Micronase (glyburide) is a second-generation sulfonylurea oral antidiabetic medication indicated for the management of hyperglycemia in type 2 diabetes mellitus. It functions by stimulating insulin release from the pancreatic beta cells and increasing peripheral tissue sensitivity to insulin. This medication is typically prescribed as an adjunct to diet and exercise when glycemic targets are not achieved through lifestyle modifications alone. Proper patient selection and adherence to dosing protocols are critical for optimizing therapeutic outcomes and minimizing risks.

Features

• Active ingredient: Glyburide (USP)
• Available in 1.25 mg, 2.5 mg, and 5 mg scored tablets
• Second-generation sulfonylurea class
• Oral administration
• Onset of action: Approximately 2–4 hours post-dose
• Duration of effect: Up to 24 hours
• Bioavailability: Nearly complete
• Protein binding: >99%
• Metabolism: Hepatic via CYP2C9 and CYP3A4
• Excretion: Primarily renal (50%) and fecal (50%)

Benefits

• Effectively lowers both fasting and postprandial blood glucose levels
• Reduces glycosylated hemoglobin (HbA1c) by an average of 1–2%
• Convenient once-daily dosing regimen for many patients
• Well-established safety and efficacy profile from decades of clinical use
• May be used as monotherapy or in combination with other antidiabetic agents
• Cost-effective treatment option within its therapeutic class

Common use

Micronase is primarily indicated for the management of type 2 diabetes mellitus in adults. It is used when glycemic control cannot be achieved through diet, exercise, and weight reduction alone. The medication may be prescribed as initial pharmacotherapy or added to existing treatment regimens that include other oral antidiabetic agents. It is not indicated for type 1 diabetes mellitus or diabetic ketoacidosis, as these conditions require insulin therapy.

Dosage and direction

The initial recommended dose is 1.25–5 mg once daily, taken with breakfast or the first main meal. Dosage should be titrated upward in increments of no more than 2.5 mg at weekly intervals based on blood glucose response. The maximum recommended daily dose is 20 mg. For doses exceeding 10 mg daily, administration in divided doses is recommended. Patients should be instructed to take Micronase with food to minimize gastrointestinal upset and reduce the risk of hypoglycemia.

Precautions

Regular monitoring of blood glucose levels is essential. Hepatic and renal function should be assessed before initiation and periodically during treatment. Use with caution in elderly patients, malnourished individuals, and those with adrenal or pituitary insufficiency. Patients should be educated about recognizing and managing hypoglycemia. Alcohol consumption should be avoided due to increased risk of disulfiram-like reactions and hypoglycemia. Stress situations such as fever, trauma, infection, or surgery may require temporary insulin therapy.

Contraindications

Hypersensitivity to glyburide or any component of the formulation. Diabetic ketoacidosis, with or without coma. Type 1 diabetes mellitus. Severe renal impairment (creatinine clearance <30 mL/min) or end-stage renal disease. Severe hepatic impairment. Concomitant use with bosentan.

Possible side effect

• Hypoglycemia (most common)
• Gastrointestinal disturbances (nausea, epigastric fullness, heartburn)
• Allergic skin reactions (rash, urticaria, pruritus)
• Hematologic effects (leukopenia, thrombocytopenia, hemolytic anemia)
• Hepatic enzyme elevations
• Photosensitivity reactions
• Syndrome of inappropriate antidiuretic hormone secretion (SIADH)

Drug interaction

• Enhanced hypoglycemic effects with: insulin, other oral antidiabetics, ACE inhibitors, anabolic steroids, chloramphenicol, fibrates, fluconazole, MAO inhibitors, probenecid, salicylates, sulfonamides
• Reduced hypoglycemic effects with: corticosteroids, diazoxide, diuretics, estrogens, glucagon, isoniazid, nicotinic acid, phenothiazines, phenytoin, sympathomimetics, thyroid products
• Beta-blockers may mask hypoglycemic symptoms
• Warfarin: Altered anticoagulant effect
• Bosentan: Contraindicated due to increased hepatotoxicity risk

Missed dose

If a dose is missed, it should be taken as soon as remembered unless it is almost time for the next dose. Do not double the dose to make up for the missed one. If multiple doses are missed, contact healthcare provider for guidance on resuming therapy. Monitor blood glucose levels closely following missed doses.

Overdose

Symptoms primarily consist of hypoglycemia (sweating, tremor, tachycardia, hunger, confusion, drowsiness, visual disturbances). Severe overdose may lead to seizures, coma, and neurological damage. Treatment involves immediate glucose administration (oral if conscious, intravenous if unconscious). Hospitalization and continuous glucose monitoring are required for severe cases. Dialysis is not effective due to high protein binding.

Storage

Store at controlled room temperature (20–25°C or 68–77°F). Protect from light and moisture. Keep container tightly closed. Do not store in bathroom or near sink. Keep out of reach of children and pets. Do not use after expiration date printed on packaging.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Micronase should be used only under the supervision of a qualified healthcare professional. Individual response to medication may vary. Patients should not alter their dosage or discontinue treatment without consulting their physician. The prescriber should be informed of all medications being taken, including over-the-counter drugs and supplements.

Reviews

Clinical studies demonstrate that Micronase effectively reduces HbA1c levels by 1.5–2.0% in most patients when used as monotherapy. The drug shows particular efficacy in patients with relatively recent onset of type 2 diabetes who retain some beta-cell function. Long-term observational studies indicate sustained glycemic control in compliant patients. Some studies suggest potential cardiovascular safety concerns with sulfonylureas as a class, though Micronase specifically has not shown increased risk in controlled trials. Patient satisfaction surveys indicate good tolerability and convenience of once-daily dosing, though hypoglycemia remains a concern, particularly in elderly patients and those with irregular meal patterns.