Glimepiride

Glimepiride (brand name Amaryl) is an anti-diabetic drug in the sulfonylureas class.

Description
Glimepiride is the first III generation sulphonyl urea it is a very potent sulphonyl urea with long duration of action.

Mechanism of Action
Glimepiride distinctly lower the blood glucose level by both defects of NIDDM, by stimulating pancreatic beta cells to produce more insulin and induced increased activity of peripheral insulin intra cellular receptor.

Clinical Pharmacology
With Glimepiride GI absorption is complete with no interference of meals. Significant absorption of glimepiride was seen within one hour, and distributed through out the body, bound to the plasma protein to an extended of 99.5% and it is metabolised by oxidative biotransformation and 60% is excreted in the urine, and remaining is excreted in the feces.

Indications
Type 2 diabetes (or) NIDDM

Dosage
There is no fixed dosage regimen for the management of diabetes mellitus with GLI, in general the dosage of GLI should be lowest which is sufficient to achieve the desired metabolic control. Starting dose : 1-2mg OD Maintenance :1-4mg OD Maximum recommended dose : 8mg OD

Contra-Indication
Hypersensitivity to glimepiride or other sulphonyl urea.

Drug Interactions
With NSAIDs like Salicylates, Sulphoamides, Chlorampenicol, coumarin and probencid may potentiate the hypoglycemic action of glimepride. Thiazides, other diuretic, phothiazides, thyroid products, oral contraceptives, phenytoin tend to produce hyperglycemia.

Special Precautions
In the initial weeks of treatment the risk of hypoglycemia, may be increased and necessities especially careful monitoring.

Adverse Effects
GI disturbance, rarely thrombopenia, leucopenia, haemolytic anaemia, occasionally allergic.