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RILD Building, Royal Devon & Exeter NHS Foundation Trust, Barrack Road, Exeter, EX2 5DW, UK

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ALERT: UK wide problem with Glibenclamide supply – 27/09/2019 key issue for neonatal diabetes due to KCNJ11 or ABCC8


Information:

  • The UK manufacturers Wockhardt have stopped making Glibenclamide currently (likely to be the case for at least 6 months)
  • This means UK supplies are likely to be very limited. Local pharmacy teams by contacting  local wholesalers may be able to identify some limited stocks.
  • We are investigating the possibility of accessing Glibenclamide from elsewhere (e.g. Europe) to see if that is  possible

Recommendations: (for those with KCNJ11 and ABCC8 neonatal diabetes currently treated with glibenclamide)

  • For blood glucose control  (if cannot get hold of glibenclamide) we are suggesting GLIMEPIRIDE is probably the best drug to use.
  • We suggest initially transferring by replacing 5mg glibenclamide with 2mg glimepiride (you can get it in 1, 2, 3 and 4mg tablets).
  • We do not have a lot of experience and would be very keen to hear how things go on this alternative.
  • We do not know if there will be a difference in the availability of sulphonylurea to the brain – it would be interesting to ask families if they see any difference on Glimepiride. Any change is likely to be slow (over days)  after transfer and not immediate because of the long half-life of glibenclamide.
  • We know in these patients there is very little danger of hypoglycaemia even with very high doses so it is worth considering going higher than this dose if either the glucose or the CNS suggests it might be needed.
  • Other sulphonylureas are likely to control blood glucose -doses should be calculated from the maximum doses (eg Gliclazide 80mg = Glibenclamide 5mg)

Contact:

If any questions contact Prof Maggie Shepherd (m.h.shepherd@exeter.ac.uk) or Prof Andrew Hattersley (a.t.hattersley@exeter.ac.uk)