Dosage

Adults: Oral:

Initial therapy (no prior treatment with sulfonylurea or metformin): 1.25 mg/250 mg once daily with a meal; patients with Hb A1c >9% or fasting plasma glucose (FPG) >200 mg/dL may start with 1.25 mg/250 mg twice daily

Dosage may be increased in increments of 1.25 mg/250 mg, at intervals of not less than 2 weeks; maximum daily dose: 10 mg/2000 mg (limited experience with higher doses)

Previously treated with a sulfonylurea or metformin alone: Initial: 2.5 mg/500 mg or 5 mg/500 mg twice daily; increase in increments no greater than 5 mg/500 mg; maximum daily dose: 20 mg/2000 mg

When switching patients previously on a sulfonylurea and metformin together, do not exceed the daily dose of glyburide (or glyburide equivalent) or metformin.

Note: May combine with a thiazolidinedione in patients with an inadequate response to glyburide/metformin therapy (risk of hypoglycemia may be increased).

Elderly: Oral: Conservative doses are recommended in the elderly due to potentially decreased renal function; do not titrate to maximum dose; should not be used in patients 80 years of age unless renal function is verified as normal

Dosage adjustment in renal impairment: Risk of lactic acidosis increases with degree of renal impairment; contraindicated in renal disease or renal dysfunction (see Contraindications)

Dosage adjustment in hepatic impairment: Use conservative initial and maintenance doses and avoid use in severe hepatic disease
Note: Dose must be individualized. Dosages expressed as glyburide/metformin components.