Glucotrol: Initial Dose: The recommended starting dose is 5 mg, given before breakfast.
Geriatric patients or those with liver disease may be started on 2.5 mg.
Titration: Dosage adjustments should ordinarily be in increments of 2.5–5
mg, as determined by blood glucose response. At least several days should elapse
between titration steps. If response to a single dose is not satisfactory,
dividing that dose may prove effective. The maximum recommended once daily dose
is 15 mg. Doses above 15 mg should ordinarily be divided and given before meals
of adequate caloric content. The maximum recommended total daily dose is 40 mg.
Maintenance: Some patients may be effectively controlled on a once-a-day
regimen, while others show better response with divided dosing. Total daily
doses above 15 mg should ordinarily be divided. Total daily doses above 30 mg
have been safely given on a b.i.d. basis to long-term patients. Glyburide: Usual Starting Dose
The usual starting dose of Diaßeta as initial therapy is 2.5 to 5 mg daily,
administered with breakfast or the first main meal. Those patients who may be
more sensitive to hypoglycemic drugs should be started at 1.25 mg daily. Failure
to follow an appropriate dosage regimen may precipitate hypoglycemia. Patients
who do not adhere to their prescribed dietary and drug regimen are more prone to
exhibit unsatisfactory response to therapy.
Transfer of patients from other oral antidiabetic regimens to Diaßeta should be
done conservatively and the initial daily dose should be 2.5 to 5 mg. When
transferring patients from oral hypoglycemic agents other than chlorpropamide,
to Diaßeta, no transition period and no initial priming dose is necessary. When
transferring patients from chlorpropamide, particular care should be exercised
during the first two weeks because the prolonged retention of chlorpropamide in
the body and subsequent overlapping drug effects may provoke hypoglycemia.
Some Type II diabetic patients being treated with insulin may respond
satisfactorily to Diaßeta. If the insulin dose is less than 20 units daily,
substitution of Diaßeta 2.5 to 5 mg as a single daily dose may be tried. If the
insulin dose is between 20 and 40 units daily, the patient may be placed
directly on Diaßeta 5 mg daily as a single dose. If the insulin dose is more
than 40 units daily, a transition period is required for conversion to Diaßeta.
In these patients, insulin dosage is decreased by 50% and Diaßeta 5 mg daily is
started. Please refer to Usual Maintenance Dose for further explanation.
Usual Maintenance Dose
The usual maintenance dose is in the range of 1.25 to 20 mg daily, which may be
given as a single dose or in divided doses (See Dosage Interval Section). Dosage
increases should be made in increments of no more than 2.5 mg at weekly
intervals based upon the patient's blood glucose response.
No exact dosage relationship exists between Diaßeta and the other oral
hypoglycemic agents. Although patients may be transferred from the maximum dose
of other sulfonylureas, the maximum starting dose of 5 mg of Diaßeta should be
observed. A maintenance dose of 5 mg Diaßeta provides approximately the same
degree of blood glucose control as 250 to 375 mg chlorpropamide, 250 to 375 mg
tolazamide, 500 to 750 mg acetohexamide, or 1000 to 1500 mg tolbutamide.
When transferring patients receiving more than 40 units of insulin daily, they
may be started on a daily dose of Diaßeta 5 mg concomitantly with a 50%
reduction in insulin dose. Progressive withdrawal of insulin and increase of
Diaßeta in increments of 1.25 to 2.5 mg every 2 to 10 days is then carried out.
During this conversion period when both insulin and Diaßeta are being used,
hypoglycemia may rarely occur. During insulin withdrawal, patients should
self-test their blood for glucose and their urine for acetone at least 3 times
daily and report results to their physician. Self-testing of urinary glucose is
a less desirable alternative. The appearance of persistent acetonuria with
glycosuria indicates that the patient is a Type I diabetic who requires insulin
Daily doses of more than 20 mg are not recommended.
Glucotrol and Glyburide package
In elderly patients, debilitated or malnourished patients, and patients
with impaired renal or hepatic function, the initial
and maintenance dosing should be conservative to avoid hypoglycemic
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The authors make no claims of the accuracy of the information contained herein; and these suggested doses are not a substitute for clinical
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