Medicine Information

Dianorm

Name: Dianorm
Brand: Dianorm
Rating: 4.5 (117 reviews)

Tablet1 mgOral hypoglycaemic agentsATC: A10BB12

Generic Name

Glimepiride

Manufacturer

Eskayef Pharmaceuticals Ltd.

Country

Bangladesh

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Price Details

Current market pricing information

Variant	Unit Price	Strip Price
dianorm 1 mg tablet	৳ 3.75	N/A

Description

Overview of the medicine

Dianorm 1 mg Tablet contains Glimepiride, an oral antidiabetic medication from the sulfonylurea class. It is used to lower blood glucose levels in adults with type 2 diabetes mellitus when diet and exercise alone are not sufficient. It works by stimulating the pancreas to release more insulin.

Uses & Indications

Adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.

Can be used as monotherapy or in combination with metformin or insulin.

Dosage

Adults

Initially 1-2 mg once daily with breakfast or the first main meal. Dose can be increased by 1-2 mg at 1-2 week intervals based on blood glucose response, up to a maximum of 8 mg per day.

Elderly

Start with a lower initial dose (e.g., 1 mg once daily) and titrate carefully, considering increased sensitivity to hypoglycemic effects.

Renal_impairment

Initial dose of 1 mg once daily should be used with caution, and dose titration should be based on careful monitoring of blood glucose levels and renal function. Avoid in severe renal impairment.

How to Take

Take orally once daily with breakfast or the first main meal. Do not crush or chew the tablet; swallow it whole with water.

Mechanism of Action

Glimepiride primarily lowers blood glucose by stimulating the release of insulin from the beta cells of the pancreatic islets. It binds to a specific receptor on the beta-cell membrane, leading to the closure of ATP-sensitive potassium channels. This depolarizes the membrane, opening voltage-gated calcium channels, which results in calcium influx and subsequent insulin secretion.

Pharmacokinetics

Onset

Onset of action is typically observed within 2-3 hours.

Excretion

Approximately 60% of the dose is excreted in the urine and 40% in the feces, mainly as inactive metabolites.

Half life

The terminal elimination half-life is approximately 5 to 9 hours.

Absorption

Rapid and complete absorption from the gastrointestinal tract. Peak plasma concentrations are achieved within 2 to 3 hours.

Metabolism

Extensively metabolized in the liver by cytochrome P450 2C9 (CYP2C9) to two main metabolites.

Side Effects

Contraindications

Hypersensitivity to glimepiride or other sulfonylureas or sulfonamides.
Type 1 diabetes mellitus.
Diabetic ketoacidosis (DKA) with or without coma.
Severe renal or hepatic impairment.
Pregnancy and lactation.

Drug Interactions

Warfarin

Glimepiride may potentiate or weaken the effect of warfarin.

Fluconazole

Increases plasma concentrations of glimepiride, leading to an increased risk of hypoglycemia.

Beta-blockers

May mask symptoms of hypoglycemia and potentiate the hypoglycemic effect.

Corticosteroids

May increase blood glucose levels, counteracting glimepiride's effect.

Thiazide diuretics

Can cause hyperglycemia, thus reducing the efficacy of glimepiride.

NSAIDs (e.g., ibuprofen)

Can potentiate the hypoglycemic effect of glimepiride.

Sulfonamides (e.g., cotrimoxazole)

May enhance the hypoglycemic action.

Storage

Store in a cool, dry place below 30°C. Protect from moisture and light. Keep out of reach of children.

Overdose

Overdose of glimepiride can lead to hypoglycemia, which may range from mild to severe, including coma. Management involves immediate administration of glucose (oral for mild cases, intravenous for severe cases) and monitoring blood glucose levels for 24-48 hours due to the prolonged half-life and potential for recurrent hypoglycemia.

Pregnancy & Lactation

Glimepiride is contraindicated during pregnancy due to potential harm to the fetus (e.g., hypoglycemia in neonates). It is also contraindicated during lactation as it may be excreted in breast milk and cause hypoglycemia in the infant.

Frequently Asked Questions

Common questions about this medicine

Pack Sizes

10 Tablets (Blister pack)30 Tablets (Box)50 Tablets (Box)

Shelf Life

24 to 36 months from the date of manufacture.

Availability

Available in retail pharmacies and hospitals

Approval Status

Approved by regulatory bodies (e.g., FDA, DGDA) for the management of type 2 diabetes mellitus.

Patent Status

Off-patent (generic available)

WHO Essential Medicine

Yes

Clinical Trials

Extensive clinical trials have demonstrated the efficacy and safety of glimepiride in reducing HbA1c and fasting plasma glucose levels in patients with type 2 diabetes mellitus, both as monotherapy and in combination with other antidiabetic agents.

Lab Monitoring

Regular monitoring of blood glucose levels (fasting and postprandial)
HbA1c levels every 3-6 months
Periodic monitoring of renal function (especially in elderly or renally impaired patients)
Periodic monitoring of liver function tests and complete blood count.

Doctor Notes

Educate patients thoroughly about hypoglycemia symptoms, prevention, and immediate management.
Emphasize the importance of consistent diet, regular exercise, and adherence to medication.
Regularly monitor glycemic control (HbA1c, fasting glucose) and assess for side effects.
Consider renal and hepatic function before initiating and during therapy, especially in susceptible populations.

Patient Guidelines

Take Dianorm 1 mg Tablet exactly as prescribed by your doctor, usually once daily with breakfast or the first main meal.
Do not skip meals or delay eating after taking this medication to avoid hypoglycemia.
Be aware of the symptoms of low blood sugar (hypoglycemia) such as sweating, dizziness, trembling, hunger, and confusion. Carry sugar or glucose tablets to treat mild hypoglycemia.
Adhere to your prescribed diet and exercise regimen, as these are crucial for managing type 2 diabetes.
Inform your doctor about all other medications, supplements, and herbal products you are taking.

Missed Dose Advice

If a dose is missed, take it as soon as you remember, unless it is almost time for your next dose. In that case, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.

Driving Precautions

Patients should be aware of the symptoms of hypoglycemia, which can impair the ability to concentrate and react, posing a risk when driving or operating machinery. Blood glucose levels should be checked before driving if there is a risk of hypoglycemia.