Antidiabetic Agents, Sulfonylurea (Systemic)

Proper Use of This Medicine

Use this medicine only as directed even if you feel well and do not notice any signs of high blood sugar. Do not take more of this medicine and do not take it more often than your doctor ordered . To do so may increase the chance of serious side effects. Remember that this medicine will not cure your diabetes but it does help control it. Therefore, you must continue to take it as directed if you expect to lower your blood sugar and keep it low. You may have to take an antidiabetic medicine for the rest of your life . If high blood sugar is not treated, it can cause serious problems, such as heart failure, blood vessel disease, eye disease, or kidney disease.

Your doctor will give you instructions about diet, exercise, how to test your blood sugar levels, and how to adjust your dose when you are sick.

• Diet - The daily number of calories in the meal plan should be adjusted by your doctor or a registered dietitian to help you reach and maintain a healthy body weight. In addition, regular meals and snacks are arranged to meet the energy needs of your body at different times of the day. It is very important that you follow your meal plan carefully .
• Exercise - Ask your doctor what kind of exercise to do, the best time to do it, and how much you should do each day.
• Blood tests - This is the best way to tell whether your diabetes is being controlled properly. Blood sugar testing helps you and your health care team adjust the dose of your medicine, meal plan, or exercise schedule.
• On sick days - When you become sick with a cold, fever, or the flu, you need to take your usual dose of sulfonylurea, even if you feel too ill to eat. This is especially true if you have nausea, vomiting, or diarrhea. Infection usually increases your need to produce more insulin. Sometimes you may need to be switched from your sulfonylurea to insulin for a short period of time while you are sick to properly control blood sugar. Call your doctor for specific instructions.
  Continue taking your sulfonylurea and try to stay on your regular meal plan. If you have trouble eating solid food, drink fruit juices, nondiet soft drinks, or clear soups, or eat small amounts of bland foods. A dietitian or your health care professional can give you a list of foods and the amounts to use for sick days.
  Test your blood sugar level at least every 4 hours while you are awake and check your urine for ketones. If ketones are present, call your doctor at once. If you have severe or prolonged vomiting, check with your doctor. Even when you start feeling better, let your doctor know how you are doing.

For patients taking glipizide extended-release tablets :

• Swallow the tablet whole, without breaking, crushing, or chewing it.
• You may sometimes notice what looks like a tablet in your stool. Do not worry. After you swallow the tablet, the medicine in the tablet is absorbed inside your body. Then the tablet passes into your stool without changing its shape. The medicine has entered your body and will work properly.

Dosing - The dose of these medicines will be different for different patients. Follow your doctor's orders or the directions on the label . The following information includes only the average doses of these medicines. If your dose is different, do not change it unless your doctor tells you to do so.

The number of tablets that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the amount of sugar in your blood or urine .

For acetohexamide
• For oral dosage form (tablets):
  • For treating type 2 diabetes:
    • Adults - At first, 250 milligrams (mg) once a day. Some elderly people may need a lower dose at first. Then, your doctor may change your dose a little at a time if needed. The dose is usually not more than 1.5 grams a day. If your dose is 1 gram or more, the dose is usually divided into two doses. These doses are taken before the morning and evening meals.
    • Children - The type of diabetes treated with this medicine is rare in children. However, if a child needs this medicine, the dose would have to be determined by the doctor.

For chlorpropamide
• For oral dosage form (tablets):
  • For treating type 2 diabetes:
    • Adults - At first, 250 milligrams (mg) once a day. Some elderly people may need a lower dose of 100 to 125 mg a day at first. Then, your doctor may change your dose a little at a time if needed. The dose is usually not more than 750 mg a day.
    • Children - The type of diabetes treated with this medicine is rare in children. However, if a child needs this medicine, the dose would have to be determined by the doctor.

For gliclazide
• For oral dosage form (tablets):
  • For treating type 2 diabetes:
    • Adults - 80 milligrams (mg) a day with a meal as a single dose or 160 to 320 mg divided into two doses taken with the morning and evening meals.
    • Children - The type of diabetes treated with this medicine is rare in children. However, if a child needs this medicine, the dose would have to be determined by the doctor.

