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interactions
Glyburide (Diabeta, Micronase)
Integrative Therapies
Definition
Glyburide
generic name: Glyburide
trade names: Diabeta®, Glynase®, Micronase®, Pres Tab®
related drugs: Acetohexamide®, Chlorpropamide®, Glibenclamide®, Gliclazide®, Glipizide®, Tolbutamide®
type of drug: Sulfonylurea, oral hypoglycemic agent.
used to treat: Hyperglycemia in non-insulin-dependent (NIDDM or Type 2) diabetes mellitus which is stable, mild, and nonketosis-prone and cannot be controlled solely by proper dietary management, exercise and weight reduction.
» Interactions:
herb affecting drug performance: Aloe vera (Aloe)
nutritional synergy/interaction: Several studies have found that Aloe vera can work as an effective agent in bringing down high blood glucose levels. If taken at the same time as glyburide, Aloe may reduce the dosage of the drug needed or, if unsupervised, could potentially cause blood glucose levels to drop excessively. In one study of diabetics who had been unresponsive to glibenclamide alone, significantly improved blood sugar and lipid levels resulted when one tablespoon of aloe juice twice daily was combined with the glibenclamide.
(Bunyapraphatsara, N, et al. Phytomed 1996;3:245-248.; Ghannam N, et al. Horm Res 1986;24(4):288-294.)
herb/nutrient affecting drug performance: Cyamopsis tetragonolobus (Guar gum)
research: Huupponen found that the co-administration of 5 gm of guar gum to healthy patients significantly enhanced the insulinogenic and blood glucose lowering effect of glyburide. Several years later Uusitupa et al conducted a randomized double-blind placebo controlled crossover study and came to two conclusions: 1.) guar gum improved the metabolic control and decreased serum lipids of patients with NIDDM, 2.) guar gum ingested with glibenclamide did not interfere with the absorption of glibenclamide.
(Huupponen R. Res Commun Chem Pathol Pharmacol 1986 Oct;54(1):137-140; Neugebauer G, et al. Beitr Infusionther Klin Ernahr 1983;12:40-47; Uusitupa M, et al. Int J Clin Pharmacol Ther Toxicol 1990 Apr;28(4):153-157.)
nutritional concern: If taken at the same time as glyburide, guar gum may reduce the dosage of the drug needed or, if unsupervised, could potentially cause blood glucose levels to drop excessively. Individuals taking glyburide or related drugs should avoid the consumption of guar gum at the same time as their medication.
Footnotes
Bunyapraphatsara, N, Yongchaiyudha, S, Rungpitarangsi, V, Chokechaijaroenporn, O. Antidiabetic activity of Aloe vera L. juice. II. Clinical trial in diabetes mellitus patients in combination with glibenclamide. Phytomed 1996;3:245-248.
Ghannam N, Kingston M, Al-Meshaal IA, Tariq M, Parman NS, Woodhouse N. The antidiabetic activity of aloes: preliminary clinical and experimental observations. Horm Res 1986;24(4):288-294.
Abstract: The dried sap of the aloe plant (aloes) is one of several traditional remedies used for diabetes in the Arabian peninsula. Its ability to lower the blood glucose was studied in 5 patients with non-insulin-dependent diabetes and in Swiss albino mice made diabetic using alloxan. During the ingestion of aloes, half a teaspoonful daily for 4-14 weeks, the fasting serum glucose level fell in every patient from a mean of 273 +/- 25 (SE) to 151 +/- 23 mg/dl (p less than 0.05) with no change in body weight. In normal mice, both glibenclamide (10 mg/kg twice daily) and aloes (500 mg/kg twice daily) induced hypoglycaemia after 5 days, 71 +/- 6.2 and 91 +/- 7.6 mg/dl, respectively, versus 130 +/- 7 mg/dl in control animals (p less than 0.01); only glibenclamide was effective after 3 days. In the diabetic mice, fasting plasma glucose was significantly reduced by glibenclamide and aloes after 3 days. Thereafter only aloes was effective and by day 7 the plasma glucose was 394 +/- 22.0 versus 646 +/- 35.9 mg/dl, in the controls and 726 +/- 30.9 mg/dl in the glibenclamide treated group (p less than 0.01). We conclude that aloes contains a hypoglycaemic agent which lowers the blood glucose by as yet unknown mechanisms.
Huupponen R. The effect of guar gum on the acute metabolic response to glyburide. Res Commun Chem Pathol Pharmacol 1986 Oct;54(1):137-140.
Abstract: The effect of 5 g guar gum on the acute blood glucose, insulin and C-peptide response to 5 mg glyburide (HB 419) was investigated in 10 healthy volunteers after an overnight fast. The co-administration of guar gum significantly enhanced the insulinogenic and blood glucose lowering effect of glyburide.
Neugebauer G, Akpan W, Abshagen U. [Interaction of guar with glibenclamide and bezafibrate]. Beitr Infusionther Klin Ernahr 1983;12:40-47. [Article in German]
Uusitupa M, Sodervik H, Silvasti M, Karttunen P. Effects of a gel forming dietary fiber, guar gum, on the absorption of glibenclamide and metabolic control and serum lipids in patients with non-insulin-dependent (type 2) diabetes. Int J Clin Pharmacol Ther Toxicol 1990 Apr;28(4):153-157.
Abstract: Nine patients with non-insulin-dependent diabetes (NIDDM) treated with glibenclamide (3.5 mg twice daily) participated in this randomized double-blind placebo controlled crossover study to evaluate the effects of granulated guar gum (5 g three times daily with meals) on the absorption of glibenclamide and metabolic control and serum lipids. Each treatment period lasted for 4 weeks, and there was a wash-out period of one week between the treatments. The fasting blood glucose (10.5 +/- 3.4 mmol/l on guar gum vs 11.3 +/- 3.7 mmol/l on placebo, p less than 0.05) and serum total cholesterol (5.9 +/- 1.4 mmol/l on guar gum vs 6.6 +/- 1.6 mmol/l on placebo; p less than 0.05) levels were lower after the treatment with guar gum than placebo. No significant differences were observed in serum triglycerides or HDL cholesterol between guar gum and placebo treatments. The administration of guar gum together with glibenclamide did not change significantly the maximum concentration (223 +/- 196 ng/ml on guar gum vs 184 +/- 138 ng/ml on placebo; n = 7, NS) or area under the curve (AUC0-6) [729 +/- 813 (ng/ml) X h on guar gum vs 560 +/- 513 (ng/ml) X h on placebo; NS] of glibenclamide. The fasting serum glibenclamide concentrations were similar at the end of the 4-week treatment period with guar gum and placebo. In conclusion, guar gum improved the metabolic control and decreased serum lipids of patients with NIDDM. In addition, guar gum ingested with glibenclamide did not interfere with the absorption of glibenclamide.