Kommersiellt obunden läkemedelsinformation riktad till läkare och sjukvårdspersonal

Glibenklamid

Klassificering: A

Preparat: Daonil®, Euglucon®, Glibenklamid Recip

ATC kod: A10BB01

Substanser: glibenklamid

Sammanfattning

Det saknas kontrollerade studier om skillnader mellan könen avseende effekt, förutom i samband med stroke.

Vissa studier indikerar att kvinnor har högre risk att få hypoglykemi vid antidiabetikabehandling än män. Andra mindre studier har inte hittat några könsskillnader i risk för hypoglykemi vid glibenklamidbehandling.
 
Kunskapsunderlaget avseende skillnader mellan kvinnor och män är begränsat och motiverar inte olika dosering eller behandling.

Additional information

Pharmacokinetics and dosing

No studies with a clinically relevant sex analysis regarding the pharmacokinetics or dosing of glibenclamide have been found.

Effects

A study investigated whether the use of glibenclamide both at the time of stroke and during hospitalization result in better neurological and functional outcomes in patients with diabetes mellitus. Improvements occurred in patients with nonlacunar strokes and were independent of sex [3].

Adverse effects

The ACCORD study (Action to Control Cardiovascular Risk in Diabetes) was a randomized, controlled trial designed to test the effect of intensive glucose control compared with standard control on cardiovascular outcomes in patients with type 2 diabetes. The study showed that women had a higher risk of hypoglycemia than men regardless of treatment [1].In a study of 57 reported cases of glibenclamide-associated hypoglycemia to the Swedish Adverse Drug Reactions Advisory Committee in 1983, there was a female preponderance (61%). However, no adjustments for proportion women and men prescribed glibenclamide were made, which makes the results difficult to interpret. Sex did not predict the clinical course of the hypoglycemic events [4]. A small retrospective case-control study of prolonged hypoglycemia in patients (5 men, 2 women) with end-stage renal disease and type 2 diabetes receiving glibenclamide found no association between risk of hypoglycemia and sex [5].

Reproductive health issues

Regarding teratogenic aspects, please consult the Drugs and Birth Defects Database (in Swedish, Janusmed fosterpåverkan).

Other information

An observational retrospective study compared the effects of glimepiride or glibenclamide treatment on body weight over 12 months of treatment in patients with type 2 diabetes. Sex had no significant influence on change in body weight or BMI [2].

Försäljning på recept

Fler män än kvinnor hämtade ut tabletter innehållande glibenklamid (ATC-kod A10BB01) på recept i Sverige år 2015, totalt 9 250 män och 5 757 kvinnor. Det motsvarar 1,9 respektive 1,2 personer per tusen invånare. Andelen som hämtat ut läkemedel var högst i åldersgruppen 75 år och äldre hos båda könen. I genomsnitt var tabletter innehållande glibenklamid 1,8 gånger vanligare hos män [6]. Detta speglar könsskillnaden i prevalens av typ 2-diabetes [7].

Uppdaterat: 2019-02-26

Litteratursökningsdatum: 2014-06-03

Referenser

  1. Miller ME, Bonds DE, Gerstein HC, Seaquist ER, Bergenstal RM, Calles-Escandon J et al. The effects of baseline characteristics, glycaemia treatment approach, and glycated haemoglobin concentration on the risk of severe hypoglycaemia: post hoc epidemiological analysis of the ACCORD study. BMJ. 2010;340:b5444. PubMed
  2. Martin S, Kolb H, Beuth J, van Leendert R, Schneider B, Scherbaum WA. Change in patients' body weight after 12 months of treatment with glimepiride or glibenclamide in Type 2 diabetes: a multicentre retrospective cohort study. Diabetologia. 2003;46:1611-7. PubMed
  3. Kunte H, Schmidt S, Eliasziw M, del Zoppo GJ, Simard JM, Masuhr F et al. Sulfonylureas improve outcome in patients with type 2 diabetes and acute ischemic stroke. Stroke. 2007;38:2526-30. PubMed
  4. Asplund K, Wiholm BE, Lithner F. Glibenclamide-associated hypoglycaemia: a report on 57 cases. Diabetologia. 1983;24:412-7. PubMed
  5. Krepinsky J, Ingram AJ, Clase CM. Prolonged sulfonylurea-induced hypoglycemia in diabetic patients with end-stage renal disease. Am J Kidney Dis 2000 Mar;35(3):500-5 PubMed
  6. Socialstyrelsens statistikdatabas . Stockholm: Socialstyrelsen. 2015 [cited 2016-03-14.] Socialstyrelsens statistikdatabas
  7. Läkemedelsverket. Läkemedelsboken 2014. Uppsala: Läkemedelsverket; 2014.

Författare: Linnéa Karlsson Lind, Desirée Loikas

Faktagranskat av: Mia von Euler

Godkänt av: Karin Schenck-Gustafsson