Glyburide/Metformin: Price, Dosage & Where to Buy

Glyburide/Metformin is an oral glucose-lowering combination used to improve blood glucose control in adults with type 2 diabetes alongside diet and exercise. Its pharmacological class is not specified, although the glyburide component belongs to the sulfonylurea group. This medicine requires a prescription in the United Kingdom, and the glyburide label describes individualised treatment with regular blood glucose monitoring.

The glyburide label lists treatment of type 2 diabetes mellitus in adults, alongside diet and exercise, to improve blood glucose control. It also describes glyburide being added to metformin when metformin alone has not produced an adequate response. The aim is to improve control of blood glucose, with treatment adjusted according to the patient's response.

The indication described here is for glyburide tablets; it does not establish a separate indication for every fixed-combination tablet. Glyburide is contraindicated in type 1 diabetes and in diabetic ketoacidosis.

The components act through different glucose-lowering mechanisms. Glyburide belongs to the sulfonylurea group, which stimulates the pancreas to release insulin. Insulin helps glucose move from the blood into tissues where it can be used.

Metformin reduces glucose production by the liver and helps the body respond more effectively to insulin. Together, these mechanisms can lower blood glucose. Because sulfonylureas increase insulin release, they can also cause blood glucose to fall too low.

The label lists oral tablets and film-coated oral tablets containing glyburide/metformin in strengths of 1.25 mg/250 mg, 2.5 mg/500 mg and 5 mg/500 mg. The dosing statements below concern glyburide tablets rather than a fixed-combination dosing schedule. The label lists a usual glyburide starting dose of 2.5 to 5 mg daily, administered with breakfast or the first main meal.

The label lists 1.25 mg daily for patients more sensitive to glucose-lowering medicines. The label lists a glyburide maintenance range of 1.25 to 20 mg daily, as a single dose or divided doses. The label lists daily glyburide doses of more than 20 mg as not recommended.

There is no fixed dosage regimen, and blood glucose monitoring guides individual adjustment. The label describes gradual addition of glyburide to metformin and notes that the risk of low blood glucose continues and may increase with combined treatment.

A missed dose may affect blood glucose control. A double dose should not be used to compensate, because glyburide can cause low blood glucose. Advice from a pharmacist or the prescribing clinician can clarify how to resume the prescribed schedule, particularly if meal timing has changed or there is uncertainty about the last dose.

The glyburide label does not recommend use in pregnancy, although its pregnancy section states that use should be limited to situations where clearly needed. Animal studies found no evidence of harm to the fetus, but adequate, well-controlled studies in pregnant women are lacking. Severe, prolonged low blood glucose has been reported in newborns after maternal sulfonylurea use around delivery.

The label states that glyburide should be discontinued at least two weeks before expected delivery if used during pregnancy. Lactation information is not specified; pregnancy and breastfeeding should be discussed with a doctor or pharmacist.

The glyburide tablet label specifies storage at 20º to 25ºC, with excursions permitted between 15º to 30ºC. It specifies well closed containers with safety closures and keeping the container tightly closed. For combination tablets, follow the storage directions on the product label.