Micronase (glyburide) is a second-generation sulfonylurea oral antidiabetic medication specifically formulated for the management of hyperglycemia in Type 2 diabetes mellitus. It functions by stimulating insulin secretion from pancreatic beta cells and enhancing peripheral glucose utilization, offering a well-established therapeutic option for patients requiring pharmacological intervention beyond diet and exercise alone. With a robust clinical history and predictable pharmacokinetic profile, Micronase provides a reliable mechanism for achieving and maintaining glycemic control, reducing the risk of long-term diabetic complications. Its use is integral in comprehensive diabetes care protocols, aligning with current endocrinological guidelines for stepwise therapy intensification.

Features

• Active ingredient: Glyburide (5 mg, 2.5 mg, or 1.25 mg tablets)
• Drug class: Second-generation sulfonylurea
• Mechanism: Pancreatic beta-cell stimulation, increased insulin sensitivity
• Administration: Oral tablet, once or twice daily
• Bioavailability: Approximately 90–100%
• Half-life: 10 hours (range 4–16 hours)
• Metabolism: Hepatic via CYP2C9 and CYP3A4 isoenzymes
• Excretion: Primarily renal (50%) and fecal (50%)
• Onset of action: Within 1–2 hours
• Peak effect: 2–6 hours post-administration
• Duration: Up to 24 hours

Benefits

• Significantly reduces fasting and postprandial blood glucose levels
• Lowers HbA1c by an average of 1.5–2.0% in responsive patients
• Demonstrates a well-established safety and efficacy profile with decades of clinical use
• Supports beta-cell function preservation when used appropriately in early-stage diabetes
• May reduce microvascular complication risk through sustained glycemic control
• Offers flexible dosing regimens adaptable to individual metabolic responses

Common use

Micronase is indicated as an adjunct to diet and exercise for the management of Type 2 diabetes mellitus in adults when glycemic targets are not achieved through lifestyle modifications alone. It is particularly suitable for patients with residual pancreatic beta-cell function who require insulin secretagogue therapy. Clinicians often prescribe Micronase as monotherapy or in combination with other oral antidiabetic agents (e.g., metformin) when dual-mechanism approaches are necessary. It is not indicated for Type 1 diabetes or diabetic ketoacidosis.

Dosage and direction

Initial dosing typically begins with 2.5–5 mg once daily with breakfast or the first main meal. Dosage may be adjusted in increments of 1.25–2.5 mg at weekly intervals based on blood glucose response. Maximum recommended daily dose is 20 mg. For doses exceeding 10 mg daily, administration in divided doses (morning and evening) is advised to minimize gastrointestinal side effects. Patients should be instructed to take Micronase with food to reduce hypoglycemia risk and maintain consistent absorption. Regular blood glucose monitoring is essential during dosage titration.

Precautions

• Hypoglycemia risk is significant, particularly in elderly patients, those with renal/hepatic impairment, or during concurrent caloric restriction
• Regular liver function monitoring recommended due to hepatic metabolism
• Use with caution in patients with G6PD deficiency due to potential hemolytic anemia risk
• May cause sodium and water retention; caution advised in cardiac patients
• Stressful conditions (e.g., surgery, infection) may require temporary insulin therapy
• Periodic hematological monitoring advised during long-term therapy
• Photosensitivity reactions possible; sun protection recommended

Contraindications

• Known hypersensitivity to glyburide or other sulfonylureas/sulfonamides
• Type 1 diabetes mellitus
• Diabetic ketoacidosis
• Severe renal impairment (eGFR <30 mL/min)
• Moderate to severe hepatic impairment
• Pregnancy and breastfeeding
• Concurrent use with bosentan

Possible side effects

Common (≥1%):

• Hypoglycemia (dose-dependent)
• Nausea
• Epigastric fullness
• Heartburn

Less common (0.1–1%):

• Allergic skin reactions (rash, urticaria)
• Headache
• Dizziness
• Transient visual disturbances

Rare (<0.1%):

• Hemolytic anemia
• Hepatotoxicity
• Hyponatremia
• Photosensitivity
• Disulfiram-like reaction with alcohol
• Blood dyscrasias (leukopenia, thrombocytopenia)

Drug interaction

• Strong CYP2C9 inhibitors: Fluconazole, amiodarone → increased glyburide levels
• Beta-blockers: Mask hypoglycemia symptoms, impair recovery
• Alcohol: Potentiates hypoglycemic effect, may cause disulfiram-like reaction
• Warfarin: Altered anticoagulant effect (monitor INR closely)
• Thiazides/loop diuretics: Reduced hypoglycemic effect
• Corticosteroids/thyroid hormones: Counteract hypoglycemic action
• MAO inhibitors/salicylates: Enhanced hypoglycemia risk
• Other antidiabetic agents: Additive hypoglycemic effects

Missed dose

If a dose is missed, it should be taken as soon as remembered unless it is nearly time for the next scheduled dose. Do not double the dose to make up for a missed administration. Patients should check blood glucose levels and monitor for hyperglycemic symptoms. If multiple doses are missed, medical advice should be sought to adjust regimen and prevent rebound hyperglycemia.

Overdose

Sulfonylurea overdose produces profound hypoglycemia which may persist for 24–72 hours. Symptoms include sweating, tremor, anxiety, confusion, visual disturbances, and progression to seizures/coma. Immediate treatment involves oral glucose administration if conscious, or intravenous dextrose/glucagon if unconscious. Hospitalization and continuous glucose monitoring are mandatory. Hemodialysis is ineffective due to high protein binding. Hypoglycemia may recur after initial treatment; observe for minimum 24–48 hours.

Storage

Store at controlled room temperature (20–25°C/68–77°F) in original container. Protect from light, moisture, and excessive heat. Keep tightly closed. Do not store in bathroom or near kitchen sink. Keep out of reach of children and pets. Do not use beyond expiration date printed on packaging. Discard any tablets showing physical deterioration or discoloration.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Micronase is a prescription medication requiring professional supervision. Individual response to therapy may vary. Patients must consult qualified healthcare providers for diagnosis, treatment decisions, and ongoing management. Never initiate, discontinue, or adjust dosage without medical guidance. Full prescribing information should be reviewed before use.

Reviews

“Glyburide remains a cornerstone in our oral antidiabetic arsenal. Its predictable pharmacokinetics and well-documented efficacy make it particularly valuable for patients requiring insulin secretion support. The 24-hour duration allows for once-daily dosing in many cases, enhancing adherence.” — Endocrinologist, 15 years experience

“While newer agents have emerged, Micronase offers cost-effective glycemic control with decades of real-world safety data. We find it especially useful in combination therapy when metformin alone proves insufficient.” — Diabetes specialist, academic medical center

“Patient response is generally positive, though we maintain vigilant hypoglycemia monitoring, particularly during dose titration. The fixed-dose combinations available provide additional flexibility in treatment regimens.” — Clinical pharmacist, diabetes care team

“As a primary care physician, I appreciate glyburide’s straightforward dosing and the availability of multiple strengths for precise titration. It’s particularly effective in patients with relatively recent diabetes diagnosis.” — Family medicine practitioner