Glimepiride


Glimepiride
Glimepiride
Systematic (IUPAC) name
3-ethyl-4-methyl-N-(4-[N-((1r,4r)-4-methylcyclohexylcarbamoyl)sulfamoyl]phenethyl)-2-oxo-2,5-dihydro-1H-pyrrole-1-carboxamide
Clinical data
Trade names Amaryl
AHFS/Drugs.com monograph
MedlinePlus a696016
Pregnancy cat.  ?
Legal status  ?
Routes Oral
Pharmacokinetic data
Bioavailability 100%
Protein binding >99.5%
Half-life 5 Hours
Excretion Urine & Fecal
Identifiers
CAS number 93479-97-1 YesY
ATC code A10BB12
PubChem CID 3476
DrugBank DB00222
ChemSpider 16740595 YesY
UNII 6KY687524K YesY
KEGG D00593 YesY
ChEMBL CHEMBL1481 YesY
Chemical data
Formula C24H34N4O5S 
Mol. mass 490.617 g/mol
SMILES eMolecules & PubChem
 N(what is this?)  (verify)

Glimepiride is a medium-to-long acting sulfonylurea anti-diabetic drug. It is marketed as Amaryl by Sanofi-Aventis and GLIMY by Dr.Reddy's Labs. Glimepiride is the first third-generation sulfonylurea, and is very potent.

It is sometimes classified as third-generation,[1] and sometimes classified as second-generation.[2]

Contents

Indications

Type 2 Diabetes Mellitus

Contraindications

  • Hypersensitivity to glimepiride or other sulfonylureas
  • Pregnancy

Adverse effects

GI disturbance, rarely thrombocytopenia , leukopenia, hemolytic anemia, occasionally allergic reactions occur. In the initial weeks of treatment, the risk of hypoglycemia may be increased.

Pharmacokinetics

With glimepiride GI absorption is complete, with no interference of meals. Significant absorption of glimepiride was seen within 1 hour, and distributed throughout the body, bound to the plasma protein to an extent of 99.5% and it is metabolized by oxidative biotransformation and 60% is excreted in the urine, the remaining being excreted in the feces.

Mechanism of action

Like all sulfonylureas, glimepiride acts as a secretagogue.[3] It lowers blood sugar by stimulating the release of insulin by pancreatic beta cells and by inducing increased activity of intracellular insulin receptors.

Not all secondary sufonylureas have the same risks of hypoglycemia. Glibenclamide (glyburide) is associated with an incidence of hypoglycemia of up to 20–30%, compared to 2% to 4% with glimepiride. Glibenclamide also interferes with the normal homeostatic suppression of insulin secretion in reaction to hypoglycemia, whereas glimepiride does not have this property. Furthermore, glibenclamide diminishes the glucagon secretion in reaction to hypoglycemia, whereas glimepiride does not suppress this counter-regulatory reaction.[4]

Interactions

With NSAIDs like Salicylates, Sulphonamides, Chloramphenicol, coumadin and probenecid may potentiate the hypoglycemic action of glimepiride. Thiazides, other diuretic, phothiazides, thyroid products, oral contraceptives, phenytoin tend to produce hyperglycemia.

References

  1. ^ Hamaguchi T, Hirose T, Asakawa H, et al. (December 2004). "Efficacy of glimepiride in type 2 diabetic patients treated with glibenclamide". Diabetes Res. Clin. Pract. 66 Suppl 1: S129–32. doi:10.1016/j.diabres.2003.12.012. PMID 15563963. http://linkinghub.elsevier.com/retrieve/pii/S0168-8227(04)00148-2. 
  2. ^ Davis SN (2004). "The role of glimepiride in the effective management of Type 2 diabetes". J. Diabetes Complicat. 18 (6): 367–76. doi:10.1016/j.jdiacomp.2004.07.001. PMID 15531188. http://linkinghub.elsevier.com/retrieve/pii/S1056-8727(04)00078-9. 
  3. ^ Nissen SE, Nicholls SJ, Wolski K, et al. (April 2008). "Comparison of pioglitazone vs glimepiride on progression of coronary atherosclerosis in patients with type 2 diabetes: the PERISCOPE randomized controlled trial". JAMA 299 (13): 1561–73. doi:10.1001/jama.299.13.1561. PMID 18378631. http://jama.ama-assn.org/cgi/pmidlookup?view=long&pmid=18378631. 
  4. ^ Davis, Stephen N. (2005). "60. Insulin, oral hypoglycemic agents, and the pharmacology of the endocrine pancreas". In Brunton, Laurence L.; Lazo, John S.; Parker, Keith L. (eds.). Goodman & Gilman's The Pharmacological Basis of Therapeutics. New York: McGraw-Hill. p. 1636. ISBN 0071422803. 

External links


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