Medicine & USMLE


Diabetes Drugs
  1. Insulin Overview
  2. Rapid Acting Insulin
  3. Short Acting Insulin
  4. Intermediate Acting Insulin
  5. Long Acting Insulin
  6. Metformin
  7. Sulfonylureas
  8. Meglitinides
  9. Thiazolidinediones (TZDs)
  10. DPP-4 Inhibitors
  11. Incretin Mimetics
  12. SGLT2 Inhibitors
  13. Alpha Glucosidase Inhibitors
  14. Pramlintide


Sulfonylureas are a drug class of medications used to treat type 2 diabetes through increasing insulin release. First generation sulfonylureas drug names include tolbutamide and chlorpropamide. Second generation drug names include glimepiride, glyburide, and glipizide. Side effects of sulfonylureas include weight gain, hypoglycemia, rash, and nausea and vomiting. Sulfonylureas should be taken with breakfast, first thing in the morning. Patients who have a sulfa allergy should not take sulfonylureas to treat their diabetes. Patients taking sulfonylureas must avoid alcohol to prevent severe hypoglycemia and a disulfiram-like reaction.

Key Points

  • Sulfonylureas
    • Drug Names
      • First generation
        • Chlorpropamide
        • Tolbutamide
      • Second generation
        • Glimepiride
        • Glipizide
        • Glyburide
    • Mechanism
      • Stimulate insulin release
        • Acts on the beta cells in the pancreas to release more insulin
    • Clinical Use
      • Treats Type 2 Diabetes Mellitus (DM)
        • The end result of sulfonylureas is a decrease in blood glucose levels in patients with type 2 diabetes mellitus
    • Side Effects
      • Causes hypoglycemia
        • Eat consistent meals to avoid hypoglycemia
      • Causes nausea/vomiting
      • Causes weight gain
      • Causes rash
        • And other skin reactions including Stevens-Johnson Syndrome (SJS) and photosensitivity
    • Considerations
      • Take with breakfast
      • Sulfa allergy
        • Patients who are allergic to other sulfa drugs (sulfonamide antibiotics, thiazide diuretics, sulfasalazine, etc.) should not take sulfonylureas
      • Avoid alcohol
        • Alcohol lowers blood sugar, so the combination of alcohol and sulfonylureas can cause severe hypoglycemia.
        • Causes a disulfiram-like reaction
          • Disulfiram-like reaction includes nausea, vomiting, dizziness, flushing, headache, etc.