended human dose based on body surface area showed no evidence of impaired fertility. This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist. No evidence of teratogenicity was found in rats following oral administration of glimepiride at doses approximately 4000 times the maximum recommended human dose based on body surface area, or in rabbits following administration of glimepiride at doses approximately 60 times the maximum recommended human dose based on body surface area. Phillips RE, Looaressuwan S, White NJ, et al. Hypoglycaemia and antimalarial drugs: quinidine and release of insulin. BMJ 1986; 292: 1319-21. You should time your medicines so that you take your diabetes medicine 4 hours or more before your colesevelam. If you have any questions about how to take your medicines, ask your pharmacist. Your doctor may want you to check your blood glucose more frequently while you are taking these medicines together.
Rett K, Wicklmayr M, Dietz GJ. Hypoglycemia in hypertensive diabetic patients treated with sulfonylurea, biguanides, and captopril. N Engl J Med 1988; 319: 1609. Other than the above information, there is no additional information relating to its proper use, precautions, or side effects for this use. Initial: Oral, 250 mg once a day, the dosage being changed by 50 to 125 mg every three to five days if needed. Hanson RL, Nelson RG, McCance DR, et al. Comparison of screening tests for non-insulin-dependent diabetes mellitus. Arch Intern Med 1993 Sep; 153: 2133-40. Some elderly patients may be more sensitive than younger adults to the effects of sulfonylureas, especially when more than one antidiabetic medicine is being taken or if other medicines that affect blood sugar are also being taken. This may increase your chance of developing low blood sugar during treatment. Furthermore, the first signs of low or high blood sugar are not easily seen or do not occur at all in older patients. This may increase the chance of low blood sugar developing during treatment. Warren SE. False-positive urine ketone test with captopril. N Engl J Med 1980; 30317: 1003-4. Koda-Kimble MA, Young LY, editors. Applied therapeutics: the clinical use of drugs. 5th ed. Vancouver, WA: Applied Therapeutics, Inc; 1992. Patients with renal function impairment should receive an initial dose of 1 mg once a day. Keep out of the reach of children. Groop LC, DeFronzo RA, Luzi L, Melander A. Hyperglycaemia and absorption of sulphonylurea drugs. Lancet 1989 Jul; 1989; 129-30. avana
Chlorpropamide is also indicated as secondary therapy in selected patients to treat partial central diabetes insipidus. Used as an antidiuretic, chlorpropamide has successfully reduced polyuria in about 50% of such treated patients. Chlorpropamide may be used alone or in combination with another agent such as carbamazepine or clofibrate so that the dose of both can be reduced and side effects minimized. Desmopressin is considered the primary treatment for diabetes insipidus. Chlorpropamide seems to potentiate the effect of minimal concentrations of antidiuretic hormone present in patients with partial central diabetes insipidus. It has been suggested by some studies, including the University Group Diabetes Program UGDP that certain sulfonylurea antidiabetic agents increase cardiovascular mortality in diabetic patients, a population that already has a greater risk of cardiovascular disease and mortality when blood glucose is not controlled. Other studies have not reached a similar conclusion and have in fact suggested that control of elevated blood glucose with sulfonylurea antidiabetic agents may lessen the danger of cardiovascular disease and mortality. Despite questions regarding the interpretation of the results and the adequacy of the experimental design, the findings of the UGDP study provide an adequate basis for caution, especially for certain high risk patients with coronary artery disease, congestive heart failure, or angina pectoris. If sulfonylurea treatment is necessary, glyburide or gliclazide may be the preferred sulfonylureas for use in patients at risk for conditions causing cardiac hypoxia. The patient should be informed of the potential risks and advantages of sulfonylurea antidiabetic agents and of alternative modes of therapy. F in a tight container, unless otherwise specified by manufacturer. When patients are transferred to glipizide from another sulfonylurea antidiabetic medication with the exception of chlorpropamide no transition period is required. When transferring patients from chlorpropamide, caution should be exercised during the first 1 to 2 weeks because of the prolonged retention of chlorpropamide in the body. Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When patients are transferred to tolazamide from another sulfonylurea antidiabetic medication with the exception of chlorpropamide no transition period is required. When transferring patients from chlorpropamide, caution should be exercised during the first 1 to 2 weeks because of the prolonged retention of chlorpropamide in the body. High blood sugar hyperglycemia is another problem related to uncontrolled diabetes. Al-Badr AA, El-Obeid HA. Acetohexamide. In: Brittain HG, editor. Analytical profiles of drug substances and excipients. San Diego: Academic Press; 1992. p. 1-41. Galloway JA, McMahon RE, Culp HW, et al. Metabolism, blood levels and rate of excretion of acetohexamide in human subjects. Diabetes 1967; 162: 118-27. Cipro ciprofloxacin hydrochloride US prescribing information. Chlorpropamide: Chlorpropamide has been found to be distributed into breast milk at a concentration of 5 mcg per mL after 5 hours for a single 500-mg dose after 5 hours, blood concentration for a single dose of 250 mg chlorpropamide is 30 mcg per mL; therefore, its use during breast-feeding is not recommended. Its effect on the nursing infant is not known. For a listing of dosage forms and brand names by country availability, see Dosage Forms sections. Jacobs DS, DeMott WR, Strobel SL, et al. Chemistry. In: Jacobs DS, Kasten BL, DeMott WR, editors. Laboratory test handbook. Mack RB. He is happy whom the muses love: Micronase sulfonylurea overdose. NC Med J 1989 Jun; 506: 312-4. Initial: Oral, 1 to 2 mg once a day with breakfast or the first main meal. opad.info ciprofloxacin
Acetohexamide Dimelor, Lilly. In: Gillis MC, editor. CPS Compendium of pharmaceuticals and specialties. 33rd ed. Ottawa: Canadian Pharmacists Association; 1998. p. 498-9. Check with your doctor or pharmacist to find out what you should do if you miss a meal. Crockett SE, Marsh D, Lewis RP, et al. Lack of cardiac inotropic effect of tolbutamide in intact man. Metabolism 1974; 823: 763-9. Remenchik AP, Hoover C, Talso PJ. Insulin secretion by hypersensitive patients receiving hydrochlorothiazide. JAMA 1970; 212: 869. Basler A, Baumann M, Rohrborn G. In vitro testing of chlorpropamide with human lymphocyte cultures in the presence of liver microsome fraction S9 mix of rats. Arzneimittelforschung 1982; 327: 724-6. cheap gynera purchase store uk
Stapleton JT, Gillman MW. Hypoglycemic coma due to disopyramide toxicity. South Med J 1983; 76: 1453. There may be a time when you need emergency help for a problem caused by your diabetes. You need to be prepared for these emergencies. Del Prato S, Vigili de Kreutzenberg S, Riccio A, et al. Partial recovery of insulin secretion and action after combined insulin-sulfonylurea treatment in Type 2 non-insulin-dependent diabetic patients with secondary failure to oral agents. Diabetologia 1990; 3311: 688-95. Oral, 100 to 250 mg as a single dose daily, the dosage being adjusted at two- or three-day intervals as needed and tolerated. Groop L, Schalin C, Franssila-Kallunki A, et al. Characteristics of non-insulin-dependent diabetic patients with secondary failure to oral antidiabetic therapy. Am J Med 1989; 872: 183-90. Ober KF. Mechanism of interaction of tolbutamide and phenylbutazone in diabetic patients. Eur J Clin Pharmacol 1974; 7: 291-4. pharmacy neurontin malarone
Other family members need to learn how to prevent side effects or help with side effects in the patient if they occur. Also, patients with diabetes, especially teenagers, may need special counseling about sulfonylurea or insulin dosing changes that might occur because of lifestyle changes, such as changes in exercise and diet. Furthermore, counseling on contraception and pregnancy may be needed because of the problems that can occur in women with diabetes who become pregnant. Check the labels on all your medicines such as -and-cold products because they may contain ingredients that could affect your sugar. Ask your pharmacist about using those products safely. Rapidly and well absorbed but may have wide inter- and intra-individual variability. At first, 100 to 250 milligrams mg once a day in the morning. Then, your doctor may change your dose a