Micronase (glyburide) is a second-generation sulfonylurea oral antidiabetic agent designed to manage hyperglycemia in patients with type 2 diabetes mellitus. By stimulating insulin secretion from pancreatic beta cells and enhancing peripheral glucose utilization, it offers a targeted mechanism for sustained blood sugar regulation. This medication is typically prescribed as part of a comprehensive diabetes management plan that includes diet, exercise, and regular glucose monitoring. Clinicians favor Micronase for its well-established efficacy, predictable pharmacokinetics, and flexibility in dosing to align with individual metabolic needs.

Features

• Active ingredient: Glyburide (USP grade)
• Available in 1.25 mg, 2.5 mg, and 5 mg scored tablets
• Second-generation sulfonylurea with high specificity for ATP-sensitive potassium channels
• Rapid absorption with onset of action within 2–4 hours
• Duration of effect: up to 24 hours (dose-dependent)
• Excreted equally in urine and bile as inactive metabolites

Benefits

• Effectively lowers fasting and postprandial blood glucose levels
• Reduces glycated hemoglobin (HbA1c) by 1.5–2% on average
• May decrease microvascular complication risk through consistent glycemic control
• Supports beta-cell function preservation with appropriate use
• Flexible dosing allows for tailored therapeutic regimens
• Cost-effective compared to newer antidiabetic agents

Common use

Micronase is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. It is suitable for patients who have not achieved desired glucose levels through lifestyle modifications alone. It may be used as monotherapy or in combination with other antidiabetic agents like metformin, though careful monitoring is required when used with insulin due to heightened hypoglycemia risk. It is not indicated for type 1 diabetes or diabetic ketoacidosis.

Dosage and direction

The initial dose for most patients is 2.5–5 mg once daily, taken 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. The maximum recommended daily dose is 20 mg. For patients requiring more than 10 mg daily, the dose should be divided and given twice daily with meals. Geriatric patients or those with hepatic or renal impairment should start at 1.25 mg daily. Always take exactly as prescribed; do not crush or chew tablets.

Precautions

• Regular self-monitoring of blood glucose is essential to avoid hypoglycemia
• Inform your physician if you are pregnant, planning pregnancy, or breastfeeding
• Use caution in elderly patients and those with adrenal or pituitary insufficiency
• Alcohol consumption may increase risk of hypoglycemia or disulfiram-like reactions
• Stress, fever, trauma, infection, or surgery may require temporary insulin therapy
• Periodic liver and kidney function tests are recommended during long-term therapy

Contraindications

• Hypersensitivity to glyburide or other sulfonylureas/sulfonamides
• Type 1 diabetes mellitus or diabetic ketoacidosis
• Severe renal or hepatic impairment
• Concurrent use of bosentan
• Pregnancy (Category C: risk cannot be ruled out)

Possible side effect

Common (≥1%):

• Hypoglycemia (dizziness, sweating, tremor, hunger)
• Gastrointestinal disturbances (nausea, epigastric fullness, heartburn)
• Headache

Less common:

• Skin reactions (rash, urticaria, pruritus)
• Hematologic effects (leukopenia, thrombocytopenia)
• Elevated liver enzymes
• Hyponatremia (especially with thiazide diuretics)

Rare but serious:

• Severe hypoglycemia requiring intervention
• Hemolytic anemia
• Disulfiram-like reaction with alcohol
• Syndrome of inappropriate antidiuretic hormone (SIADH)

Drug interaction

• Increased hypoglycemia risk with: insulin, other oral antidiabetics, ACE inhibitors, beta-blockers, fluconazole, MAO inhibitors, salicylates, sulfonamides
• Reduced efficacy with: thiazides, corticosteroids, phenothiazines, thyroid products, estrogens, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, isoniazid
• Potential for disulfiram-like reaction with alcohol
• Bosentan: contraindicated due to decreased glyburide concentration

Missed dose

Take the missed dose as soon as remembered, unless it is almost time for the next dose. Do not double the dose to make up for a missed one. If a dose is missed and the next dose is due within a few hours, skip the missed dose and resume the regular schedule. Monitor blood glucose closely and contact your healthcare provider if unsure.

Overdose

Symptoms: severe hypoglycemia (sweating, tachycardia, nausea, coma, seizures). Treatment: immediate glucose administration (oral if conscious, intravenous if unconscious). Hospitalization and continuous glucose infusion may be necessary. Monitor for hypoglycemia recurrence for 24–48 hours. Dialysis is not effective due to high protein binding.

Storage

Store at 20–25°C (68–77°F) in a tight, light-resistant container. Keep away from moisture and heat. Do not store in bathroom. Keep out of reach of children and pets. Discard unused medication after expiration date. Do not flush; dispose of properly per local regulations.

Disclaimer

This information is for educational purposes only and does not replace professional medical advice. Always consult a qualified healthcare provider for diagnosis, treatment decisions, and personalized medical guidance. Individual response to medication may vary. Not all side effects or interactions are listed here.

Reviews

“Micronase has been a cornerstone in my type 2 diabetes management for years. Its consistent effect on my HbA1c levels—maintaining them between 6.2–6.5%—has provided reassurance. The twice-daily dosing aligns well with my meals, though I remain vigilant about hypoglycemia symptoms, especially during increased physical activity.” — Marianne T., patient, 8 years use

“As an endocrinologist, I appreciate Micronase’s predictable pharmacokinetics and dose-response relationship. It remains a valuable option for patients who need effective insulin secretion stimulation without the financial burden of newer agents. However, careful patient education on hypoglycemia recognition is non-negotiable.” — Dr. Evan R., MD, Endocrinology