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Glibenclamide

Hypoglycemic Agents
CATEGORIES

Hypoglycemic Agents, Anti-Arrhythmia Agents, Antidiabetic Agents


ALIASES

Daonil®, Euglucon, Euglucon®, Glibenklamid Recip, Glyburide, Glynase, Micronase, Novo-Glyburide, Semi-Daonil


SUBSTANCES

glibenclamide


ENVIRONMENTAL CONCERN: HIGH
Glyburide is an oral antihyperglycemic agent used for the treatment of non-insulin-dependent diabetes mellitus (NIDDM). It belongs to the sulfonylurea class of insulin secretagogues, which act by stimulating β cells of the pancreas to release insulin. Sulfonylureas increase both basal insulin secretion and meal-stimulated insulin release. Medications in this class differ in their dose, rate of absorption, duration of action, route of elimination and binding site on their target pancreatic β cell receptor. Sulfonylureas also increase peripheral glucose utilization, decrease hepatic gluconeogenesis and may increase the number and sensitivity of insulin receptors. Sulfonylureas are associated with weight gain, though less so than insulin. Due to their mechanism of action, sulfonylureas may cause hypoglycemia and require consistent food intake to decrease this risk. The risk of hypoglycemia is increased in elderly, debilitated and malnourished individuals. Glyburide has been shown to decrease fasting plasma glucose, postprandial blood glucose and glycosolated hemoglobin (HbA1c) levels (reflective of the last 8-10 weeks of glucose control). Glyburide appears to be completely metabolized, likely in the liver. Although its metabolites exert a small hypoglycemic effect, their contribution to glyburide's hypoglycemic effect is thought to be clinically unimportant. Glyburide metabolites are excreted in urine and feces in approximately equal proportions. The half-life of glyburide appears to be unaffected in those with a creatinine clearance of greater than 29 ml/min/1.73m2.

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IN SCOPE
HIGH

REFERENCES

  1. Goodpoint. Prioritering av läkemedel med miljörisk inom SLL. Stockholm: Goodpoint; 2016. Rapport LS 2016–0634.
  2. IVL Swedish Environmental Research Institute Ltd. Fick J, Lindberg RH, Kaj L, Brorström-Lundén E. Results from the Swedish National Screening Programme 2010. Subreport 3. Pharmaceuticals.
  3. IVL Swedish Environmental Research Institute Ltd Fick J, Lindberg RH, Fång J, Magnér J, Kaj L, Brorström-Lundén E. Screening 2014. Analysis of pharmaceuticals and hormones in samples from WWTPs and receiving waters. Rapport C 135.
  4. Fick J, Lindberg RH, Tysklind M, Larsson DG. Predicted critical environmental concentrations for 500 pharmaceuticals. Regul Toxicol Pharmacol. 2010;58:516-23.
  5. Stockholms läns landsting. Förteckning över miljöbelastande läkemedel med åtgärdsförslag framtagen inom ramen för SLL:s miljöprogram 2017–2021.
  6. Fass.se för vårdpersonal
  7. Socialstyrelsen. Statistikdatabas för läkemedel.
  8. Stockholms läns landsting. Janusinfo: Läkemedelsuppföljning

SOURCES

  1. Drugbank, The DrugBank database is a unique bioinformatics and cheminformatics resource that combines detailed drug data with comprehensive drug target information.
  2. PubChem, PubChem is the world's largest collection of freely accessible chemical information. Search chemicals by name, molecular formula, structure, and other identifiers
  3. ECHA, The European Chemicals Agency (ECHA) is the driving force among regulatory authorities in implementing the EU's groundbreaking chemicals legislation for the benefit of human health and the environment as well as for innovation and competitiveness.
  4. EMA, The mission of the European Medicines Agency (EMA) is to foster scientific excellence in the evaluation and supervision of medicines, for the benefit of public and animal health in the European Union (EU).
  5. EU watch-list, Commission Implementing Decision (EU) 2018/840 of 5 June 2018 establishing a watch list of substances for Union-wide monitoring in the field of water policy pursuant to Directive 2008/105/EC of the European Parliament.
  6. Umweltbundesamt, Since its founding in 1974, the German Environment Agency (Umweltbundesamt – UBA) has been Germany’s main environmental protection agency.
  7. Naturvårdsverket, A public agency in Sweden that is responsible for environmental issues. The Agency carries out assignments on behalf of the Swedish Government relating to the environment in Sweden, the EU and internationally
  8. Läkemedelsverket, The Swedish Medical Products Agency (MPA) is the Swedish national authority responsible for regulation and surveillance of the development, manufacturing and marketing of drugs and other medicinal products.
  9. FASS, The Swedish environmental classification of pharmaceuticals at www.fass.se has now been running since October 2005. Since then a large amount of environmental information of pharmaceuticals has been published.
  10. Janusinfo, Janusinfo is providing drug information to support healthcare professionals in their everyday work. The website is the electronic means of communication of the Drug Therapeutic Committee and the Health and Medical Care Administration of the Stockholm County Council, Sweden.