Glimepiride 磺醯尿素類 SU Amaryl. Amepiride, 慢性腎病減量 eGFR 30以下避免使用

商品名: Amaryl. Amepiride,
其他商品名: Amadm., Amalin., Amaride., Amarine., Donglu., Glimaryl., Glimepine., Glipid., Glipiride., Glufar., Glusafe., Grumed., Nonin

用法: 一天一次, 通常早餐前服用, 或用餐時服用, 也可以在主餐前(一天之中吃最多的那一餐)服用.
食物不會影響吸收, 吃藥之後一小時內就會顯著吸收,

半衰期是 5-7 小時

禁忌:
懷孕謹慎使用, C級,
哺乳不建議使用, 資料不足

Glimepiride 肝臟代謝成兩種主要代謝物, 兩者皆有降低血糖的效果,
慢性腎病患者, 代謝物會累積, glimepiride 可能會引起嚴重低血糖, 持續超過 24 小時

eGFR > 60 時, glimepiride 尚安全
eGFR 30-60 需減量
eGFR < 30 使用 glimepiride 很危險.

Glimepiride is metabolized by the liver to two major metabolites each of which has hypoglycemic activity. In renal disease these metabolites summed. Although the half-life is 5-7 h, the drug can cause severe hypoglycemia that lasts more than 24 h. Its use is safe in GFR > 60 mL/min and with a reduced dose of up to 30 mL/min. In CKD stage 4 or 5 the use of glimepiride is dangerous

不同的磺醯尿素類, 低血糖的機率各有不同

Glimepiride 低血糖機率 2%-4%

Glibenclamide 低血糖機率 20-30%

Glibenclamide (glyburide) is associated with an incidence of hypoglycemia of up to 20–30%, compared to as low as 2% to 4% with glimepiride.