Type 2 DM
Should be taken with food. Take w/ breakfast or the 1st main meal of the day.
Oral Type 2 diabetes mellitus Adult: Initially, 2.5-5 mg daily, may increase wkly by increments of 2.5-15 mg daily. Doses >10 mg daily should be given in 2 divided doses. Max: 20 mg daily. Elderly: Initially, 1.25 mg daily. Hepatic impairment: Severe: Contraindicated.
Safety and efficacy not established
Renal impairment: Severe: Contraindicated.
Severe or life-threatening hyperglycaemia, severe liver or renal failure, type 1 diabetes, diabetic ketoacidosis with or without coma, patients with severe infection or trauma.
Glibenclamide lowers blood glucose concentration principally by stimulating secretion of endogenous insulin from the pancreatic beta-cells. Hypoglycaemic action associated w/ short-term therapy appears to include reduction of basal hepatic glucose production and enhancement of peripheral insulin action at target sites.
Elderly; malnourished; mild to moderate renal and hepatic disorders. Impaired alertness. Avoid alcohol. Careful monitoring of blood-glucose concentration. Adrenocortical insufficiency. Changes in diet or prolonged exercise may also provoke hypoglycaemia. Increased risk of hypoglcaemia due to its long half-life. Avoid in severe hepatic impairment. Pregnancy, lactation. Lactation: Not known if crosses into breast milk; avoid use in nursing women
Hypoglycaemia; cholestatic jaundice; agranulocytosis; aplastic anaemia; haemolytic anaemia. Blood dyscrasias (reversible), liver dysfunction, GI symptoms, allergic skin reactions. Potentially Fatal: Prolonged hypoglycaemia seen in elderly or debilitated patients with hepatic or renal diseases.
Serum levels may be reduced by colesevelam. May increase hypoglycaemic effect w/ MAOIs, chloramphenicol, fluoroquinolones (e.g. ciprofloxacin), probenecid, NSAIDs, ACE inhibitors, fluoxetine, disopyramide, clarithromycin, salicylates, sulfonamides, beta-blockers. Increased serum levels w/ antifungal antibiotics (e.g. miconazole, fluconazole). May decrease hypoglycaemic effect w/ nonthiazide (e.g. furosemide) and thiazide diuretics, corticosteroids, phenothiazines, thyroid agents, oestrogens, OC, phenytoin, nicotinic acid, sympathomimetic agents, rifampicin, Ca channel blockers, isoniazid. Potentially Fatal: May increase hepatotoxic effect of bosentan.