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Action/Kinetics:
Lowers blood glucose by stimulating the release of insulin from functioning pancreatic beta cells and by increasing the sensitivity of peripheral tissues to insulin. Completely absorbed from the GI tract within 1 hr.
Onset: 2-3 hr.
t
1/2, serum: About 9 hr.
Duration: 24 hr. Completely metabolized in the liver and metabolites are excreted through both the urine and feces.
Uses:
As an adjunct to diet and exercise to lower blood glucose in non-insulin-dependent diabetes mellitus (Type II diabetes mellitus). In combination with insulin to decrease blood glucose in those whose hyperglycemia cannot be controlled by diet and exercise in combination with an oral hypoglycemic drug. In combination with metformin (Glucophage) if control is not reached with diet, exercise, and either hypoglycemic alone.
Contraindications:
Diabetic ketoacidosis with or without coma. Use during lactation.
Special Concerns:
The use of oral hypoglycemic drugs has been associated with increased CV mortality compared with treatment with diet alone or diet plus insulin. Safety and efficacy have not been determined in children.
Side Effects:
The most common side effect is hypoglycemia.
GI: N&V;, GI pain, diarrhea, cholestatic jaundice (rare).
CNS: Dizziness, headache.
Dermatologic: Pruritus, erythema, urticaria, morbilliform or maculopapular eruptions.
Hematologic: Leukopenia, agranulocytosis, thrombocytopenia, hemolytic anemia, aplastic anemia, pancytopenia.
Miscellaneous: Hyponatremia, increased release of ADH, changes in accommodation and/or blurred vision.
Drug Interactions: See
Hypoglycemic Agents
