Dynor

Indications

Glibenclamide is used to control blood sugar in adults with type 2 diabetes, together with diet and exercise, when diet alone is not enough. It may be used on its own or with other diabetes medicines such as Metformin.

How It Works

It belongs to the sulfonylurea group. It makes the pancreas release more insulin, the hormone that moves sugar from the blood into the body's cells. It only works if the pancreas can still make some insulin, so it is not used in type 1 diabetes.

Dosage and Administration

Adults: usually started at 2.5 to 5 mg once a day with breakfast or the first main meal. The doctor may increase the dose slowly, based on blood sugar tests, usually to no more than 15 mg a day. Older people and those with kidney problems are started on a low dose or given a different medicine. Do not skip meals after taking it.

Interactions

• Insulin and other diabetes medicines increase the risk of low blood sugar.
• Fluconazole, Miconazole, Clarithromycin, sulfonamide antibiotics and some painkillers can increase its effect.
• Corticosteroids, thiazide diuretics and some hormone medicines can raise blood sugar and weaken its effect.
• Beta-blockers such as Propranolol can hide the warning signs of low blood sugar.
• Alcohol increases the risk of low blood sugar.
• Bosentan should not be taken with it because of liver risk.

Contraindications

• Type 1 diabetes or diabetic ketoacidosis.
• Severe kidney or liver disease.
• Allergy to glibenclamide, other sulfonylureas or sulfonamide medicines.
• Porphyria.
• Pregnancy and breastfeeding.

Side Effects

The most important side effect is low blood sugar (hypoglycaemia): sweating, shaking, hunger, fast heartbeat, headache, confusion or blurred vision. Eat or drink something sugary straight away if this happens. Other effects include weight gain, nausea, stomach upset and skin rash.

Get urgent medical help if low blood sugar does not improve after taking sugar, or if there is fainting, fits or unusual drowsiness; also for yellow skin or eyes, a blistering or peeling rash, or unusual bruising or bleeding.

Pregnancy and Lactation

Not recommended in pregnancy; women with diabetes who are pregnant or planning pregnancy are usually switched to insulin, so speak to the doctor early. It should not be used while breastfeeding because it may lower the baby's blood sugar.

Precautions and Warnings

• Glibenclamide acts for a long time, so low blood sugar can be prolonged, especially in older people and those with kidney problems.
• Eat regular meals and take extra care with exercise, fasting (including Ramadan), illness or alcohol.
• People with G6PD deficiency may develop anaemia.
• Check blood sugar regularly and carry a sugary snack.

Overdose

An overdose can cause severe and long-lasting low blood sugar, which can return many hours later. If the person is awake, give sugar or a sweet drink and get to hospital straight away. If the person is drowsy or unconscious, do not put food in the mouth; call for emergency help.

Therapeutic Class

Sulfonylurea (oral antidiabetic medicine).

Storage

Store below 30°C in a dry place, away from light and out of the reach of children.