Glibenclamide
Summary
This summary information for glibenclamide on persistence, bioaccumulation och toxicity comes from Fass. The risk comes from the report by Goodpoint.
Persistence. Glibenclamide is potentially persistent.
Bioaccumulation. Glibenclamide has high potential for bioaccumulation
Toxicity. Glibenclamide has low chronic toxicity.
Risk. See the report by Goodpoint.
Suggestions on how to reduce the emissions of glibenclamide
Detailed information
Fass environmental information
Fass environmental information for Daonil (glibenclamide) from Sanofi AB (downloaded 2020-11-02).
Hazard
Persistence: "Inherent degradation: Test showed 5% degradation in 28 days (OECD 302B). [---] Glibenclamide fails to pass the criteria for inherent biodegradability which justifies the phrase “Glibenclamide is potentially persistent”."
Bioaccumulation: "Glibenclamide has high potential for bioaccumulation, as indicated by a Log Pow of 4.79 (calculation Hansch/Leo method)."
Toxicity: There are data for 3 trophic levels, most sensitive algae (Desmodesmus subspicatus) NOEC 72 h (growth rate): 4 970 microg/l.
Risk
PEC/PNEC is based on sales data in Sweden in year 2018. PEC/PNEC = 0.000017 which gives the risk insignificant.
Assessment report
Assessment report for Amglidia (glibenclamide) 22 February 2018, EMA/153558/2018.
Hazard
Persistence: No data.
Bioaccumulation: Log Kow = 4.23.
Toxicity: No data.
Risk
PECsurfacewater = 0.000032 microg/L.
"An adequate ERA in accordance with available guidance was performed. The predicted environmental concentration in surface water of glibenclamide is below 0.01 µg/l. The log Kow is lower than 4.5, no further PBT assessment is required. In conclusion, Amglidia, in the proposed use, is not expected to pose a risk to the environment."
Report Goodpoint
In Sweden, glibenclamide has been found in wild fish in concentrations close to therapeutic concentrations in humans, which also is reasonable based on the substance solubility in fat and measured concentration in wastewater. Mechanism-based efficacy data is lacking.
Glibenclamide is included in Region Stockholm's table of pharmaceuticals with a negative environmental impact according to the environmental programme 2017–2021.
Suggestions on how to reduce the emissions of glibenclamide
Concrete proposals on how to work to reduce emissions of environmentally harmful pharmaceuticals on the list have been developed in close cooperation with the Stockholm Drug and Therapeutics Committee's expert groups. The action proposals were developed from an environmental perspective. The patient's best always goes first and several pharmaceuticals on the list are also included in the Wise list. (The Wise list is the drug formulary of essential medicines for common diseases in Region Stockholm from the Drug and Therapeutics Committee.) However, for such pharmaceuticals, there may be measures that could reduce the environmental impact.
Concrete proposal for glibenclamide
- Glibenclamide is not recommended in the Wise list.
- Individual pharmaceutical adjustment in the treatment of diabetes mellitus type 2 is important to optimize the treatment and avoid side effects.
- Alternatives may be glimepiride (recommended in the Wise list and has approximately the same environmental risk as glibenclamide) or repaglinide (recommended in the Wise list and is better from an environmental point of view than glibenclamide).
- Healthy living habits such as weight loss in obesity, increased physical activity, well-balanced diet and avoiding over-consumption of alcohol could help reduce pharmaceutical use in some patients.
References
- Fass.se för vårdpersonal
- European Medicines Agency. European public assessment report (EPAR) Amglidia (glibenclamide) 22 February 2018, EMA/153558/2018.
- Goodpoint. Prioritering av läkemedel med miljörisk inom SLL. Stockholm: Goodpoint; 2016. Rapport LS 2016–0634.
- 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.
- 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.
- Provtagningar av läkemedelsrester i vatten, sediment och fisk för Region Stockholm.
- Region Stockholm. Förteckning över miljöbelastande läkemedel med åtgärdsförslag framtagen inom ramen för Region Stockholms miljöprogram 2017–2021.
Author: Health and Medical Care Administration, Region Stockholm