As discussed above, the primary disadvantage of sulfonylurea use is a risk of hypoglycemia, especially in individuals with hepatic or renal dysfunction. Drug interactions between sulfonylureas and other pharmacologic agents (salicylates, sulfonamides, fibric acid derivatives, and warfarin) can prolong the activity of either medication, and requires both close glucose monitoring and measurement of serum drug levels when possible. The activity of metabolites prolongs the drug effect, which can be beneficial in improving glycemic control, but dangerous if buildup of the metabolites occurs. Finally, weight gain is common in persons on sulfonylurea therapy.

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