Daonil (Glibenclamide (Glyburide))
Also sold as: Daonil, Euglucon, Glynase (micronised), Glucovance (with metformin), Glinil
Pregnancy
Cat C
Lactation
Caution
Schedule
H
Forms
Tablet 1.25mg, 2.5mg, 5mg
Indications
- Type 2 diabetes mellitus — monotherapy or combination
- Gestational diabetes (selected cases — specialist guidance)
Adult Dosing
T2DM
Start 2.5-5 mg PO OD with breakfast; increase by 2.5 mg/week to max 20 mg/day
Doses >10 mg: divide BD. Take with first meal of day.
Pediatric Dosing
Occasionally used in neonatal diabetes under specialist guidance
Renal Dose Adjustment
| CrCl / eGFR | Dose Adjustment |
|---|---|
| Mild CKD (CrCl > 50) | Use with caution; monitor closely |
| CrCl < 50 mL/min | AVOID — active metabolite accumulates; severe prolonged hypoglycaemia risk. Use glipizide or glimepiride instead. |
Hepatic Adjustment
AVOID in hepatic impairment — hepatic metabolism; impaired gluconeogenesis increases hypoglycaemia risk
Pregnancy & Lactation
Pregnancy: Category C
Used in gestational diabetes in some settings. Crosses placenta — neonatal hypoglycaemia possible. Metformin or insulin preferred; glibenclamide used if these are not feasible.
Lactation: Caution
Excreted in breast milk in small amounts — monitor infant for hypoglycaemia.
Top Drug Interactions
| Interacting Drug | Effect | Severity |
|---|---|---|
| NSAIDs (especially azapropazone), sulfonamides, co-trimoxazole, azole antifungals, fluoroquinolones | Significantly enhance hypoglycaemic effect — severe hypoglycaemia risk | Major |
| Beta-blockers | Mask hypoglycaemia symptoms (except sweating); may prolong hypoglycaemia | Major |
| Alcohol | Enhances hypoglycaemic effect and masks symptoms | Major |
| Corticosteroids / Thiazides / Oral contraceptives | Reduce hypoglycaemic effect (hyperglycaemia) | Moderate |
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Side Effects
Common
- Hypoglycaemia (most significant — prolonged and severe with glibenclamide vs newer sulfonylureas)
- Weight gain
- Nausea
- Skin rash
- Photosensitivity
Serious / Discontinue If
- Severe prolonged hypoglycaemia (particularly in elderly, renal impairment, missed meals, alcohol use — may require IV dextrose for 24-48 hours)
- Agranulocytosis (rare)
- Hepatotoxicity (rare)
- Haemolytic anaemia (G6PD deficiency)
Contraindications
- Type 1 diabetes
- DKA
- CrCl < 50 mL/min
- Severe hepatic impairment
- Sulfonamide allergy
- G6PD deficiency
- Major surgery / fasting (switch to insulin)
Available Indian Brands
| Brand | Manufacturer | Price (approx) |
|---|---|---|
| Daonil 5mg | Sanofi | 20 tab ₹28 |
| Euglucon 5mg | Roche | 20 tab ₹32 |
| Glinil 5mg | Lupin | 20 tab ₹25 |
Monitoring Required
- Blood glucose (pre-meal and 2-hour post-meal)
- HbA1c (3-6 monthly)
- Renal function (eGFR — annually)
- Weight
- Hypoglycaemia episodes (frequency, severity)
Patient Counseling Points
- Take with breakfast — NEVER on empty stomach (hypoglycaemia risk)
- NEVER skip a meal while on glibenclamide
- Carry glucose tablets or sugar always
- Hypoglycaemia: eat something immediately (glucose tablet, biscuit, fruit juice)
- Avoid alcohol — worsens hypoglycaemia and masks symptoms
- Beta-blockers (propranolol, metoprolol) will mask low blood sugar warning signs
- Older patients and those with kidney problems have HIGH risk of severe hypo — inform family
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Clinically reviewed by: Dr. Meena Reddy, DM (Endocrinology), Senior Diabetologist
Last reviewed: 2026-04-01
References
- BNF — Glibenclamide
- ADA Standards of Care 2025
- IDF T2DM Guidelines
- RSSDI Guidelines India 2023