Glyburide

About Glyburide

Glyburide makes the pancreas release insulin whatever the blood sugar level, so it works reliably but can push blood sugar too low. It is used with diet and exercise in adults with type 2 diabetes, alone, with other medicines or combined with metformin in one tablet, and is not used in type 1 diabetes.

Micronized glyburide uses finer drug particles, so lower strengths are used: the label states that 3 mg micronized is not bioequivalent to 5 mg regular, and anyone moving between them is retitrated. The Glynase brand is discontinued, but generic micronized tablets are still made, and a pharmacist cannot swap one form for the other.

Shakiness, sweating, confusion and a fast heartbeat signal a low, made more likely by skipped meals, alcohol, hard exercise, kidney or liver disease and older age; MedlinePlus advises that older adults should not usually take it, because other medicines are safer or more effective for them. Nausea, heartburn, rash and sun sensitivity can occur. It must not be taken with bosentan, can cause hemolytic anemia in G6PD deficiency, and carries a special warning, not a boxed one, about a possible rise in cardiovascular deaths with drugs of this class. In pregnancy, the label advises stopping it at least two weeks before delivery.

Taking Glyburide

How to take it

Once a day with breakfast or the first main meal, or twice a day if prescribed, at least 4 hours before colesevelam. Ask what to do on days you cannot eat normally, and carry fast-acting sugar.

If you miss a dose

Take it as soon as you remember, unless it is almost time for the next dose; in that case skip the missed dose and carry on as usual. Never take two doses at once to make up.

Storage

At room temperature in a tightly closed container, away from light and moisture.

Interactions to know about

Never with bosentan. Aspirin and other salicylates, anti-inflammatories, sulfonamide and fluoroquinolone antibiotics, miconazole, other diabetes medicines and alcohol can push blood sugar too low; thiazide diuretics, steroids, thyroid hormone and estrogens can raise it. Beta blockers can hide the warning signs of a low. Report yellowing skin, dark urine or unusual bruising.

This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.

Why the cash price for Glyburide differs from pharmacy to pharmacy

Regular glyburide costs pharmacies little, so the cash price is mostly fee and mark-up, and the biggest factor is whether a pharmacy has a flat-price generic list. Micronized glyburide has far fewer makers and cannot be filled with regular tablets, so quotes vary more and it may need ordering. The metformin combination costs more than the two generics separately at some pharmacies and less at others, since one prescription carries one fee.

Ways to pay less for Glyburide without insurance

• Ask whether glyburide is on the pharmacy’s flat-price generic list, and for a ninety-day supply once the dose is stable.
• If micronized tablets are hard to find or quoted high, ask the prescriber whether regular glyburide or glipizide would suit you; the prescriber sets the new dose.
• If you take metformin too, ask for quotes on the combination tablet and on the two generics separately.
• Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.

Questions to ask your pharmacist about Glyburide

1. 1.Is this regular or micronized glyburide, and the same form as last time?
2. 2.What should I do on a day I skip a meal?
3. 3.How do I recognize and treat low blood sugar?
4. 4.Is glyburide a good choice at my age?
5. 5.Is it safe with alcohol and my other medicines?

Related medications