Sulfonylureas are a commonly used oral hypoglycemic agents which are relatively safe to take.


Sulfonylureas include:

(1) tolbutamide (Orinase)

(2) chlorpropamide (Diabinese)

(3) glyburide (Micronase, DiaBeta, Glynase)

(4) glipizide (Glucotrol)


Mechanism of action: increased secretion of insulin by the pancreatic islet cells


Absolute contraindications:

(1) hypersensitivity to sulfa drugs or other sulfonylureas

(2) history of adverse hematologic response to the sulfonylurea (cytopenia, aplastic anemia)


Relative contraindications:

(1) insufficient pancreatic tissue (lack of insulin secretory capacity)

(2) glyburide if history of glyburide-induced hepatitis

(3) chlorpropamide if history of chlorpropamide-induced cholestatic jaundice

(4) history of sulfonylurea-induced porphyria

(5) history of photoxicity associated with sulfonylurea therapy

(6) history of SIADH while taking chlorpropamide or tolbutamide.



(1) Avoid alcohol if a disulfiram-like reactions occurs.


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