Description and Composition of Perglim
Perglim is a third-generation sulfonylurea which was introduced in 1995 in the United States for the treatment of type 2 diabetes mellitus. (Please note: some classify Glimepiride as a second generation sulfonylurea). It decreases the HbA1C by 1–2%. Sulfonylureas as antidiabetics have been in the market for more than long and have been established to be safe and effective. It usually comes as 1 mg, 2 mg, 3 mg, 4 mg, 6 mg, and 8 mg tablets. It exhibits a more potent glucose- lowering effect and longer duration of hypoglycemic effect than other sulfonylureas in the class
Pharmacological Classification of Perglim
Glimepiride is a third generation sulfonylurea. It is an oral hypoglycaemic agent used in the treatment of type 2 diabetes mellitus.
Indications and Uses of Perglim
It is indicated as an adjunct to diet and exercise to lower blood glucose in patients with non-insulin dependent (type 2) diabetes mellitus (NIDDM) whose hyperglycaemia cannot be controlled by diet exercise alone.
Dosage and direction for use of Perglim
The desired blood glucose level determines the dosage of Glimepiride. The dosage must be the lowest that is sufficient to achieve the desired metabolic control. If necessary, the daily dose can be increased. It is recommended that the increase be guided by regular blood glucose monitoring and that the dose can be increase gradually i.e. at intervals of one to two weeks and according to the following dose steps, 1 mg 2mg 3mg 4mg-6mg. Daily doses of more than 6mg are more effective only in a minority of patients. A maximum of 8 mg per day may not be exceeded. Normally, a single daily dose of Glimepiride is sufficient to provide metabolic control over 24 hours It is recommended that this dose be taken immediately before a substantial breakfast or, if none is taken, immediately before the first main meal.
Pharmacological Actions of Perglim
The pharmacological actions of Glimepiride is synonymous to its mechanism of action or how it works.
It is a sulfonylurea and it decreases blood glucose level by stimulating insulin release from the pancreatic beta cells.
Contraindication of Perglim
- Glimepiride must not be used in patients hypersensitive to Glimepride, other sulphonyurcas, other sulfonamides, or any of the excipients (risk of hypersensitivity reactions)
- It must not be used in pregnant or breast-feeding women as safety has not been shown, impaired liver function and moderate to more severe impaired renal function and children.
- It is not suitable for the treatment of insulin-dependent (Type 1) diabetes mellitus
Side Effects of Perglim
Hypoglycaemia (sometimes life-threatening) may occur as a result of the blood glucose-lowering action of Glimepride. This happens when there is an imbalance between Glimepride dosage, carbohydrate intake (diet), physical exercise and other factors influencing metabolism.
Possible symptoms of hypoglycaemia include headache, ravenous hunger, nausea, vomiting, lassitude, sleepiness, sleep disorders, restlessness,aggressiveness, impaired concentration, impaired alertness and reactions, depression confusion, speech disorders, aphasia, visual disorders, tremor, paresis, sensory disturbances, dizziness, helplessness, loss of self control, delirium, cerebral convulsion, somnolence and loss of consciousness up to and including coma, shallow respiration and bradycardia. In addition, signs of adrenergic counter-regulation may be present such as sweating, clammy skin, anxiety, tarchycardia, hypertension, palpitations, angina pectoris, and cardiac arrhythmias. The clinical picture of a severe hypoglycemia may persist if hypoglyceamia is corrected.
Especially at the start of treatment, there may be temporary visual impairment due to the change in blood glucose levels. The cause is a temporary alteration in the turgidity and hence the refractive index of the lens, this being dependent on blood glucose level.
Occasionally, gastrointestinal symptoms such as nausea, vomiting, sensations of pressure of fullness in the epigastrium, abdominal pain and diarrhoea may occur.
Interactions of Perglim
Patients who take or discontinue taking certain other medicines while undergoing treatment with Glimepiride may experience changes in blood glucose control.
The following interactions must be considered:
Potentiation of the blood-glucose-lowering effect and, thus, in some instances, hypoglycaemia may occur when one of the following drugs is taken:
- MAO Inhibitors
- ACE Inhibitors
- Anabolic steroids and male sex hormones
The blood-glucose-lowering effect could be reduced and, thus, in some instances, hyperglyccamia may occur when one of the following drugs is taken:
Chemical Structure of Perglim
Store in a cool, dark & dry place.
Keep this medication out of the reach of children.
- Mepiryl: Glimepiride of May & Baker Nigeria Plc.
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