Sulfonylureas 

What are Sulfonylureas?

Sulfonylureas are a class of medication that may be prescribed to treat people who have type 2 diabetes. They are also one of the oldest diabetes medications available.

Sulfonylureas work by directly stimulating the cells in the pancreas to increase the amount of insulin that it produces. Insulin is the hormone that transfers glucose (sugar) from the bloodstream into the cells of the body. This additional insulin helps to lower blood sugar levels. Sulfonylureas can be combined with other types of diabetes medicines. Sulfonylureas work well at first, but can lose their effectiveness over time.

The AACE guidelines recommend that sulfonylureas are suitable to use with caution for certain people with type 2 diabetes who:

  • Have tried unsuccessfully to manage their blood glucose with lifestyle therapy (healthy diet and exercise) and need to try a diabetes medication.
  • Have tried to control their blood sugar with other diabetes medications, but now need to add another medication.

What are first generation vs. second generation sulfonylureas?

There are two generations of sulfonylureas – first and second. First generation sulfonylureas can cause more hypoglycemia than their second generation counterparts and aren’t prescribed as often. First generation sulfonylureas include:

Second-generation sulfonylureas have largely replaced the first generation ones in regular use because they are more potent and can be administered in lower doses. Some of the second-generation sulfonylureas include:

What is Chlorpropamide?

Chlorpropamide, also known under the trade name Diabinese, is a type of sulfonylurea that can help adults with type 2 diabetes control their blood sugar levels. Chlorpropamide works by stimulating the release of insulin by the pancreas which then helps to lower blood sugar levels. Chlorpropamide should be used in combination with a healthy diet and regular exercise.

Chlorpropamide is taken by mouth in tablet form and is generally taken in the morning with breakfast. Always follow your health care providers instructions for use.

Some of the most common side effects caused by treatment with Chlorpropamide include:

Some people may develop serious side effects after taking Chlorpropamide, talk to your healthcare provider about these.

Do not take Chlorpropamide if you are allergic to it or any of the ingredients found in it. Also talk to your healthcare provider about potential drug interactions before starting therapy or if you experience any side effects.

What is Tolazamide?

Tolazamide, also known by the trade name Tolinase, is a kind of sulfonylureas that can help control blood sugar levels in adults with type 2 diabetes. Tolazamide works by stimulating the release of insulin by the pancreas and in turn helps to reduce blood sugar levels. Tolazamide should be used in combination with a healthy diet and regular physical activity.

Tolazamide comes in tablet form to be taken by mouth usually with the first meal of the day. Always follow your health care providers instructions for use.

Some of the most common side effects caused by treatment with Tolazamide include:

  • Hypoglycemia
  • Nausea
  • Heartburn
  • Diarrhea

Do not take Tolazamide if you are allergic to it or any of the ingredients found in it. Also talk to your healthcare provider about potential drug interactions before starting therapy or if you experience any side effects.

What is Tolbutamide?

Tolbutamide, also known by the trade name Orinase, is a kind of sulfonylurea that helps control blood sugar levels in adults with type 2 diabetes. Tolbutamide works by causing the pancreas to produce more insulin which in turn helps to reduce blood sugar levels. Tolbutamide should be used in combination with a healthy diet and exercise.

Tolbutamide comes in tablet form to be taken by mouth usually in the morning. Always follow your health care providers instructions for use.

Some of the most common side effects caused by treatment with Tolbutamide include:

Do not take Tolbutamide if you are allergic to it or any of the ingredients found in it. Also talk to your healthcare provider about potential drug interactions before starting therapy or if you experience any side effects.

What is Glimepiride?

Glimepiride, sold under the brand name Amaryl, is a second-generation sulfonylurea that helps lower blood sugar levels in adults with type 2 diabetes. Glimepiride works by causing the pancreas to produce more insulin which in turn helps to reduce blood sugar levels. Glimepiride should be used along with a healthy diet and regular exercise.

Glimepiride comes in tablet form to be taken by mouth usually with breakfast or the first meal of the day. Always follow your health care providers instructions for use.

Some of the most common side effects caused by treatment with Glimepiride include:

  • Hypoglycemia
  • Nausea
  • Dizziness
  • Headache

Do not take Glimepiride if you are allergic to it or any of the ingredients found in it. Also talk to your healthcare provider about potential drug interactions before starting therapy or if you experience any side effects.

What is Glipizide?

Glipizide, sold under several brand names including Glipizide XL, Glucotrol, Glucotrol XL, is a type of sulfonylurea that helps reduce blood sugar levels in adults with type 2 diabetes. Glipizide works by causing the pancreas to produce more insulin which in turn helps to lower blood sugar levels. Glipizide should be used along with healthy diet and regular exercise.

Glipizide comes in the form of a tablet and an extended-release (long-acting) tablet to be taken by mouth. The regular tablet should usually be taken 30 minutes before a meal, while the extended-release tablet is usually taken with breakfast.

Some of the most common side effects caused by treatment with Glipizide include:

  • Hypoglycemia
  • Diarrhea
  • Gas
  • Dizziness
  • Skin reaction
  • Hives
  • Blisters

Do not take Glipizide if you are allergic to it or any of the ingredients found in it. Also talk to your healthcare provider about potential drug interactions before starting therapy or if you experience any side effects.

What is Glyburide?

Glyburide, known by several trade names including Glycerin, Glynase, Glynase PresTab, Micronase, is a type of second-generation sulfonylurea that helps reduce blood sugar levels in adults with type 2 diabetes. Glyburide works by stimulating the pancreas to produce more insulin which in turn helps to lower blood sugar levels. Glyburide should be used along with healthy diet and regular exercise.

Glyburide comes in tablet form to be taken by mouth usually with breakfast or the first mail meal of the day.

Some of the most common side effects caused by treatment with Glyburide include:

  • Hypoglycemia
  • Nausea
  • Heartburn
  • Rash

Do not take Glyburide if you are allergic to it or any of the ingredients found in it. Also talk to your healthcare provider about potential drug interactions before starting therapy or if you experience any side effects.

Written by: Amna Rizvi | Last reviewed: April 2017
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