Glimepiride
Glimepiride is an oral, once-daily **anti-hyperglycemic agent** belonging to the sulfonylurea class. > **Clinical Pearl:** While dogs almost exclusively develop insulin-dependent diabetes mellitus (IDDM) requiring exogenous insulin, cats frequently develop non-insulin dependent diabetes mellitus (NIDDM), similar to human Type 2 diabetes. This makes oral hypoglycemic agents like glimepiride potentially useful in feline patients whose pancreas still retains some beta-cell function. - **Advantages:** Its longer duration of action allows for convenient **once-daily dosing** in cats, and it may present fewer side effects compared to older generation sulfonylureas like glipizide. - **Limitations:** Clinical experience in veterinary medicine remains very limited, and it is considered an investigational or adjunctive therapy.
Mecanismo: Glimepiride is a medium- to long-acting **secretagogue sulfonylurea**. **Primary Mechanism:** - Binds to the **SUR1 receptor** on the membrane of functioning pancreatic beta cells. - Closes ATP-sensitive potassium (K+) channels → cell depolarization. - Opens voltage-gated calcium (Ca2+) channels → calcium influx. - Triggers the exocytosis and **release of insulin** granules into the bloodstream. **Secondary Mechanism:** - With continued use, it may also increase peripheral tissue sensitivity to insulin, reducing insulin resistance.
Dosificación por especie
- Treatment of NIDDM · 2 mg (total dose) per cat · PO · once daily
- Treatment of NIDDM · 1-2 mg (total dose per cat) · PO · once daily
Las dosis son una referencia clínica para veterinarios colegiados. Confirme siempre con la ficha técnica vigente y el paciente individual.
Vías de administración
Contraindicaciones
- Hypersensitivity to glimepiride or other sulfonylureas
- Diabetic ketoacidosis (DKA)
Efectos adversos
- Hypoglycemia
- Dizziness
- Asthenia
- Liver function impairment (rare)
- Allergic respiratory reactions (rare)
- Dermatologic reactions (rare)
- Hematologic reactions (rare)
Interacciones farmacológicas
- Azole Antifungals (ketoconazole, itraconazole, fluconazole) · May increase plasma levels of glimepiride
- Beta-Blockers · May potentiate hypoglycemic effect
- Chloramphenicol · May displace glimepiride from plasma proteins
- Corticosteroids · May reduce efficacy
- Thiazide Diuretics · May reduce hypoglycemic efficacy
- Isoniazid · May reduce hypoglycemic efficacy
- Niacin · May reduce hypoglycemic efficacy
- Phenothiazines · May reduce hypoglycemic efficacy
- Phenytoin · May reduce hypoglycemic efficacy
- Sulfonamides · May displace glimepiride from plasma proteins
- Sympathomimetic Agents · May reduce hypoglycemic efficacy
- Warfarin · May displace glimepiride from plasma proteins
Monitorización
- Fasting blood glucose
- Appetite and attitude
- Body condition
- PU/PD resolution
- Serum fructosamine
- Glycosylated hemoglobin levels
- Signs of hypoglycemia
Sobredosis
Overdoses can lead to **hypoglycemia**, ranging from mild to severe and life-threatening. **Treatment:** - Immediate **glucose administration** (oral if conscious, IV dextrose if severe/unconscious). - **Intensive monitoring** is critical. - Due to the drug's long duration of activity, patients may require continuous glucose support (e.g., IV dextrose CRI) for **at least 48 hours** post-ingestion, even after apparent clinical recovery.
La referencia de fármacos de VetSheet está destinada a veterinarios colegiados como apoyo a la decisión clínica, no sustituye el juicio profesional ni la ficha técnica vigente del fabricante.