Sulfonylureas

Sulfonylureas are a class of oral medications that treat Type 2 diabetes by lowering your blood sugar.

They work by stimulating your pancreas to release more insulin. Sulfonylureas target certain receptors on the beta cells of your pancreas. This causes those cells to release insulin into your bloodstream. Insulin is the hormone that helps keep blood sugar levels in a healthy range.

You should continue to monitor your blood sugar (glucose) levels when you take this medication. Contact your healthcare provider if you notice any major changes. This is how they ensure the medication is working.

What are some examples of sulfonylureas?

Here’s a list of the most prescribed sulfonylureas and their brand names:

• Gliclazide: Diamicron, Diamicron MR (not approved in the U.S.)
• Glimepiride: Amaryl®
• Glipizide: Glucotrol XL®
• Glyburide: DiaBeta™, Glynase®

Healthcare providers will choose your medication based on your health history. Together, you and your provider can discuss the pros and cons and what will work best for you.

What are the benefits and risks of sulfonylureas?

The medication has been shown to lower blood sugar levels in people with Type 2 diabetes. Other benefits include:

• You can take it with other medications for diabetes (like metformin)
• It’s easy to take as a tablet
• It works quickly
• It’s relatively inexpensive compared to other drugs for diabetes

Sulfonylureas aren’t a treatment option for Type 1 diabetes.

The main risk is that these medications can make your blood sugar drop too low (hypoglycemia). To prevent this, your provider may suggest that you take it just before or with a meal. This is also why it’s important to monitor your blood sugar levels.

Other possible risks of the medication include:

• Nausea or diarrhea
• Skin reactions like rash or itching (rare)
• Weight gain

People with kidney disease or liver disease should ask their provider before taking sulfonylureas.

What dosage strengths and forms do sulfonylureas come in?

Sulfonylureas vary in dosage strength (ranging from 1 to 10 mg). All of them are medications that you swallow. They’re taken once or twice per day. Don’t take more or less than your healthcare provider prescribes.

What happens if I miss a dose?

Missing a dose can cause your blood sugar to be too high (hyperglycemia). But this doesn’t mean you should double up on your next dose. This can cause dangerously low blood sugar. You should be able to take your missed dose if you remember within a few hours and if it’s far enough away from your next dose. Continue to monitor your blood sugar closely if you miss or skip a dose. Ask your provider or your pharmacist if you have questions about taking your medication.

Is it possible to overdose on this medication?

Yes. Taking more than your provider prescribes can cause your blood sugar to drop too low. Watch for signs of severely low blood sugar. They include:

• Slurred speech
• Fainting
• Seizure

What other medications and products can interact with sulfonylureas?

There are some medications that can increase your risk of low blood sugar if you take them with sulfonylureas. Some of those are:

• Azole antifungals
• Insulin
• Fluoroquinolones and tetracyclines (antibiotics for bacterial infections)
• GLP-1 agonists
• NSAIDs
• Warfarin

Other medications may make sulfonylureas less effective. Always let your healthcare provider know about all the medications and supplements you take. They may recommend other treatments that work better together.

Can I drink alcohol while I take this medication?

You can, but there are risks. Alcoholic beverages can raise or lower your blood sugar level (depending on what you drink). In general, you should:

• Avoid drinking on an empty stomach
• Limit how much you drink
• Drink alcohol that’s low in sugar
• Monitor your blood sugar if you’re drinking alcohol

When should I call my healthcare provider?

It’s important to see your healthcare provider regularly so they can make sure your treatment is working.

Call your provider if you have:

• Blood sugar readings that are consistently too high or too low
• Signs of low blood sugar like shaking and sweating
• Health changes like surgery, pregnancy or new medications

What else should I know about sulfonylureas?

This class of drugs may be less effective over time. If this happens, your provider will recommend another treatment. Keeping your follow-up appointments and monitoring your blood sugar can help you detect if the medication is still working well.

Knowing the signs of low blood sugar is also helpful when you take sulfonylureas. Early signs include:

• Blurred vision
• Confusion
• Dizziness
• Shakiness or trembling
• Sweating