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This document provides crucial safety and warning information regarding the use of glyburide. It is essential to understand these details and discuss any concerns with your healthcare provider.

• Low Blood Sugar (Hypoglycemia): Glyburide can cause dangerously low blood sugar levels, which may be life-threatening. Symptoms include a rapid heartbeat, sweating, pale skin, shakiness, confusion, and irritability. Always carry a form of fast-acting sugar, such as 4 glucose tablets, 3-4 pieces of hard candy, half a cup of fruit juice, or half a can of regular soda, to counteract low blood sugar. Consult your healthcare provider or pharmacist if you have questions. Factors that increase the risk include dietary changes, physical activity, alcohol consumption, other medications that lower blood sugar, age over 65, and liver or kidney issues.

• Heart Problems: There is a potential risk of increased heart-related death when using glyburide, similar to the risk observed with tolbutamide, another sulfonylurea. Discuss the advantages and risks of glyburide with your healthcare provider to determine if it is suitable for you.

• Breakdown of Red Blood Cells: Individuals with glucose-6-phosphate dehydrogenase (G6PD) deficiency are at higher risk of hemolytic anemia when taking glyburide. Your healthcare provider may perform a test for this genetic condition before starting treatment. If you have G6PD deficiency, you might be able to take glyburide with regular monitoring of your blood cell counts. Discontinue use and contact your provider immediately if you notice dark urine, fatigue, weakness, dizziness, or pale skin, as these can indicate hemolytic anemia.

Contraindications:

• Do not use glyburide if you have diabetic ketoacidosis, type 1 diabetes mellitus, or if you are currently taking bosentan (Tracleer). Consult your healthcare provider if any of these conditions apply to you, as taking glyburide could pose serious health risks.

Common side effects:

• Feeling bloated
• Nausea
• Heartburn
• Weight gain
• Temporary skin reactions (rashes or redness)

Less common but important to monitor:

• Low blood sugar (hypoglycemia)
• High blood sugar (hyperglycemia)

Serious side effects:

• Signs of infection (persistent sore throat or fever)
• Unusual bleeding or bruising
• Severe stomach pain
• Jaundice (yellowing of the eyes or skin)
• Dark urine
• Extreme fatigue
• Sudden weight gain
• Mental or mood changes
• Swelling of hands or feet
• Seizures
• Severe allergic reactions (rash, swelling of face, tongue, or throat, severe dizziness, difficulty breathing)

Glyburide may interact with a variety of medications and supplements. It is important to inform your doctor and pharmacist about all the medications and supplements you are currently taking, including prescription, over-the-counter, vitamins, and herbal products. Not all possible interactions are listed here, but key ones include:

1. Bosentan: It is advised not to use glyburide with bosentan, as the combination can lead to unwanted interactions. Your doctor might choose alternative treatments or adjust your current medications.

2. Blood Sugar Influencing Drugs: Many medications can impact your blood sugar levels, complicating diabetes management. Regularly monitor your blood sugar and communicate the results to your doctor. If you experience symptoms of high or low blood sugar, notify your doctor promptly. Adjustments to your diabetes medication, exercise routine, or diet may be necessary.

3. Beta-blockers (e.g., Metoprolol, Propranolol, Timolol): These medications can obscure certain symptoms of low blood sugar, such as a rapid heartbeat. However, they do not affect other symptoms like dizziness, hunger, or sweating. If taking these along with glyburide, your doctor may need to modify your treatment plan.

4. Other Medications: Glyburide may also interact with medications like Acarbose, Aspirin, various antibiotics, and drugs affecting glucose levels. If these are necessary, your doctor may adjust dosages or monitor you closely for side effects.

Always consult your healthcare provider before making any changes to your medication regimen.