|Indication||For management of Type II Diabetes Mellitus|
|Mechanism of Action||
Glimepiride stimulates the insulin release from pancreatic β-cells and reduces glucose output from the liver. It also increases insulin sensitivity at peripheral target sites.
Duration: 24 hr.
Absorption: Completely absorbed from the GI tract. Time to peak plasma concentration: 2-3 hr.
Distribution: Volume of distribution: 8.8 L. Plasma protein binding: >99.5%.
Metabolism: Extensively metabolised in the liver via oxidation by CYP2C9 isoenzyme to 2 main metabolites.
Excretion: Via urine (approx. 60%) and faeces (40%). Half-life: Approx. 9 hr.
Potentially Fatal: Severe hypoglycaemia. Dizziness, headache, nausea, increased serum ALT, flu-like symptoms, accidental injury, dyspnoea, fall in BP, shock, thrombocytopenia and thrombocytopenic purpura.
Patient with G6PD deficiency, autonomic neuropathy, thyroid or adrenocortical insufficiency. Patient exposed to stress (e.g. fever, trauma, infection, surgery). Mild to moderate hepatic or renal impairment. Elderly, debilitated and malnourished patients.
Pregnancy and lactation: Patient Counselling Adhere to diet and exercise regimen.
Monitoring Parameters: Monitor blood glucose, glycosylated Hb level, signs and symptoms of hypoglycaemia.
Type 2 diabetes mellitus
Adult: Initially, 1-2 mg daily. May be increased in increments of 1-2 mg at intervals of 1-2 wk. Maintenance: 4 mg daily. Max: 6 mg daily.
Elderly: Initially, 1 mg once daily.
Renal impairment: Severe: Contraindicated.
Hepatic impairment: Severe: Contraindicated.