Glimepiride

CLINICAL USE


Non-insulin dependent diabetes mellitus

DOSE IN NORMAL RENAL FUNCTION

1–4 mg daily; maximum 6 mg daily taken shortly before or with first main meal

PHARMACOKINETICS

  • Molecular weight &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :490.6
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :>99
  • %Excreted unchanged in urine &nbsp &nbsp : 0 (58–60% as metabolites)
  • Volume of distribution (L/kg) &nbsp &nbsp &nbsp :0.113
  • half-life – normal/ESRD (hrs)&nbsp &nbsp &nbsp :5–9/Prolonged

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

  • 20 to 50 &nbsp &nbsp : Dose as in normal renal function
  • 10 to 20 &nbsp &nbsp : Dose as in normal renal function
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : Start with a low dose and monitor closely

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp:Unlikely to be dialysed. Dose as in GFR <10 mL/min

  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Unlikely to be dialysed. Dose as in GFR <10 mL/min
  • HDF/high flux &nbsp :Unlikely to be dialysed. Dose as in GFR <10 mL/min
  • CAV/VVHD &nbsp &nbsp &nbsp:Unlikely to be dialysed. Dose as in GFR 10 to 20 mL/min

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugs
  • Analgesics: effects enhanced by NSAIDs
  • Antibacterials: effects enhanced by chloramphenicol, sulphonamides, and trimethoprim; effect reduced by rifamycins
  • Anticoagulants: effect possibly enhanced by coumarins; also possibly changes to INR
  • Antifungals: concentration increased by fluconazole and miconazole and possibly voriconazoleSulfinpyrazone: enhanced effect of sulphonylureas

    ADMINISTRATION

    Reconstition

    Route

    Oral

    Rate of Administration

    Comments