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Metahexamide is a long-acting, first-generation sulfonylurea oral hypoglycemic agent used in the treatment of type 2 diabetes mellitus. It belongs to the cyclohexyl-containing subgroup of sulfonylureas and was first described in 1959. Metahexamide lowers blood glucose by stimulating insulin secretion from pancreatic beta cells, primarily through closure of ATP-sensitive potassium channels on these cells, leading to cell depolarization and subsequent insulin release. Its antihyperglycemic effect is more potent than that of chlorpropamide and it has a slow metabolism with enhanced peripheral glucose utilization[1][2][7]. Metahexamide is rarely used today due to the availability of newer antidiabetic agents with improved safety profiles. It may cause hypoglycemia and other side effects typical for first-generation sulfonylureas[5].
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