- 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 ATC code A10BB12 PubChem CID 3476 DrugBank DB00222 ChemSpider 16740595 UNII 6KY687524K KEGG D00593 ChEMBL CHEMBL1481 Chemical data Formula C24H34N4O5S Mol. mass 490.617 g/mol SMILES eMolecules & PubChem (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
Main article: SulfonylureaContraindications
- Hypersensitivity to glimepiride or other sulfonylureas
- Pregnancy
Adverse effects
Main article: SulfonylureaGI 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
Main article: SulfonylureaLike 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
- ^ 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.
- ^ 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.
- ^ 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.
- ^ 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
- http://www.drugdigest.org/DD/DVH/Uses/1,3915,298%7CAmaryl%2BTablets%7C2805,00.html*
- http://www.theodora.com/drugs/amaryl_tablets_sanofi_aventis.html
- http://www.rxlist.com/cgi/generic/glimepiride.htm
- http://www.pharmgkb.org/do/serve?objId=213&objCls=DrugProperties
Oral anti-diabetic drugs and Insulin analogs (A10) Insulin K+ ATP1st generation: Acetohexamide • Carbutamide • Chlorpropamide • Tolbutamide • Tolazamide
2nd generation: Glibenclamide (Glyburide)# • Glipizide • Gliquidone • Glyclopyramide • Glimepiride • Gliclazide •Meglitinides/"glinides"GLP-1 analogsExenatide • Liraglutide • Taspoglutide† • Albiglutide† • LixisenatideAnalogs/other insulinsfast-acting (Insulin lispro • Insulin aspart • Insulin glulisine) • short-acting (Regular insulin) • long-acting (Insulin glargine • Insulin detemir • NPH insulin) • ultra-long-acting (Insulin degludec†) • inhalable Exubera‡Other Amylin analogSGLT2 inhibitorsCanagliflozin† • Dapagliflozin† • Remogliflozin§ • Sergliflozin§OtherBenfluorex‡ • Tolrestat‡
{{gastrointestinal-drug-stuCategories:- Sulfonylureas
- Pyrrolines
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