glyburideglibenclamide

Glyburideglibenclamide refers to the sulfonylurea antidiabetic medication whose two names—glyburide (used in the United States) and glibenclamide (used in many other countries)—denote the same chemical compound. It is a second-generation sulfonylurea used to improve glycemic control in adults with type 2 diabetes mellitus when diet and exercise alone do not suffice. It is not appropriate for type 1 diabetes or diabetic ketoacidosis.

Mechanism and use: The drug stimulates pancreatic beta cells to release insulin by inhibiting ATP-sensitive potassium channels, which leads to cell depolarization and insulin secretion. It is generally taken orally, usually once daily with meals to reduce hypoglycemia risk, with dose initiation commonly around 2.5 mg daily and gradual titration up to about 20 mg per day in divided doses, based on response and tolerance. The medication is metabolized in the liver (primarily by CYP2C9) and excreted in urine and feces; pharmacokinetics can be altered in older individuals or those with liver or kidney impairment.

Safety and monitoring: Hypoglycemia is the most common adverse effect, often accompanied by weight gain. Other possible effects include hypersensitivity reactions. Caution is advised in the elderly and in patients with hepatic or renal impairment; the drug is typically avoided in severe hepatic impairment. Contraindications include type 1 diabetes and diabetic ketoacidosis; pregnancy use is generally avoided, with insulin often preferred for gestational diabetes. Interactions that increase hypoglycemia risk include alcohol, beta-blockers, and certain other medications, while some drugs may diminish its effectiveness.

Brand names and availability: Glyburide/glibenclamide is marketed under various names worldwide. Regional naming conventions reflect the same medication rather than a different drug.