 Glibenclamide
Exerts
both pancreatic(short-term) and extrapancreatic(long-term) actions.
Rapid increase in insulin release but not it’s biosynthesis.
Reduces hepatic gluconeogenesis and glycogenolysis. Glucose uptake
increased in liver and utilization increased in skeletal muscle.
Indications
& Dosage:
Oral
–
Non-insulin dependent diabetes mellitus: Start 2.5mg/day. Increase
gradually upto 20mg/day taken 30 mins before breakfast. Elderly:
Start with 1.2mg/day and increase gradually. Renal failure: Start
at 1.25mg daily and increase carefully as required using blood glucose
levels. Children:Not indicated.
Composition:
Each
Capsule Contains
Glibenclamide
B.P. 300mg.
Safety
Alert:
CL:
Severe or life threatening hyperglycaemia, liver disease, severe
renal failure, juvenile diabetes, ketaoacidosis , pre-coma and diabetic
coma, adrenocortical insuffiency, pregnancy, and lactation.
SP: Overdosage, elderly, dietary errors, renal
disorders. Impaired alertness. Avoid Alcohol.
INT POT-HAZ: Warfarin, salicylates, sulphonamides
and alcohol potentiate hypoglycaemic effect. Glucocorticoids, diuretics
and oestrogen reduce hypoglycaemic effect. Beta blockers (propranolol)
mask early symptoms of hypoglycaemia. Others: Synergistic hypoglycaemic
action with metformin.
ADR POT-LT: Prolonged hypoglycemia seen in elderly/debilitated
patients with hepatic/renal diseases. Others: Blood dyscrasias(reversible),
liver dysfunction, hypoglycaemia, G.I. symptoms, allergic skin reactions.
INT FOOD: None except high fibre diet delayed absorption
in one study.
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