Micronase

Micronase is used for treating type 2 diabetes.

Product dosage: 5mg
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Synonyms Daonil Diabeta Euglucon Glez Gliben Glibenclamide Gliburida Med glybe Novo-glyburide Nu-glyburide

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 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 use requires understanding its pharmacokinetics, therapeutic indications, and safety profile to optimize patient outcomes and minimize risks.

Features

• Active ingredient: Glyburide (USP)
• Drug class: Sulfonylurea, insulin secretagogue
• Available in tablet strengths: 1.25 mg, 2.5 mg, and 5 mg
• Administration: Oral, once or twice daily
• Bioavailability: Nearly complete
• Onset of action: Within 2–4 hours
• Peak plasma concentration: Approximately 4 hours
• Elimination half-life: 10 hours
• Metabolism: Hepatic via CYP2C9 and CYP3A4
• Excretion: Primarily renal (50%) and fecal (50%)

Benefits

• Stimulates endogenous insulin secretion: Enhances the release of insulin from functional pancreatic beta cells, addressing a core pathophysiological defect in type 2 diabetes.
• Improves peripheral glucose utilization: Increases insulin sensitivity in muscle and adipose tissue, facilitating better uptake and utilization of glucose.
• Reduces hepatic glucose production: Suppresses gluconeogenesis in the liver, contributing to lower fasting blood glucose levels.
• Convenient dosing regimen: Allows for once- or twice-daily administration, supporting adherence and consistent glycemic control.
• Proven efficacy in HbA1c reduction: Clinically demonstrated to lower glycated hemoglobin levels, reducing the risk of long-term diabetic complications.
• Cost-effective therapeutic option: Provides an affordable alternative or adjunct to newer antidiabetic agents within treatment algorithms.

Common use

Micronase is primarily indicated for the management of type 2 diabetes mellitus in adult patients. It is used when glycemic control is not adequately achieved through diet, exercise, and weight reduction alone. The medication may be used as monotherapy or in combination with other oral antidiabetic agents, such as metformin, or with insulin, depending on the patient’s metabolic needs and treatment goals. It is not indicated for type 1 diabetes or diabetic ketoacidosis.

Dosage and direction

The initial dose is usually 2.5–5 mg once daily, taken with breakfast or the first main meal. Dosage adjustments should be made in increments of no more than 2.5 mg at weekly intervals based on blood glucose response. The maintenance dose ranges from 1.25 to 20 mg per day, administered as a single dose or in divided doses. Doses exceeding 10 mg daily are usually given in two divided doses. Geriatric patients, or those with renal or hepatic impairment, should start at the lower end of the dosing range (1.25 mg daily). Blood glucose should be monitored regularly to determine the minimum effective dose.

Precautions

• Hypoglycemia risk: Micronase can cause severe hypoglycemia, particularly in elderly, debilitated, or malnourished patients, and those with renal or hepatic impairment.
• Hepatic function: Use with caution in patients with liver disease; impaired metabolism may increase the risk of hypoglycemia.
• Renal function: Reduced clearance in renal impairment necessitates dose adjustment and careful monitoring.
• Stress situations: During fever, trauma, infection, or surgery, temporary insulin therapy may be required.
• Photosensitivity: Some patients may experience increased sensitivity to sunlight; protective measures are advised.
• Hemolytic anemia: Possible in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency.
• Alcohol consumption: May potentiate hypoglycemic effects and cause disulfiram-like reactions.
• Pregnancy and lactation: Not recommended; insulin is the preferred therapy during pregnancy.

Contraindications

• Known hypersensitivity to glyburide or other sulfonylureas
• Type 1 diabetes mellitus
• Diabetic ketoacidosis, with or without coma
• Severe renal or hepatic impairment
• Concomitant use of bosentan

Possible side effect

• Common: Hypoglycemia, nausea, epigastric fullness, heartburn
• Less common: Allergic skin reactions (e.g., pruritus, erythema, urticaria), dizziness, asthenia, headache
• Rare: Hematologic effects (leukopenia, thrombocytopenia, agranulocytosis), hepatic dysfunction (e.g., cholestatic jaundice), hyponatremia from SIADH
• Very rare: Photosensitivity reactions, porphyria cutanea tarda, disulfiram-like reaction with alcohol

Drug interaction

• Enhanced hypoglycemic effect: Insulin, other oral antidiabetics, ACE inhibitors, anabolic steroids, chloramphenicol, fluconazole, MAO inhibitors, probenecid, salicylates, sulfonamides, warfarin
• Reduced hypoglycemic effect: Corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, isoniazid
• Risk of hypoglycemia or hyperglycemia: Beta-blockers may mask hypoglycemia symptoms and potentiate hypoglycemia
• Disulfiram-like reaction: Alcohol
• Increased risk of lactic acidosis: With metformin (caution in combination)

Missed dose

If a dose is missed, it should be taken as soon as remembered on the same day. If it is near the time of the next dose, skip the missed dose and resume the regular schedule. Do not double the dose to make up for a missed one, as this increases the risk of hypoglycemia.

Overdose

Sulfonylurea overdose, including Micronase, can produce severe and prolonged hypoglycemia. Symptoms include sweating, tremor, blurred vision, hunger, and confusion, potentially progressing to seizures, coma, and death. Management includes immediate glucose administration (oral or intravenous), continuous glucose monitoring, and possibly octreotide or diazoxide in refractory cases. Hospitalization is often required for observation, as hypoglycemia may recur after initial treatment.

Storage

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

Disclaimer

This information is for educational purposes and does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider for personalized recommendations. Do not initiate, discontinue, or change the dosage of any medication without medical supervision. Individual patient responses and requirements may vary.

Reviews

Clinical studies and patient reports consistently affirm Micronase’s efficacy in reducing HbA1c and fasting plasma glucose levels when used appropriately. Many patients achieve significant glycemic improvement, though individual responses vary. Adherence to dosing schedules and dietary recommendations is critical for optimal outcomes. Healthcare providers emphasize the importance of regular glucose monitoring to mitigate hypoglycemia risk, particularly during dose titration. Overall, it remains a valuable option within structured diabetes management protocols.