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Glimepiride Indications

glimepiride indications

Description

Glimepiride is a long-acting oral anti-diabetic which lower the blood sugar level. It is used only in patients diagnosed with Type II Diabetes. It may be used along with Insulin or other medicines in order to achieve better control over the blood sugar levels. This medicine, when taken along with a controlled diet and regular exercise routine, may give better results.

uses

Glimepiride is indicated for the treatment of adult patients with type 2 diabetes (non-insulin-dependent diabetes mellitus). This substance is used, alone or in combination with other hypoglycemic substances, in addition to a slimming diet and lifestyle measures such as physical exercise to achieve a balance of blood glucose.

properties

Glimepiride owes its hypoglycemic action to the stimulation of insulin secretion by pancreatic cells: beta cells of islets of Langerhans. The action of glimepiride is glucose-dependent. This active substance has extrapancreatic properties such as, among others, the decrease of insulin uptake by the liver and the improvement of peripheral tissue sensitivity to insulin

Cons-indications

Glimepiride is contraindicated in people who are hypersensitive to this substance, sulfonylureas, sulfonamides and drugs derived from urea. Patients with type 1 diabetes (insulin-dependent diabetes mellitus), ketoacidosis or diabetic coma should not use drugs containing this active substance. Drugs containing this active substance should not be used during pregnancy and lactation.

The use of glimepiride is contraindicated in patients with renal or hepatic impairment. The combination of glimepiride with other drugs should be done with caution, including insulin, some oral antidiabetic agents, salicylic acid derivatives, phenylbutazone and its derivatives, anticoagulants derived from coumarin,

Oral dosage

Initially 1 mg or 2 mg PO once daily, administered with breakfast or the first main meal of the day. Patients with risk factors for hypoglycemia, such as the geriatric adult, may be started at 1 mg PO once daily. After achieving a dose of 2 mg/day, upward titration in dosing of 1 mg or 2 mg/day should occur no more frequently than at 1 to 2 week intervals, based on blood glucose. The usual dosage range is 1 to 4 mg once daily. Max: 8 mg/day PO.

Safety and efficacy have been evaluated; however, glimepiride is not generally recommended in pediatric patients as a first line agent because of its adverse effects on body weight and hypoglycemia compared to metformin. In a manufacturer-sponsored clinical trial of pediatric patients 8 to 17 years, the overall mean treatment difference in A1C values between glimepiride and metformin was 0.2%, favoring metformin (95% confidence interval -0.3% to +0.6%); the trial did not meet its primary objective of showing a similar reduction in A1C compared to metformin. Glimepiride was initiated at 1 mg PO once daily, and then titrated up to 2, 4, or 8 mg/day (mean last dose 4 mg/day) through Week 12, targeting a self-monitored fasting fingerstick blood glucose less than 126 mg/dL. Hypoglycemic events were observed in 4% of pediatric patients treated with glimepiride vs. 1% of those treated with metformin.

One patient in each treatment group experienced a severe hypoglycemic episode. Use of glimepiride vs. metformin has also been described in the literature, with similar outcomes, in pediatric patients 8 to 17 years. Glimepiride was initiated at a dose of 1 mg PO once daily in the morning and titrated as needed by doubling the dose at weeks 4, 8, and 12 according to blood glucose goals. Max dose: 8 mg/day PO. The mean final dose for glimepiride was 3.8 mg/day (range 1 to 8 mg/day PO). While both metformin and glimepiride were similarly effective in treating diabetes, weight gain occurred and hyperglycemia rates were higher in the glimepiride group.

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