For glimepiride
• For oral dosage form (tablets):
  • For treating type 2 diabetes:
    • Adults:
      • Glimepiride alone: At first, 1 to 2 milligrams (mg) once a day with breakfast or the first main meal. The dose then may be increased by your doctor based on your blood sugar level.
      • Glimepiride with metformin: The usual dose is 8 mg once a day with breakfast or the first main meal.
      • Glimepiride with insulin: The usual dose is 8 mg once a day with breakfast or the first main meal.
    • Children - The type of diabetes treated with this medicine is rare in children. However, if a child needs this medicine, the dose would have to be determined by the doctor.

For glipizide
• For oral dosage form (tablets):
  • For treating type 2 diabetes:
    • Adults - At first, 5 milligrams (mg) once a day. Some elderly people may need a lower dose of 2.5 mg a day at first. Then, your doctor may change your dose a little at a time if needed. The dose is usually not more than 40 mg a day. If your dose is 15 mg or more, the dose is usually divided into two doses. These doses are taken thirty minutes before the morning and evening meals.
    • Children - The type of diabetes treated with this medicine is rare in children. However, if a child needs this medicine, the dose would have to be determined by the doctor.
• For oral dosage form (extended-release tablets):
  • For treating type 2 diabetes:
    • Adults - At first, 5 mg once a day with breakfast. Then, your doctor may change your dose a little at a time if needed. The dose is usually not more than 20 mg a day.
    • Children - The type of diabetes treated with this medicine is rare in children. However, if a child needs this medicine, the dose would have to be determined by the doctor.

For glyburide
• For oral dosage form (nonmicronized tablets):
  • For treating type 2 diabetes:
    • Adults - At first, 2.5 to 5 milligrams (mg) once a day. Some elderly people may need a lower dose of 1.25 to 2.5 mg a day at first. Then, your doctor may change your dose a little at a time if needed. The dose is usually not more than 20 mg a day. If your dose is 10 mg or more, the dose usually is divided into two doses. These doses are taken with the morning and evening meals.
    • Children - The type of diabetes treated with this medicine is rare in children. However, if a child needs this medicine, the dose would have to be determined by the doctor.
• For oral dosage form (micronized tablets):
  • For treating type 2 diabetes:
    • Adults - At first, 1.5 to 3 mg a day. Some elderly people may need a low dose of 0.75 to 3 mg a day at first. Then, your doctor may change your dose a little at a time if needed. The dose is usually not more than 12 mg a day. If your dose is 6 mg or more, the dose is usually divided into two doses. These doses are taken with the morning and evening meals. A single dose is taken with breakfast or with the first meal.
    • Children - The type of diabetes treated with this medicine is rare in children. However, if a child needs this medicine, the dose would have to be determined by the doctor.

For tolazamide
• For oral dosage form (tablets):
  • For treating type 2 diabetes:
    • Adults - At first, 100 to 250 milligrams (mg) once a day in the morning. Then, your doctor may change your dose a little at a time if needed. The dose is usually not more than 1 gram a day. If your dose is 500 mg or more, the dose is usually divided into two doses. These doses are taken with the morning and evening meals.
    • Children - The type of diabetes treated with this medicine is rare in children. However, if a child needs this medicine, the dose would have to be determined by the doctor.

For tolbutamide
• For oral dosage form (tablets):
  • For treating type 2 diabetes:
    • Adults - At first, 1000 to 2000 milligrams (mg) a day. Some elderly people may need lower doses to start. The dose is usually divided into two doses. These doses are taken before the morning and evening meals. Your doctor may change your dose a little at a time if needed. The dose is usually not more than 3000 mg a day.
    • Children - The type of diabetes treated with this medicine is rare in children. However, if a child needs this medicine, the dose would have to be determined by the doctor.

Missed dose - If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage - To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Do not store in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.