Other Brands/Names

Actaryl, Amadiab, Amaryl, Amaryl M, Anpiride, Avandaryl, Diaglime, Diaversa, Friladar, Glamarol, Glimefion, Glimeryl, Glimetic, Glimexal, Glucokaf, Glocoryl, Gluvas, Mapryl, Mepirilid, Metrix, Norizec, Paride, Pimaryl, Pridiab, relide, Simryl, Solosa, Velacom, Versibet.

How It Works

Glimepiride is an antidiabetic of the sulfonylurea class used to lower blood glucose in patients with type 2 diabetes mellitus (DM). High glucose levels or hyperglycemia can arise from several pathological mechanisms in the body, including reduced pancreatic insulin production.

Insulin is a hormone that lowers and regulates blood glucose levels. Glimepiride can increase insulin secretion and improves insulin sensitivity in the body. It also reduces hepatic glucose output, thereby lowering blood glucose levels in patients with type 2 DM.

Indications

This medicine is used to decrease blood glucose levels in individuals with type 2 DM. Patients are also advised to follow a healthy diet and maintain regular exercise (and in some cases, glimepiride is combined with other antidiabetic agents).

Contraindication

This drug should not be given to patients with the following conditions:

• Hypersensitivity to this medicine or to other sulfonylureas such as glibenclamide or gliquidone.

• Type 1 diabetes mellitus.

• Diabetic coma or diabetic ketoacidosis, a life-threatening complication of diabetes.

• Severe hepatic or renal impairment.

Side Effects

The main adverse effects of sulfonylureas, including glimepiride, are hypoglycemia (low blood sugar) and weight gain.

Symptoms of hypoglycemia may include:

• Weakness

• Cold sweats

• Hand tremors

• Rapid heartbeat

• Hunger

• Dizziness

• Peripheral tingling sensation

People with diabetes should monitor blood glucose regularly to detect if their current blood glucose levels are too high or too low. They should also check body weight routinely to identify changes that may occur with this medicine. Other possible adverse effects include:

• Nausea and vomiting

• Diarrhea

• Liver problems

• Reduced blood cell counts

• Vision disturbances

• Headache

• Abdominal pain

Types

Tablets: 1 mg, 2 mg, 3 mg, and 4 mg.

Dosage

Adults: The initial dose of glimepiride is 1–2 mg once daily, taken in the morning with or shortly after breakfast. The dose can be increased to 1–2 mg at 1–2 week intervals based on patient's response. Maximum daily dose is 6 mg or 8 mg.

Safety

Glimepiride is categorized as FDA category C in pregnancy. There are still insufficient datas from human studies; but animal studies have reported fetal adverse effects.

Insulin is the first-line therapy for diabetes during pregnancy; therefore, oral antidiabetics should be switched to insulin injections in pregnant patients. Consult your doctor regarding treatment.

Drug Interactions

• Risk of hypoglycemia may increase if glimepiride interacts with:
  

  • NSAID analgesics such as ibuprofen

  • Antibiotics such as chloramphenicol, levofloxacin, clarithromycin, and trimethoprim

  • Antihypertensives including beta-blockers (e.g., bisoprolol) and ACE inhibitors (e.g., captopril)

  • The antifungal miconazole

• Glimepiride effectiveness may decrease if it interacts with:
  

  • Oral contraceptives

  • Diuretic antihypertensives such as hydrochlorothiazide

  • Barbiturate anticonvulsants

  • Antituberculosis drugs rifampin and isoniazid

• Concurrent use with colesevelam (a cholesterol-lowering agent) may lower glimepiride blood levels. If coadministered, take glimepiride at least 4 hours before colesevelam.

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