Sulfonylureas, a class of oral hypoglycemic agents, are associated with several side effects:
Hypoglycemia
- Sulfonylureas are known to cause hypoglycemia, a significant concern with their use
- The risk of hypoglycemia is particularly elevated when sulfonylureas are used in conjunction with certain antimicrobial drugs or β-blockers
- Long-acting, non-specific sulfonylureas such as glyburide and glimepiride have a higher risk of severe hypoglycemia compared to short-acting, pancreas-specific sulfonylureas like gliclazide and glipizide
Cardiovascular events
- Sulfonylureas have been associated with an increased risk of cardiovascular events, including myocardial infarction and ischemic stroke
- However, the risk of sudden cardiac arrest and ventricular arrhythmia may be lower with glyburide compared to glipizide
Mortality
- The use of sulfonylureas has been linked to an increased risk of all-cause mortality compared to continuing metformin monotherapy
Other side effects
- Sulfonylureas can cause weight gain and may interact with certain antimicrobial drugs, increasing the risk of hypoglycemia
- They may also attenuate ST-segment elevation during an acute myocardial infarction, potentially leading to inappropriate withholding of thrombolytic therapy in diabetic patients
In conclusion, while sulfonylureas are effective in lowering HbA1c levels, their use is associated with several side effects, including hypoglycemia, cardiovascular events, and increased mortality risk. These factors should be carefully considered when prescribing sulfonylureas, particularly in patients with comorbid conditions or those taking other medications that may interact with sulfonylureas.