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Precautions and Warnings With Glyburide and Metformin

Some Precautions and Warnings With Glyburide and Metformin

Some glyburide and metformin warnings and precautions to be aware of include:
 
  • Oral diabetes drugs, including glyburide and metformin, may increase the risk of death due to heart or blood vessel problems, compared to diabetes treatment with diet or insulin. This warning is based on one research study that looked at a diabetes medication similar to glyburide and metformin. It is unclear at this time how important this risk may be in people taking glyburide and metformin.
     
  • Very rarely, metformin (one of the active ingredients of glyburide and metformin) may cause a life-threatening condition called lactic acidosis. Your risk of lactic acidosis increases with other medical conditions, including congestive heart failure (CHF), kidney failure, and liver problems (see Metformin and Lactic Acidosis for more information, including possible symptoms of lactic acidosis).

 

  • Drinking alcohol can increase your risk of lactic acidosis. Drinking large amounts of alcohol on a regular basis or drinking a large amount of alcohol at once (binge drinking) should be avoided while taking metformin (see Metformin and Alcohol)

 

  • Since liver disease (including liver failure and cirrhosis) can increase your risk of lactic acidosis, you should not take glyburide and metformin if your liver is not functioning normally. Also, your kidney function needs to be monitored while you are taking glyburide and metformin. This means that you should have blood tests that check your kidneys before you start glyburide and metformin, and these tests should be repeated at least once every year. If your kidney function is very poor, you should not take glyburide and metformin, due to an increased risk of lactic acidosis.
     
  • Taking metformin (one of the active ingredients in glyburide and metformin) and contrast dye at the same time can increase your risk of kidney damage. Contrast dye is used for certain radiology procedures, including some x-rays, CT scans, and heart catheterizations (see Metformin and Contrast Medium for more information). Also, glyburide and metformin should be temporarily stopped for most major surgeries and should be restarted when you are eating normally again.
     
  • Glyburide and metformin can cause low blood sugar (hypoglycemia) in some people. This is more common in elderly people and in people with adrenal, pituitary, liver, or kidney problems -- as well as during fasting before surgery and after prolonged exercise. Your risk of hypoglycemia also increases if you drink alcohol or do not eat as much as you usually do. Low blood sugar symptoms may include irritability, trembling, cold sweats, or blurry vision, among other things (see Glucovance and Hypoglycemia for more information).
 
  • Sulfonylurea medications (such as glyburide) may cause a dangerous problem known as hemolytic anemia in people who have a genetic condition known as glucose-6-phosphate dehydrogenase deficiency (G6PD deficiency). Nonsulfonylurea medications may be better choices for such people.

 

  • If you are allergic to sulfonamides ("sulfa" medications), you may also be allergic to glyburide and metformin -- though most people with sulfa allergies can take glyburide and metformin without problems. Let your healthcare provider know if you have a sulfa allergy.

 

  • Fever, infections, injury, or surgery can temporarily increase blood sugar, even in people with well-controlled diabetes. Glyburide and metformin may not be enough to treat your diabetes at these times, and the use of insulin may be required. Contact your healthcare provider if you have a fever, infection, or injury -- or if you will be having surgery. Also, make sure you know the symptoms of high blood sugar and how to check your blood sugar levels (see Glucovance and Hypoglycemia for more information).
     
  • Let your healthcare provider know if you drink a much lower amount of liquid than normal, or if you have an illness that causes severe vomiting, diarrhea, or fever. These conditions can lead to severe dehydration (loss of water in your body). You may need to stop taking glyburide and metformin for a short time.
     
  • Glyburide and metformin can decrease your levels of vitamin B12. Your healthcare provider should monitor your vitamin B12 levels, especially if you have a vitamin B12 deficiency (including pernicious anemia).
      
  • Glyburide and metformin can interact with certain other medications (see Drug Interactions With Glyburide and Metformin).
     
  • Glyburide and metformin is considered a pregnancy Category B medication. This means that while glyburide and metformin is probably safe for use in pregnant women, the full risks of taking glyburide and metformin during pregnancy are not known. Talk with your healthcare provider before taking glyburide and metformin during pregnancy (see Glucovance and Pregnancy).
     
  • It is not known if glyburide and metformin passes through breast milk. Therefore, if you are breastfeeding or plan to start breastfeeding, be sure to talk with your healthcare provider about this.
     
  • Sulfonylurea medicines, such as the glyburide component of glyburide and metformin, have been reported to increase sensitivity to the sun. Therefore, when going outdoors, try wearing long sleeves, pants, and a hat. Any exposed skin should be covered with sunscreen that is at least SPF 15.
     
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