little at a time if needed. The dose is usually not more than 1 gram a day. If your dose is 500 mg or more, the dose is usually divided into two doses. These doses are taken with the morning and evening meals. Studies in humans have not been done. During conversion from insulin therapy to tolazamide therapy, no gradual dosage adjustment usually is required for patients using less than 40 USP Units of insulin daily. Patients requiring 40 or more USP Units daily should receive a 50% reduction of insulin during the first few days, with gradual dosage adjustment of tolazamide as needed. Hospitalization for some patients on a higher insulin dosage may be required for uneventful conversion. In general, no overall difference in safety or efficacy was apparent in persons over 65 years of age when compared to persons younger than 65 years of age taking sulfonylureas for type 2 diabetes. Lower doses are used initially because of possible increased sensitivity to these agents due to age-related metabolism and excretion changes; the steady state concentration of extended-release glipizide has been delayed for 1 or 2 days in elderly patients. The risk of adverse reactions is relatively low when other factors for toxicity, including liver and kidney disease and known drug interactions, are considered. Special counseling with emphasis on hydration, diet, and exercise may be necessary because of the greater risk of hypoglycemia in this age group. Special instruction to recognize hypoglycemia may be needed because early warning adrenergic symptoms of hypoglycemia such as sweating, weakness, tachycardia, and nervousness are absent in many patients. Hypoglycemia manifests as neurological symptoms such as headache, irritability, mental confusion, unusual tiredness, and drowsiness and may be more prolonged and severe in the elderly. Combining antidiabetic agents sulfonylureas with metformin or insulin or using long-acting sulfonylureas, such as chlorpropamide and glyburide, is most often associated with hypoglycemia in elderly patients and is not generally recommended; shorter-acting sulfonylureas cause fewer problems. Also, instructions may be needed to help the patient monitor urine or blood glucose if visual problems are present. Niemi M, Backman JT, Neuvonen PJ. Effects of trimethoprim and rifampin on the pharmacokinetics of the cytochrome P450 2C8 substrate rosiglitazone. Do not use chocolate because its fat slows down the sugar entering the bloodstream. Combination use of insulin and sulfonylurea agents in patients with type 1 diabetes is controversial because many studies have indicated that sulfonylureas are not effective in the treatment of these patients. The effectiveness of sulfonylureas in controlling blood glucose can decrease over time. If maximum doses of a sulfonylurea fail to control blood glucose, switching to another sulfonylurea or adding metformin to a sulfonylurea treatment regimen may be beneficial in increasing glycemic control and lipoprotein metabolism and may help avoid initiation of insulin therapy. This is especially successful in patients with type 2 diabetes whose blood sugar levels are poorly controlled by insulin alone, in short-term diabetics, or in patients who are 120 to 160% over ideal baseline body weight but who are not excessively insulin-resistant. Glimepiride and metformin may be used concomitantly when diet, exercise and glimepiride or metformin alone do not adequately control blood glucose levels. Combined use of glimepiride and metformin may increase the potential for hypoglycemia. Alternatively, low-dose insulin in conjunction with sulfonylureas can help to avoid using large doses of insulin, especially for patients with type 2 diabetes who are obese. However, complications, such as weight gain, the effects of hyperinsulinemia, and an increased risk of hypoglycemia need to be considered. Some patients with type 2 diabetes who are nonobese and who are experiencing secondary sulfonylurea failure may be best treated with insulin. A sulfonylurea should be discontinued any time it fails to contribute to the lowering of plasma glucose in a patient for whom compliance with proper diet and sulfonylurea dosing has been determined to be adequate. No teratogenic effects were found in studies in rats and rabbits. Food delays absorption of chlorpropamide. Not recommended for use in patients with renal function impairment. Managing with mannitol and dexamethasone.
