Abstract
Diuretic action of glibenclamide and antidiuretic action of 1-deamino-8-D-arginine-vasopressin (DDAVP), carbamazepine, clofibrate and chlorpropamide were investigated (alone and in various combinations) during a four-year study carried out in 11 patients with pituitary diabetes insipidus while onad libitum fluid intake. Glibenclamide significantly enhanced free water excretion in all patients. The diuretic effect continued for several days after withdrawal of the drug. The diuretic action was significantly inhibited by DDAVP, carbamazepine or clofibrate. On the other hand, the antidiuretic action of DDAVP, carbamazepine and clofibrate was significantly inhibited by glibenclamide. Two alternative hypotheses are suggested to account for the diuretic effect of glibenclamide: 1) glibenclamide competitively inhibits the action of vasopressin; 2) glibenclamide inhibits a water reabsorbing mechanism in the collecting tubules independent of ADH. The results of the present study confirmed also the definite relationship between the dose of DDAVP, carbamazepine, clofibrate and carbamazepine plus clofibrate and the antidiuretic effect. Combination of carbamazepine and clofibrate revealed an additive antidiuretic action.
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