• Common sulfonylureas prescribed are: Glipizide-Glucotrol, Glyburide-DiaBeta, Glimepiride-Amaryl
  • A1C about 1-2%
  • Sulfonylureas work on beta cells
  • Most effective in recent onset of Type 2 DM
  • Patients must be able to make their own insulin for these drugs to work
  • These drugs interact with ATP-sensitive potassium channels in the beta cells to increase the secretion of insulin
  • Sulfonylureas can loose their potency over time
  • Do not use in patients with severe renal & hepatic disease
  • Patients must not drink- may cause a disulfiram reaction
  • May cause weight gain
  • Cannot be used in pregnancy
  • Avoid Glybride in the elderly because it has an active metabolite (Ameryl is the safest to use)


Ideal Use

  • insulinopenic patients
  • non-obese or mild obesity patients
  • Can use in combination or monotherapy



  • cheap cost for patient
  • ↓micro/macro vascular events
  • Reduces glucose levels


Side effects

  • Hypoglycemia (major side effect)
  • Weight gain
  • Glyburide has higher incidence of hypoglycemia compared to other sulfonylureas


Drug interactions with sulfonylureas (will ↑ glucose levels)

  • Thiazide diuretics
  • Estrogen
  • Steroids


Key Notes

  • Sulfonylureas and metglinides have the same MOA
  • Sulfonylurea are longer acting agents and targets fasting hyperglycemia
  • If a patient is taking a long-acting sulfonylurea discontinue it when adding basal insulin. (can cause severe hypoglycemia)
  • Diaphoresis is a symptom of hypoglycemia that a pt should be warned about it is most likely to occur if patient is taking glyburide and propranolol
  • ↓ the dose of sulfonylureas and insulin when adding a DPP-4 inhibitor agent
  • Sulfonylurea are longer acting agents and targets fasting hyperglycemia


Edmunds, M. W., & Mayhew, M. S. (2014). Pharmacology for the primary care provider (4th ed.). St. Louis, MO: Elsevier Mosby.

Harvey, R. A., Clark, M. A., Finkel, R., Rey, J. A., & Whalen, K. (2012). Pharmacology (5th ed.). Baltimore, MD: Lippincott.