Jönsson A, Rydberg T, Ekberg G, Hallengren B, Melander A
Department of Endocrinology, Lund University, Malmö General Hospital, Sweden.
Diabetes Care. 1994 Feb;17(2):142-5. doi: 10.2337/diacare.17.2.142.
To determine the terminal elimination half-life of glyburide in non-insulin-dependent diabetes mellitus (NIDDM) subjects after cessation of long-term treatment.
Ten NIDDM patients (5 of each sex, 36-72 years old, without hepatic or renal disease) taking a median glyburide dose of 14 mg/day, who were to start insulin therapy because of sulfonylurea failure, were studied. Serum glyburide concentrations, measured by a newly developed selective and sensitive liquid chromatographic method, were followed from 10 to 48 h after the last glyburide dose.
Serum glyburide levels declined in three different phases, with a terminal gamma-phase between 18 and 48 h having a mean +/- SD half-life of 15.0 +/- 6.7 h. Two patients had half-lives over 20 h. The half-life values did not correlate with fasting blood glucose, age, body weight, body mass index, or creatinine levels. The latter agrees with the assumption that glyburide is completely eliminated by metabolic transformation. Although longer than previously observed, the current half-life values are in accordance with clinical experience that glyburide is a long-acting sulfonylurea.
The elimination of glyburide in NIDDM subjects is slower than previously reported. The long half-life adds support to the use of a once-daily dosage of glyburide. It also justifies increased caution when using this sulfonylurea.
确定长期治疗停止后非胰岛素依赖型糖尿病(NIDDM)患者中格列本脲的终末消除半衰期。
对10名NIDDM患者(男女各5名,年龄36 - 72岁,无肝脏或肾脏疾病)进行研究,这些患者因磺脲类药物治疗失败而即将开始胰岛素治疗,他们服用格列本脲的中位剂量为14毫克/天。采用新开发的选择性灵敏液相色谱法测定末次服用格列本脲后10至48小时的血清格列本脲浓度。
血清格列本脲水平呈三个不同阶段下降,在18至48小时的终末γ期,平均±标准差半衰期为15.0±6.7小时。两名患者的半衰期超过20小时。半衰期值与空腹血糖、年龄、体重、体重指数或肌酐水平无关。这与格列本脲通过代谢转化完全消除的假设相符。尽管比之前观察到的要长,但目前的半衰期值与格列本脲是长效磺脲类药物的临床经验一致。
NIDDM患者中格列本脲的消除比之前报道的要慢。长半衰期支持了格列本脲每日一次给药的用法。在使用这种磺脲类药物时也需要更加谨慎。