What Are Sulfonylureas?

Sulfonylureas are a large family with many members. In recent years, new varieties (such as Glimepiride) and dosage forms (Glipizide controlled-release tablets, Glipizide sustained-release tablets) have been released. At present, the second and third generation sulfonylureas are mostly used in clinical applications, and the first generation has been basically eliminated. Due to the large variety of sulfonylureas, the pharmacokinetics, pharmacodynamics, and adverse reactions of various sulfonylureas are different. Therefore, it is necessary to fully understand the different characteristics of various drugs, combined with patient age, disease course, Liver and kidney function, pancreatic islet function, medication compliance and other specific circumstances, choose the appropriate drug.

Sulfonylureas

Right!

Sulfonylureas are a large family with many members. In recent years, new varieties (such as

One of the earliest oral hypoglycemic drugs, which has developed to the third generation, is still the first-line drug for clinical type 2 diabetes. Mainly through stimulation

Tolbutamide

It is the first generation of sulfonylureas. After oral administration, the gastrointestinal absorption is rapid, reaching a peak in 2 to 4 hours.

(Ultra hypoglycemic)

Uglycemic is the second-generation sulfonylurea drug that was first applied to the clinic. It is currently the sulfonylurea drug with the strongest effect and the longest duration of action. It usually takes effect from 20 to 30 minutes after oral administration, with a peak of 2 to 6 hours, a half-life of 10 to 16 hours, and a duration of action of up to 24 hours. Glycemic is mainly metabolized in the liver. 50% of its metabolites are excreted through the biliary tract and 50% are excreted through the kidney. The most common and most serious side effect of Uro-Glycemic is

(Damicom)

Damicon belongs to the second generation of sulfonylureas, which takes effect 30 minutes after oral administration, reaches a peak in 2 to 6 hours, has a half-life of 10 to 12 hours, and the duration of action is 12 to 24 hours. The drug is mainly metabolized in the liver, and 60% to 70% is excreted from the kidneys. Damekang has a milder hypoglycemic effect and a longer duration of efficacy. In addition to stimulating insulin secretion, Damicon can also reduce blood viscosity, reduce platelet aggregation, and prevent and treat vascular complications of diabetes.

(Mepyridine)

The drug is completely and quickly absorbed. It takes effect within 30 minutes after taking the medicine, reaches the peak of blood glucose concentration within 1 to 3 hours, the half-life is only 2 to 4 hours, and the effect can be maintained for 6 to 12 hours. This product is mainly metabolized by the liver, and is excreted by the kidneys within 24 hours. Mepyridine is second only to hypoglycemic, and is a short-acting sulfonylurea hypoglycemic agent, which is most suitable for diabetic patients with high postprandial blood glucose. And because of its short duration of effect, the risk of causing hypoglycemia is also small, so it is more suitable for the elderly. Some people in foreign countries advocate not to use long-acting hypoglycemic drugs, so as to avoid hypoglycemia due to drug accumulation or hyperinsulinemia which has adverse effects on the body.

Directions for use: Glipizide tablets are available in 2.5 mg (such as disza tablets) and 5 mg. The drug is 2.5 to 5 mg each time, 3 times a day, taken half an hour before a meal. The maximum daily dose is 30 mg. The daily dose of elderly diabetic patients should not exceed 20 mg. Glipizide is a highly effective and safe hypoglycemic agent, which can be taken by most patients with type 2 diabetes (including the elderly), especially for the control of postprandial hyperglycemia.

Glipizide Controlled Release Tablets

(Rui Yining)

6 to 12 hours after oral administration to reach the maximum effective concentration, and relatively stable release of glipizide. The fluctuation of plasma concentration throughout the day is small, and the effective plasma concentration can be maintained for 24 hours. After taking the medicine for 5 days, the blood concentration reaches a steady state, and it takes 6 to 7 days for elderly patients to reach a steady state. After the controlled-release tablet passes through the intestine, the intact drug shell is excreted with the feces.

Directions for use: 5 mg per tablet, recommended to be taken with breakfast. The starting dose is 5 mg once daily, and the dose can be further increased according to the blood glucose situation, each time adding 5 mg, the maximum dose is 20 mg / day. The usual dose is 5-10 mg / day. This product should not be taken, and patients with severe gastrointestinal disorders (such as severe gastrointestinal stenosis, severe diarrhea) should not be used.

Ruiyining is taken once a day, which is equivalent to the hypoglycemic effect of Glipizide ordinary tablets 3 times a day, does not increase body weight, does not change the body fat distribution, has good medication compliance, and the medication time is not restricted by meals , Popular with diabetes patients who cannot eat regularly.

(Sugar level)

After oral administration, the absorption is fast and complete, and the half-life is short, only 1 to 2 hours. After 8 hours, it cannot be detected in the blood, and its decomposition products have no hypoglycemic effect. Gliquidone's biggest feature is that 95% can be excreted through the bile, the proportion excreted from the kidney is less than 5%, and the action is mild, rarely causing hypoglycemia. These characteristics make it have a wide range of use, especially suitable for elderly and patients with mild to moderate diabetic nephropathy.

Medication Guide: Gliquidone 30 mg per tablet. Take 3 times a day, half an hour before a meal, with a maximum daily dose of 180 mg. The drug has a small effect on the kidney, has a good effect on controlling postprandial blood glucose, and is relatively safe. It is suitable for elderly diabetes, diabetic patients with mild renal insufficiency, and repeated hypoglycemia after taking other sulfonylurea drugs, but severe renal insufficiency By(

(Wan Suping,

Diabetic patients should choose their own drugs based on their own conditions, combining the action characteristics and prices of various sulfonylurea drugs, and use them rationally. For example, diabetic patients with mild renal insufficiency should choose the drug that is mainly excreted through the biliary tract-Tangshiping; the elderly should choose mild hypoglycemic drugs such as Tangshiping and Damengkang, and should not take hypoglycemic effect Strong and long-lasting hypoglycemic, so as not to cause severe hypoglycemia; for diabetic patients with vascular complications, it is best to choose glizide, because in addition to reducing blood sugar, it can also reduce platelet aggregation, lower blood lipids and blood viscosity , To improve blood circulation; for younger, type 2 diabetes patients with high blood sugar, not economically rich, you can choose a good hypoglycemic effect, cheaper excellent hypoglycemic; for diabetes patients with general sulfonylurea failure, can Glimepiride, the latest third-generation sulfonylurea, has a unique extraglycemic effect, and may still be effective in patients with type 2 diabetes who have failed secondary sulfonylureas.