Glibenclamide Explained

Watchedfields:changed
Verifiedrevid:461120828
Width:275
Usan:Glyburide
Tradename:Diabeta, Glynase, Micronase, others
Dailymedid:Glyburide
Pregnancy Au:C
Routes Of Administration:By mouth
Atc Prefix:A10
Atc Suffix:BB01
Legal Au:S4
Legal Uk:POM
Legal Us:Rx-only
Legal Us Comment:[1]
Legal Eu:Rx-only
Protein Bound:Extensive
Metabolism:Liver hydroxylation (CYP2C9-mediated)
Elimination Half-Life:10 hours
Excretion:Kidney and bile duct
Cas Number:10238-21-8
Pubchem:3488
Iuphar Ligand:2414
Drugbank:DB01016
Chemspiderid:3368
Unii:SX6K58TVWC
Kegg:D00336
Chebi:5441
Chembl:472
Iupac Name:5-chloro-N-[2-[4-(cyclohexylcarbamoylsulfamoyl)<br />phenyl]ethyl]-2-methoxybenzamide
C:23
H:28
Cl:1
N:3
O:5
S:1
Smiles:O=C(NC1CCCCC1)NS(=O)(=O)c2ccc(cc2)CCNC(=O)c3cc(Cl)ccc3OC
Stdinchi:1S/C23H28ClN3O5S/c1-32-21-12-9-17(24)15-20(21)22(28)25-14-13-16-7-10-19(11-8-16)33(30,31)27-23(29)26-18-5-3-2-4-6-18/h7-12,15,18H,2-6,13-14H2,1H3,(H,25,28)(H2,26,27,29)
Stdinchikey:ZNNLBTZKUZBEKO-UHFFFAOYSA-N
Melting Point:169
Melting High:170

Glibenclamide, also known as glyburide, is an antidiabetic medication used to treat type 2 diabetes. It is recommended that it be taken together with diet and exercise. It may be used with other antidiabetic medication. It is not recommended for use by itself in type 1 diabetes. It is taken by mouth.[2]

Common side effects include nausea and heartburn.[2] Serious side effects may include angioedema and low blood sugar.[2] It is generally not recommended during pregnancy but can be used during breastfeeding.[3] It is in the sulfonylureas class of medications and works by increasing the release of insulin from the pancreas.[2]

Glibenclamide was discovered in 1969 and approved for medical use in the United States in 1984.[4] [2] It is available as a generic medication.[3] In 2021, it was the 214th most commonly prescribed medication in the United States, with more than 2million prescriptions.[5] [6]

Medical uses

Glibenclamide is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes.

It is not as good as either metformin or insulin in those who have gestational diabetes.[7]

Side effects

Frequently reported side effects include: nausea, heartburn, weight gain, and bloating.[8] The medication is also a major cause of medication-induced hypoglycemia. The risk is greater than with other sulfonylureas.[9]

Contraindications

Glibenclamide may be not recommended in those with G6PD deficiency, as it may cause acute hemolysis.[10]

Pregnancy and breastfeeding

It is generally not recommended during pregnancy but can be used during breastfeeding.[3]

Mechanism of action

The medication, a sulfonylurea, works by binding to and inhibiting the ATP-sensitive potassium channels (KATP) inhibitory regulatory subunit sulfonylurea receptor 1 (SUR1)[11] in pancreatic beta cells. This inhibition causes cell membrane depolarization, opening voltage-dependent calcium Channels.[12]

This results in an increase in intracellular calcium in the pancreatic beta cell and subsequent stimulation of insulin release.[13]

After a cerebral ischemic insult, the blood–brain barrier is broken and glibenclamide can reach the central nervous system. Glibenclamide has been shown to bind more efficiently to the ischemic hemisphere.[14] Moreover, under ischemic conditions SUR1, the regulatory subunit of the KATP- and the NCCa-ATP-channels, is expressed in neurons, astrocytes, oligodendrocytes, endothelial cells[15] and by reactive microglia.[14]

As per the research papers, this sulphonylurea drugs also has extra hepatic effects. It works by inhibiting the enzyme Carnityl Acyl Transferase I (CAT-I) indirectly which is present in the mitochondria. This prevents the transport of long chain fatty acids into the mitochondria for beta-oxidation. This prevents hyperglycemia for which it is prescribed.[16] [17]

History

It was developed in 1966 in a cooperative study between Boehringer Mannheim (now part of Roche) and Hoechst (now part of Sanofi-Aventis).[18]

Society and culture

Brand names

Glibenclamide is available as a generic medication, is manufactured by many pharmaceutical companies and is sold under many brand names including Gliben-J, Daonil,[19] Diabeta,[20] Euglucon, Gilemal, Glidanil, Glybovin, Glynase, Maninil, Micronase and Semi-Daonil. It is also available in a fixed-dose combination drug with metformin that is sold under various trade names, e.g. Bagomet Plus, Benimet, Glibomet, Gluconorm, Glucored, Glucovance, Metglib and many others.[21]