This information is generalized and not intended as specific medical advice. When patients are transferred to glimepiride from another sulfonylurea antidiabetic medication with the exception of chlorpropamide no transition period is required. When transferring patients from chlorpropamide, caution should be exercised during the first 1 to 2 weeks because of the prolonged retention of chlorpropamide in the body. Chlorpropamide may also be used for other conditions as determined by your doctor. Ellenhorn MJ, Barceloux OG. Medical toxicology: diagnosis and treatment of human poisoning. New York: Elsevier; 1988. p. 440-9, 565, 785. Noroxin norfloxacin US prescribing information. Amaryl glimepiride US prescribing information. Briggs GG, Freeman RK, Yaffe SJ. A reference guide to fetal and neonatal risk. Drugs in pregnancy and lactation. Christensen LK, Skovsted L. Inhibition of drug metabolism by chloramphenicol. Lancet 1969; 1397. Rado JP, Szende L, Marosi J, et al. Inhibition of the diuretic action of glibenclamide by clofibrate, carbamazepine and 1-deamino-8-D-arginine-vasopressin DDAVP in patients with pituitary diabetes insipidus. Acta Diabetol Lat 1974; 11: 179. If high blood sugar is not treated, it can cause serious problems, such as heart failure, blood vessel disease, eye disease, or kidney disease. Conservative initial and maintenance doses may be required in patients with medical problems that make them more sensitive to effects of sulfonylureas. atomoxetine
Tolbutamide Apo-Tolbutamide, Apotex. In: Gillis MC, editor. CPS Compendium of pharmaceuticals and specialties. 33rd ed. Ottawa: Canadian Pharmacists Association; 1998. p. 122. McGavack TH, Seegers W, Haar HO, et al. Thyroid function of diabetic patients as influenced by the sulfonylureas. Ann NY Acad Sci 1957; 711: 268-74. Rocha AS, Ping WC, Kudo LH. Effect of chlorpropamide on water and urea transport in the inner medullary collecting duct. Kidney Int 1991 Jan; 391: 79-86. Breimer DD, Zilly W, Richter E. Influence of corticosteroids on hexobarbital and tolbutamide disposition. Clin Pharmacol Ther 1978; 242: 208-12. Diabeta glyburide US prescribing information. Vigneri R, Trischitta V, Italia S, et al. Treatment of NIDDM patients with secondary failure to glyburide: comparison of the addition of either metformin or bedtime NPH insulin to glyburide. Diabete Metab 1991 May; 17 1 Pt 20: 232-4. Side Effects List Glipizide-Metformin side effects by likelihood and severity. Tolbutamide general monograph, CPhA. In: Krogh CME, editor. CPS Compendium of pharmaceuticals and specialties. 29th ed. Ottawa: Canadian Pharmaceutical Association; 1994. p. 1329-30. Do not take other medicines without advice from your doctor. In most cases, if no improvement of hemoglobin A 1c is noted after three months of use of a higher dose, the previous dose should be resumed. Symptoms of severe high blood sugar called ketoacidosis or diabetic coma that need immediate hospitalization include: flushed dry skin, fruit-like breath odor, ketones in urine, passing out, troubled breathing rapid and deep. Dolger H. Experience with the tolbutamide treatment of 500 cases of diabetes on an ambulatory basis. Ann NY Acad Sci 1957; 711: 275-9. Brown KS, Armstrong IC, Wang A, Walker JR, Noveck RJ, Swearingen D, Allison M, Kissling JC, Kisicki J, Salazar DE. Effect of the bile acid sequestrant colesevelam on the pharmacokinetics of pioglitazone, repaglinide, estrogen estradiol, norethindrone, levothyroxine, and glyburide. Melander A, Bitzen P-O, Faber O, et al. Sulphonylurea antidiabetic drugs: an update of their clinical pharmacology and rational therapeutic use. Drugs 1989; 371: 58-72. Balant L. Clinical pharmacokinetics of sulphonylurea hypoglycemic drugs. Clin Pharmacokinet 1981; 6: 215-41. Hospitalization for 6 to 91 hours mean, 24 hours because the hypoglycemia may be recurrent and prolonged; for chlorpropamide this period may be extended to 3 to 5 days or longer. cheap adalat pills
