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 :490.6

%Protein binding :>99

%Excreted unchanged in urine : 0 (58–60% as metabolites)

Volume of distribution (L/kg) :0.113

half-life – normal/ESRD (hrs) :5–9/Prolonged

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Dose as in normal renal function

10 to 20 : Dose as in normal renal function

<10 : Start with a low dose and monitor closely

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

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

HD :Unlikely to be dialysed. Dose as in GFR <10 mL/min

HDF/high flux :Unlikely to be dialysed. Dose as in GFR <10 mL/min

CAV/VVHD :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

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Route

Oral

Rate of Administration

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Comments

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