Pregnancy Implications

Glyburide was not found to significantly cross the placenta in vitro and was not found in the cord serum infants of mothers taking glyburide for gestational diabetes mellitus (GDM). Reported teratogenic effects may be due to poorly controlled maternal diabetes; abnormal blood glucose levels in the mother are associated with a higher incidence of congenital abnormalities. Nonteratogenic effects such as hypoglycemia in the neonate have been associated with maternal glyburide use. The manufacturer recommends that if glyburide is used during pregnancy, it should be discontinued at least 2 weeks before the expected delivery date. Although studies have shown positive outcomes using glyburide for the treatment of GDM, use may not be appropriate for all women. When compared to insulin for the treatment of GDM, as the severity of GDM increased, the success rate of treatment decreased. It should be noted that studies using glyburide for the treatment of GDM have initiated treatment after the period of organogenesis. Insulin is considered the drug of choice for the control of diabetes mellitus during pregnancy.Reproduction studies differ by manufacturer labeling. Because adverse events were not observed in animal reproduction studies, one manufacturer classifies glyburide as pregnancy category B. Because adverse events were noted in animal studies during the period of lactation, another manufacturer classifies glyburide as pregnancy category C.