Notes and References

  1. Web site: Glynase- glyburide tablet . DailyMed . 7 October 2017 . 30 April 2022 . 6 October 2022 . https://web.archive.org/web/20221006140651/https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=a7fce80a-2f13-43cc-8e1c-561f7d3ec3d5 . live .
  2. Web site: Glyburide Monograph for Professionals . Drugs.com . American Society of Health-System Pharmacists . 18 March 2019 . 31 March 2019 . https://web.archive.org/web/20190331042659/https://www.drugs.com/monograph/glyburide.html . live .
  3. Book: British national formulary : BNF 76. 2018. Pharmaceutical Press. 9780857113382. 692. 76.
  4. Book: Diabetes in Clinical Practice: Questions and Answers from Case Studies . 2007 . John Wiley & Sons . 9780470059135 . 342 .
  5. Web site: The Top 300 of 2021 . ClinCalc . 14 January 2024 . 15 January 2024 . https://web.archive.org/web/20240115223848/https://clincalc.com/DrugStats/Top300Drugs.aspx . live .
  6. Web site: Glyburide - Drug Usage Statistics . ClinCalc . 14 January 2024 . 12 April 2020 . https://web.archive.org/web/20200412071308/https://clincalc.com/DrugStats/Drugs/Glyburide . live .
  7. Balsells M, García-Patterson A, Solà I, Roqué M, Gich I, Corcoy R . Glibenclamide, metformin, and insulin for the treatment of gestational diabetes: a systematic review and meta-analysis . BMJ . 350 . h102 . January 2015 . 25609400 . 4301599 . 10.1136/bmj.h102 .
  8. Web site: Glyburide: MedlinePlus Drug Information . MedlinePlus . 29 October 2019 . 14 April 2019 . https://web.archive.org/web/20190414144129/https://medlineplus.gov/druginfo/meds/a684058.html . live .
  9. Gangji AS, Cukierman T, Gerstein HC, Goldsmith CH, Clase CM . A systematic review and meta-analysis of hypoglycemia and cardiovascular events: a comparison of glyburide with other secretagogues and with insulin . Diabetes Care . 30 . 2 . 389–394 . February 2007 . 17259518 . 10.2337/dc06-1789 . doi . free .
  10. Meloni G, Meloni T . Glyburide-induced acute haemolysis in a G6PD-deficient patient with NIDDM . British Journal of Haematology . 92 . 1 . 159–160 . January 1996 . 8562390 . 10.1046/j.1365-2141.1996.275810.x . 41227257 .
  11. Serrano-Martín X, Payares G, Mendoza-León A . Glibenclamide, a blocker of K+(ATP) channels, shows antileishmanial activity in experimental murine cutaneous leishmaniasis . Antimicrobial Agents and Chemotherapy . 50 . 12 . 4214–4216 . December 2006 . 17015627 . 1693980 . 10.1128/AAC.00617-06 .
  12. He Y, Chang Y, Peng Y, Zhu J, Liu K, Chen J, Wu Y, Ji Z, Lin Z, Wang S, Gupta S, Zang N, Pan S, Huang K . 6 . Glibenclamide Directly Prevents Neuroinflammation by Targeting SUR1-TRPM4-Mediated NLRP3 Inflammasome Activation In Microglia . Molecular Neurobiology . 59 . 10 . 6590–6607 . October 2022 . 35972671 . 10.1007/s12035-022-02998-x . 242029244 .
  13. Web site: Wolters Kluwer N.V. . Glyburide . Lexicomp . 3 June 2023 . 2 June 2023 . https://web.archive.org/web/20230602191128/https://www.wolterskluwer.com/en/solutions/lexicomp . live .
  14. Ortega FJ, Gimeno-Bayon J, Espinosa-Parrilla JF, Carrasco JL, Batlle M, Pugliese M, Mahy N, Rodríguez MJ . 6 . ATP-dependent potassium channel blockade strengthens microglial neuroprotection after hypoxia-ischemia in rats . Experimental Neurology . 235 . 1 . 282–296 . May 2012 . 22387180 . 10.1016/j.expneurol.2012.02.010 . free . 4828181 . 2445/34278 .
  15. Simard JM, Woo SK, Schwartzbauer GT, Gerzanich V . Sulfonylurea receptor 1 in central nervous system injury: a focused review . Journal of Cerebral Blood Flow and Metabolism . 32 . 9 . 1699–1717 . September 2012 . 22714048 . 3434627 . 10.1038/jcbfm.2012.91 .
  16. Chen S, Ogawa A, Ohneda M, Unger RH, Foster DW, McGarry JD . More direct evidence for a malonyl-CoA-carnitine palmitoyltransferase I interaction as a key event in pancreatic beta-cell signaling . Diabetes . 43 . 7 . 878–883 . July 1994 . 8013751 . 10.2337/diab.43.7.878 . 25251669 .
  17. Lehtihet M, Welsh N, Berggren PO, Cook GA, Sjoholm A . Glibenclamide inhibits islet carnitine palmitoyltransferase 1 activity, leading to PKC-dependent insulin exocytosis . American Journal of Physiology. Endocrinology and Metabolism . 285 . 2 . E438–E446 . August 2003 . 12684219 . 10.1152/ajpendo.00057.2003 . 175394 .
  18. Marble A . Glibenclamide, a new sulphonylurea: whither oral hypoglycaemic agents? . Drugs . 1 . 2 . 109–115 . 1971 . 4999930 . 10.2165/00003495-197101020-00001 . 13181386 .
  19. Web site: Daonil . 26 June 2023 . News-Medical.net . en . 26 June 2023 . https://web.archive.org/web/20230626042956/https://www.news-medical.net/drugs/Daonil.aspx . live .
  20. Web site: DiaBeta (Glyburide Tablets): Uses, Dosage, Side Effects, Interactions, Warning . 26 June 2023 . RxList . en . 26 June 2023 . https://web.archive.org/web/20230626042955/https://www.rxlist.com/diabeta-drug.htm . live .
  21. Web site: Wolters Kluwer N.V. . Glyburide and metformin . Lexicomp . 3 June 2023 . 2 June 2023 . https://web.archive.org/web/20230602191128/https://www.wolterskluwer.com/en/solutions/lexicomp . live .

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