Glyburide Advantage in Malignant Edema and Stroke Pilot

Key Inclusion Criteria: * A clinical diagnosis of acute ischemic stroke in the MCA or MCA/ACA territory. * Pre-morbid mRS 0 - 1. * A baseline DWI lesion between 82 cm3 and 210 cm3 on MRI. * Patients treated with IV rtPA should meet established criteria for IV rtPA administration in the 0-3 and 3-4.5 hr time periods, respectively. * The time to the start of infusion of study compound must be ≤ 10 hr after time of symptom onset * Age ≥18 years and ≤70 years. * Provision of written informed consent by the patient or from a legally authorized representative according to institutional guidelines and national regulations. Key Exclusion Criteria: * Evidence from imaging or pre-enrollment investigation of any diagnosis other than acute ischemic stroke likely to cause the presenting symptoms and signs. * Commitment to decompressive craniectomy (DC) prior to enrollment, or follow-ing enrollment and prior to start of study compound. * Treatment with IA rtPA or by mechanical means for clot disruption or with hypo-thermia. * Patients unable to tolerate MRI scanning, e.g. those with pacemakers or automatic defibrillators. * Pre-morbid mRS ≥ 2. * Clinical signs of herniation, e.g. one or two dilated, fixed pupils; unconsciousness (i.e., ≥ 2 on item 1a on the NIHSS); loss of other brain stem reflexes attributable to herniation according to the investigator's judgment. * CT or MRI evidence of hemorrhage or anteroseptal/pineal shift greater ≥2 mm prior to enrollment. * Rapidly improving symptoms. * Severe renal disorder from the patient's history (e.g. dialysis) or eGFR of \< 30 mL/min/1.73 m2. * Severe liver disease or ALT, AST, or bilirubin \>2 times normal. * Blood glucose \<55 mg/dL at enrollment or immediately prior to administration of RP-1127, or a clinically significant history of hypoglycemia. * Diagnosis of decompensated heart failure (e.g. clinical diagnosis of pulmonary edema, chest x-ray consistent with heart failure, tachypnea \> 20, etc.) * Sulfonylurea treatment within 30 days. * Known allergy to sulfa or specific allergy to sulfonylurea drugs. * Known G6PD enzyme deficiency. * Pregnancy or breast-feeding. Women must be either post-menopausal (judged by the investigator), permanently sterilized or, if of childbearing age, must have a negative test for pregnancy obtained before enrollment. * Patients already enrolled in a non-observation-only stroke study, or with life-expectancy \<3 months not related to current stroke, or those unlikely to be com-pliant with follow up. * Patients who, in the opinion of the investigator, are not suitable for the study (reason to be documented). NOTE: Other protocol defined Inclusion/Exclusion criteria may apply