Seltzer HS. Drug-induced hypoglycemia: a review based on 473 cases. Diabetes 1972; 21: 955-66. Ferriere M, Lachkar H, Richard JL, et al. Captopril and insulin sensitivity. Ann Intern Med 1985; 102: 134-5. Pond SM, Birkett DJ, Wade DN. Mechanisms of inhibition of tolbutamide metabolism: phenylbutazone, oxyphenbutazone, sulfaphenazole. Clin Pharmacol Ther 1977; 225 Pt 1: 573-9. Committee of Drugs, American Academy of Pediatrics. Transfer of drugs and other chemicals into human milk. Pediatrics 1989; 845: 924-36. Has mild antidiuretic activity. Young DS, editor. Effects of drugs on clinical laboratory tests. 1991 supplement to the third edition. Washington: AACC Press; 1991. Chlorpropamide crosses the placenta; glyburide does not significantly cross the placenta, and it is not known whether other sulfonylureas cross the placenta. Use of insulin rather than sulfonylurea antidiabetic agents during pregnancy allows for the maintenance of blood glucose concentrations that are as close to normal as possible. Abnormal blood glucose concentrations in the mother have been associated with a higher incidence of congenital abnormalities during early pregnancy, and with increased perinatal morbidity and mortality later in pregnancy. Adequate and well-controlled studies in humans have not been done to determine whether sulfonylureas are teratogenic. It remains possible that sulfonylureas cause congenital malformations if they cross the placenta, but current data leave unresolved the issue of whether the abnormalities are due to poor glucose control or to sulfonylurea treatment. Generally, sulfonylureas are not recommended during pregnancy. In the rare case that sulfonylureas are used during pregnancy, they should be discontinued to allow an interval before delivery appropriate for the particular sulfonylurea being used because of the risk that they will cause insulin release and hypoglycemia in the neonate at delivery. McMurty RJ. Propranolol, hypoglycemia, and hypertensive crisis. Ann Intern Med 1974; 80: 669-70. Young DS, editor. Effects of drugs on clinical laboratory tests. 3rd ed. Washington: AACC Press; 1990. Mouradian M, Abourizk N. Diabetes mellitus and thyroid disease. Diabetes Care 1983 Sep-Oct; 65: 512-20. F in a well-closed container, unless otherwise specified by manufacturer. Diabetes Res Clin Prac 1985; Suppl 1: S522. Studies in male and female rats given 75 times the maximum human dose showed no evidence of impaired fertility. Tolbutamide Mobenol, Horner. In: Krogh CME, editor. CPS Compendium of pharmaceuticals and specialties. 29th ed. Ottawa: Canadian Pharmaceutical Association; 1994. p. 796. buy real celebrex online uk
Self TH, Tsiu SJ, Fowler JW Jr. Interaction of rifampin and glyburide. Immediately treating with 50 mL of 50% dextrose injection given intravenously to stabilize the patient. Rifabutin Mycobutin, Adria. In: PDR Physicians' desk reference. 48th ed. 1994. Montvale, NJ: Medical Economics Data Production Company; 1994. p. 463-5. WebMD User Reviews should not be considered as medical advice and are not a substitute for professional medical advice, diagnosis, or treatment. Never delay or disregard seeking professional medical advice from your physician or other qualified healthcare provider because of something you have read on WebMD. You should always speak with your doctor before you start, stop, or change any prescribed part of your care plan or treatment. WebMD understands that reading individual, real-life experiences may be a helpful health information resource but they are never a substitute for professional medical advice from a qualified healthcare provider. Chlorpropamide Diabinese, Pfizer. In: PDR Physicians' desk reference. 52nd ed. 1998. Montvale, NJ: Medical Economics Company; 1998. p. 2173-5. Klein W. Sulfonylurea-metformin-combination versus sulfonylurea-insulin-combination in secondary failures of sulfonylurea monotherapy. Results of a prospective randomized study in 50 patients. Diabete Metab 1991 May; 17 1 Pt 2: 235-40. Symptoms of high 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. Bioavailability of nonmicronized glyburide is lowest when given with a high-fat diet compared to fasting or a high-carbohydrate diet. Micronized glyburide is more consistent in its bioavailability and in its T max with regard to all meal types than is the nonmicronized formulation. Also, micronized glyburide is better absorbed and is effective at a lower dose than is nonmicronized glyburide. Welchol colesevelam hydrochloride US prescribing information. Daiichi Sankyo, Inc. June, 2013. In addition, your doctor may use an endoscope to take a removal of tissue to look for the presence of disease. Engl J Med 1989 Nov 2; 32118: 1231-45. Fluconazole severe hypoglycemia has been reported shortly after concurrent use of tolbutamide, glyburide, and glipizide with these oral azole antifungal agents. If any of these effects persist or worsen, tell your doctor or promptly. risperidone
