Glibenclamide

Key facts

• Glibenclamide, also called glyburide, is a sulfonylurea that lowers blood glucose in type 2 diabetes by making the pancreas release more insulin.
• It is taken by mouth, usually once or twice daily with meals. It is one of the longer-acting sulfonylureas, so its glucose-lowering effect persists for many hours.
• Glibenclamide's defining risk is hypoglycemia (low blood sugar), which can be severe and last for many hours. Never skip a meal after taking a dose. Older adults and people with kidney impairment face particular risk, because the drug and its active byproducts build up in the body.
• Seek urgent care for confusion, difficulty waking, seizures, or loss of consciousness.

What glibenclamide treats

Glibenclamide treats type 2 diabetes, lowering blood glucose when diet and exercise alone are not enough. It is not used for type 1 diabetes, where the pancreas makes little or no insulin, and it does not treat pre-diabetes.

How glibenclamide works

Glibenclamide binds to receptors on the pancreas's insulin-producing beta cells, triggering them to release insulin regardless of the current blood glucose level. This lowers blood glucose, but because insulin release is not tied only to food intake, it can push glucose too low if a meal is delayed, skipped, or smaller than usual.

Before you take it

• Do not take glibenclamide if you have type 1 diabetes, diabetic ketoacidosis, or a known allergy to sulfonylureas.
• Tell your prescriber about kidney or liver disease and your age. Glibenclamide is generally avoided in older adults and in significant kidney impairment because of the high hypoglycemia risk, and other sulfonylureas are often preferred.
• Alcohol increases the risk and severity of hypoglycemia. Tell your prescriber about all other glucose-lowering medicines.

Side effects

Common effects include hypoglycemia symptoms such as shakiness and sweating, mild nausea, and weight gain.

Stop and seek urgent medical care for:

• Confusion, slurred speech, seizures or loss of consciousness (severe hypoglycemia).
• Yellowing of the skin or eyes.
• Signs of an allergic reaction such as rash or swelling of the face or throat.

Safety essentials

• Hypoglycemia is glibenclamide's defining risk. Eat regular meals, never skip a meal after a dose, and carry a fast-acting sugar source in case of shakiness, sweating or confusion.
• Older adults and anyone with reduced kidney function face a much higher risk of severe, prolonged low blood sugar; doses are usually lower, or a different sulfonylurea is chosen instead.
• Illness, missed meals, increased exercise and alcohol all raise hypoglycemia risk; check blood glucose more often at these times.

This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.