Antidiabetic Agents, Sulfonylurea (Systemic)
Precautions While Using This Medicine
Your doctor will want to check your progress at regular visits
, especially during the first few weeks that you take this medicine.
It is very important to follow carefully any instructions
from your health care team about
Alcohol - Drinking alcohol may cause severe low blood sugar.
Discuss this with your health care team.
Tobacco - If you have been smoking for a long time and suddenly
stop, your dosage of sulfonylurea may need to be reduced. If you decide to
quit, tell your doctor first.
Other medicines - Do not take other medicines unless they have
been discussed with your doctor. This especially includes nonprescription
medicines, such as aspirin, and medicines for appetite control, asthma, colds,
cough, hay fever, or sinus problems.
Counseling - Other family members need to learn how to prevent
side effects or help with side effects in the patient if they occur. Also,
patients with diabetes, especially teenagers, may need special counseling
about sulfonylurea or insulin dosing changes that might occur because of lifestyle
changes, such as changes in exercise and diet. Furthermore, counseling on
contraception and pregnancy may be needed because of the problems that can
occur in women with diabetes who become pregnant.
Travel - Carry a recent prescription and your medical history.
Be prepared for an emergency as you would normally. Make allowances for changing
time zones, and keep your meal times as close as possible to your usual meal
Protecting skin from sunlight - Sulfonylureas can make you more
sensitive to the sun. Use of sunblock products that have a skin protection
factor (SPF) of at least 15 on your skin and lips can help to prevent sunburn.
Do not use a sunlamp or tanning bed or booth.
In case of emergency
- There may be a time
when you need emergency help for a problem caused by your diabetes. You need
to be prepared for these emergencies. It is a good idea to:
Wear a medical identification (I.D.) bracelet or neck chain at all
times. Also, carry an I.D. card in your wallet or purse that says that you
have diabetes and a list of all of your medicines.
Keep some kind of quick-acting sugar handy to treat low blood sugar.
Have a glucagon kit and a syringe and needle available in case severe
low blood sugar occurs. Check and replace any expired kits regularly.
Too much of a sulfonylurea can cause low blood sugar (also called hypoglycemia).
Symptoms of low blood sugar must be treated before they
lead to unconsciousness (passing out)
. Different people may feel different
symptoms of low blood sugar. It is important that you
learn which symptoms of low blood sugar you usually have so that you can treat
Symptoms of low blood sugar can include: anxious feeling, behavior
change similar to being drunk, blurred vision, cold sweats, confusion, cool
pale skin, difficulty in concentrating, drowsiness, excessive hunger, fast
heartbeat, headache, nausea, nervousness, nightmares, restless sleep, shakiness,
slurred speech, and unusual tiredness or weakness.
The symptoms of low blood sugar may develop quickly and may result
delaying or missing a scheduled meal or snack.
exercising more than usual.
drinking a significant amount of alcohol.
taking certain medicines.
taking too high a dose of sulfonylurea.
if using insulin, using too much insulin.
sickness (especially with vomiting or diarrhea).
Know what to do if symptoms of low blood sugar occur. Eating some
form of quick-acting sugar when symptoms of low blood sugar first appear will
usually prevent them from getting worse.
Good sources of sugar include:
Glucose tablets or gel, fruit juice or nondiet soft drink (4 to 6
ounces [one-half cup]), corn syrup or honey (1 tablespoon), sugar cubes (6
one-half-inch sized), or table sugar (dissolved in water).
Do not use chocolate because its fat slows down the sugar entering
If a snack is not scheduled for an hour or more you should also eat
a light snack, such as crackers or a half sandwich, or drink an 8-ounce glass
Glucagon is used in emergency situations such as unconsciousness.
Have a glucagon kit available, along with a syringe and needle, and know how
to prepare and use it. Members of your household also should know how and
when to use it.
High blood sugar (hyperglycemia) is another problem related to uncontrolled
diabetes. If you have any symptoms of high blood sugar,
contact your health care team right away
. If high blood sugar is not
treated, severe hyperglycemia can occur, leading to ketoacidosis (diabetic
coma) and death.
Symptoms of high blood sugar appear more slowly than those of low
blood sugar. Symptoms can include: blurred vision; drowsiness; dry mouth;
flushed and dry skin; fruit-like breath odor; increased urination; loss of
appetite; stomachache, nausea, or vomiting; tiredness; troubled breathing
(rapid and deep); and unusual thirst.
Symptoms of severe high blood sugar (called ketoacidosis or diabetic
coma) that need immediate hospitalization include: flushed dry skin, fruit-like
breath odor, ketones in urine, passing out, troubled breathing (rapid and
High blood sugar symptoms may occur if you:
have a fever, diarrhea, or an infection.
if using insulin, do not take enough insulin or skip a dose of insulin.
do not exercise as much as usual.
overeat or do not follow your meal plan.
Know what to do if high blood sugar occurs. Your doctor may recommend
changes in your sulfonylurea dose or meal plan to avoid high blood sugar.
Symptoms of high blood sugar must be corrected before they progress to more
serious conditions. Check with your doctor often to make sure you are controlling
your blood sugar, but do not change the dose of your
medicine without checking with your doctor
. Your doctor might discuss
the following with you:
Decreasing your dose for a short time for special needs, such as
when you cannot exercise as you normally do.
Increasing your dose when you plan to eat an unusually large dinner,
such as on holidays. This type of increase is called an anticipatory dose.
Delaying a meal if your blood sugar is over 200 mg/dL to allow time
for your blood sugar to go down. An extra dose or an injection of insulin
may be needed if your blood sugar does not come down shortly.
Not exercising if your blood sugar is over 240 mg/dL and reporting
this to your doctor immediately.
Being hospitalized if ketoacidosis or diabetic coma occurs with a
possible change of treatment.