Examples
| glimepiride |
Amaryl |
| glimepiride and pioglitazone |
Duetact |
| glipizide |
Glucotrol |
| glipizide and metformin |
Metaglip |
| glyburide |
DiaBeta, Glynase, Micronase |
| glyburide and metformin |
Glucovance |
Most sulfonylurea medicines for
type 2 diabetes can be taken once a day. Some need to
be taken twice a day.
These medicines work for a long time and can
cause low blood sugar. It is very important not to skip or delay meals when
taking these medicines.
Glucovance is a combination medicine that
contains glyburide and metformin, a biguanide.
Metaglip is a combination medicine that contains glipizide and
metformin.
How It Works
Sulfonylurea medicines increase the
amount of
insulin produced by the pancreas. This is the primary
action of these medicines.
Because Glucovance and Metaglip are
combination medicines that contain metformin, they decrease the amount of sugar
your liver makes and may increase your body's ability to respond to
insulin.
Why It Is Used
Sulfonylurea medicines are prescribed when changes in diet, weight loss,
and exercise do not keep the blood sugar level within a
target range. When taking one of these medicines, it is
still important to eat a balanced diet, exercise, and lose weight if
needed.
These medicines can help control blood sugar levels in
children and young adults who have type 2 diabetes and are overweight.
Sulfonylurea medicines are not safe if you:
- Are pregnant or trying to become pregnant. They may harm the
fetus.
- Have liver or kidney problems. Sulfonylurea medicines are
broken down by the liver and pass out of the body through urine produced in the
kidneys.
Tell your doctor if you have had a serious allergic
reaction to a sulfa antibiotic, such as Bactrim or Septra. You may not be able
to use a sulfonylurea.
How Well It Works
Sulfonylurea medicines work rapidly
to control elevated blood sugar levels. They often are the first medicine
selected to treat people newly diagnosed with type 2 diabetes. Metformin is
preferred for initial treatment, because it doesn't cause low blood sugar or
weight gain. Most people have better control of their blood
sugar by using a sulfonylurea medicine along with diet and exercise than by
using diet and exercise alone.
But the medicine may become less
effective after several years of use. Some people who no longer respond to one
sulfonylurea may respond to a different one.
Sulfonylurea
medicines decreased the risk for complications of the eyes (retinopathy),
kidneys (nephropathy), and nerves (neuropathy).1
These medicines do not decrease fat (triglycerides) in the blood as does
metformin.
Side Effects
Side effects are uncommon when
sulfonylureas are taken as prescribed. Low blood sugar is the most common side
effect. The risk of very low blood sugar is greater with medicines that work
longer in the body.
Drinking alcohol increases the risk of a low
blood sugar level if you take a sulfonylurea medicine. If you drink alcohol,
limit yourself to only 1 to 2 drinks a day and eat something before you drink
alcohol.
Sulfonylurea medicines can cause weight gain. They also
tend to keep insulin levels in the body high for long periods of time. Over
time, high levels of insulin (hyperinsulinemia) may increase your
chances of getting heart disease.
Blood levels of vitamin B12 can
decrease in some people who take metformin.
See Drug Reference for
a full list of side effects. (Drug Reference is not available in all
systems.)
What To Think About
Sulfonylurea medicines are an effective treatment for many people who have
type 2 diabetes. If one of these medicines keeps your blood sugar within a target range, your risks of long-term complications of diabetes can be reduced. Other
important factors that contribute to complications include
high blood pressure, being overweight,
high cholesterol levels, and smoking.
Children
Few
studies have been done on the use of oral medicines for type 2 diabetes in
children. And they have not been approved by the U.S. Food and Drug
Administration (FDA) for use in children. But because these oral medicines are
safe for adults, most doctors use them to treat children who have type 2
diabetes.
Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.
References
Citations
-
Inzucchi SE, Sherwin RS (2008). Type 2 diabetes
mellitus. In L Goldman, D Ausiello, eds., Cecil Medicine, 23rd ed, pp. 1748–1760. Philadelphia: Saunders Elsevier.
Credits
|
By
|
Healthwise Staff |
|
Primary Medical Reviewer
|
E. Gregory Thompson, MD - Internal Medicine |
|
Specialist Medical Reviewer
|
Matthew I. Kim, MD - Endocrinology |
|
Last Revised
|
June 9, 2010 |