May be preferred for those patients with moderate renal function impairment; should not be used with severe renal failure. Ikeda T, Fujiyama K, Hoshino T, et al. Glucose tolerance and gastric emptying in thyrotoxic rats. Metabolism 1989 Sep; 389: 874-7. Pharmaceutical, Inc. February, 2011. Protective activity for some cardiac arrhythmias; also, reduces platelet adhesiveness and aggregation and has fibrinolytic activity. Disulfiram-type reaction with concurrent alcohol use less likely with glyburide than with other antidiabetics. Also, displacement from plasma proteins by other medications is less likely. Secondary failure of oral antidiabetic therapy may occur in certain patients. This may be due to increasing severity of diabetes or to diminished responsiveness to the medication. For quick reference, the following sulfonylurea antidiabetic agents are numbered to match the corresponding brand names. When low blood sugar occurs, it may last longer than usual if more than a small amount of alcohol is taken, especially on an empty stomach. Small amounts of alcohol at mealtime usually do not cause problems with your blood sugar but may cause a redness called flushing in the face, arms, and neck that can be uncomfortable. May be preferred for those patients with moderate renal function impairment but should be discontinued with renal failure. National Diabetes Data Group. Classification and diagnosis of diabetes mellitus and other categories of glucose intolerance. Diabetes 1979 Dec; 28: 1039-57.
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Colesevelam may bind to your diabetes medicine in your GI tract, preventing your body from absorbing the medicine. Chlorpropamide and tolbutamide are distributed into human breast milk and potentially may cause hypoglycemia in the infant. Glimepiride is distributed into the milk of rats. It is not known whether acetohexamide, gliclazide, glipizide, glyburide, or tolazamide is distributed into breast milk. Ask your doctor what kind of exercise to do, the best time to do it, and how much you should do each day.
Self TH, Morris T. Interaction of rifampin and chlorpropamide. Groop L, Totterman KJ, Harno K, et al. Influence of beta-blocking drugs on glucose metabolism in patients with non-insulin dependent diabetes. Acta Med Scand 1982; 211: 7-12. Prolonged severe hypoglycemia lasting for 4 to 10 days has been reported in neonates born to mothers who were receiving a sulfonylurea antidiabetic agent at the time of delivery. This effect has been reported more frequently with those agents with longer half-lives, such as chlorpropamide. If sulfonylureas are used during pregnancy, they should be discontinued according to the manufacturer's labeling.
It may be harder to control your when your body is stressed such as due to fever, infection, injury, or surgery. Boyle PJ, Justice K, Krentz AJ, et al. Octreotide reverses hyperinsulinemia and prevents hypoglycemia induced by sulfonylurea overdoses. J Clin Endocrinol Metab 1993; 763: 752-6. Patients sensitive to one of the sulfonylureas may be sensitive to the others also; cross-sensitivity to other sulfonamide- or thiazide-type medications may also occur. Product Information: Amaryl, glimepiride. Hoechst Marion Roussel, Kansas City, MO, USA. The majority of a single dose of tolazamide is eliminated in urine within 24 hours and elimination is complete after 5 days. Less active metabolites include carboxytolazamide, hydroxytolazamide, and p-toulene sulfonamide.
During conversion from insulin therapy to glipizide therapy, no gradual dosage adjustment usually is required for patients using less than 20 USP Units of insulin daily. For patients using 20 or more USP Units daily, a 50% reduction of insulin the first day, with gradual dosage adjustments of glipizide as needed, is desirable. Hospitalization for some patients on a higher insulin dosage may be required for uneventful conversion. Wallach J. Intrepretation of diagnostic tests: A synopsis of laboratory medicine, 4th ed. Boston: Little, Brown and Company; 1986. Reaven GM, Fraze E, Chen NY, et al. The combined use of insulin and sulfonylurea therapy in patients with non-insulin dependent diabetes mellitus. Horm Metab Res 1989; 21: 132-6.