Glibenclamide

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Glibenclamide
Glibenclamide structural formula V.1.svg
Glibenclamide ball-and-stick model.png
Systematic (IUPAC) name
5-chloro-N-[2-[4-(cyclohexylcarbamoylsulfamoyl)
phenyl]ethyl]-2-methoxybenzamide
Clinical data
Trade names Diabeta, Glynase, Micronase Daonil, Semi-Daonil, Euglucon, Delmide, Glybovin, Gilemal
AHFS/Drugs.com International Drug Names
MedlinePlus a684058
Licence data US FDA:link
Pregnancy
category
  • AU: C
  • US: B (No risk in non-human studies)
Legal status
Routes of
administration
Oral
Pharmacokinetic data
Protein binding Extensive
Metabolism Hepatic hydroxylation (CYP2C9-mediated)
Biological half-life 10 hours
Excretion Renal and biliary
Identifiers
CAS Number 10238-21-8 YesY
ATC code A10BB01 (WHO)
PubChem CID: 3488
IUPHAR/BPS 2414
DrugBank DB01016 YesY
ChemSpider 3368 YesY
UNII SX6K58TVWC YesY
KEGG D00336 YesY
ChEBI CHEBI:5441 YesY
ChEMBL CHEMBL472 YesY
Chemical data
Formula C23H28ClN3O5S
Molecular mass 494.004 g/mol
  • O=C(NC1CCCCC1)NS(=O)(=O)c2ccc(cc2)CCNC(=O)c3cc(Cl)ccc3OC
  • InChI=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) YesY
  • Key:ZNNLBTZKUZBEKO-UHFFFAOYSA-N YesY
  (verify)

Glibenclamide (AAN, BAN, INN), also known as glyburide (USAN), is an antidiabetic drug in a class of medications known as sulfonylureas, closely related to sulfonamide antibiotics. It was developed in 1966 in a cooperative study between Boehringer Mannheim (now part of Roche) and Hoechst (now part of Sanofi-Aventis).[1]

It is sold in doses of 1.25, 2.5, and 5 mg, under the trade names Diabeta, Glynase, and Micronase in the United States and Daonil, Semi-Daonil, and Euglucon in the United Kingdom, and Delmide, Glybovin in India. It is also sold in combination with metformin under the trade names Glucovance, Benimet, and Glibomet, as well as Glucored and Glucored Forte (by Sun Pharmaceutical) in Russia, Belarus and other countries of the CIS.

Medical uses

It is used in the treatment of type 2 diabetes. As of 2003, in the United States, it was the most popular sulfonylurea.[2]

It is not as good as either metformin or insulin in those who have gestational diabetes.[3]

Side effects and contraindications

This drug is a major cause of drug-induced hypoglycemia. The risk is increased against other sulfonylureas.[4] Cholestatic jaundice is noted.

Glibenclamide may be not recommended in those with G6PD deficiency, as it may cause acute haemolysis.[5]

Recently published data suggest glibenclamide is associated with significantly higher annual mortality when combined with metformin than other insulin-secreting medications, after correcting for other potentially confounding patient characteristics. The safety of this combination has been questioned.[6]

Mechanism of action

The drug works by binding to and inhibiting the ATP-sensitive potassium channels (KATP) inhibitory regulatory subunit sulfonylurea receptor 1 (SUR1) [7] in pancreatic beta cells. This inhibition causes cell membrane depolarization, opening voltage-dependent calcium channels. This results in an increase in intracellular calcium in the beta cell and subsequent stimulation of insulin release.

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.[8] Moreover, under ischemic conditions SUR1, the regulatory subunit of the KATP- and the NCCa-ATP-channels, is expressed in neurons, astrocytes, oligodendrocytes, endothelial cells[9] and by reactive microglia.[8]

Analogs

Additional glibenclamide structural analogs have been prepared by Ahmadi et al.[10]

Research

Glibenclamide improves outcome in animal stroke models by preventing brain swelling[11] and enhancing neuroprotection.[7] A retrospective study showed, in type 2 diabetic patients already taking glyburide, NIH stroke scale scores were improved on discharge compared to diabetic patients not taking glyburide.[12]

See also

References

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