Starting dose for glibenclamide

Re: Starting dose for glibencamide

Martin Atkinson — Thu, 12 Dec 2013 11:00:22 GMT

I've found glibenclamide more effective with less side effects (vomiting) than glipzide but only marginally and only in one case. IME it's pretty useless and just delays treating the patient properly. Is there a reason you don't want to start it on insulin?

According to one specialist if you start cats with Lantus insulin glargine you can get many in remission and can then maintain with oral hypoglycaemics but if you start with oral medication you lose this opportunity and it doesn't seem to work with standard insulin. This is probably because glargine maintains a more stable glucose level and you don't get potentially damaging peaks and troughs so it allows the islets to recover to some extent. This of course means breaking the cascade which is naughty but you are already theoretically doing that using glibenclamide!!

Re: Starting dose for glibencamide

Vet2Vet — Wed, 11 Dec 2013 19:57:17 GMT

Hi , thank you , use NVS and they have glibenclamide at 2.5 mg and 5 mg which would still need to be divided for my 3kg patient

Thanks for the information

Re: Starting dose for glibencamide

Charlotte Marshall — Wed, 11 Dec 2013 18:21:02 GMT

I've used glibencamide. I used the dose from the old formulary which must be the one Andy has given you and then increased the dose as needed. However I have seen diarrhoea at higher doses which necessitated a dose reduction.

The problem I had with glipzide is that it only seems to come in 5 mg tablets at the moment which is a bit awkward for getting a small enough dose sometimes.

Re: Starting dose for glibencamide

Andrew Kent — Wed, 11 Dec 2013 17:50:32 GMT

Hi,

I assume you mean glibenclamide - this was in the previous version of the BSAVA formulary at 0.2mg/Kg PO q24h - but it gives the warning that there are no published reports of its use which is probably why it was taken out of the current edition.

Perhaps there might be better options? Like glipizide which has been used a bit more (though is still controversial to use)

Andy