Glimepiride
Glimepiride.JPG

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

    Route

    Oral

    Rate of Administration

    Comments





    See how to identify renal failure stages according to GFR calculation

    See how to diagnose irreversible renal disease

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