Glimepiride

💊 What is Glimepiride used for?

• •The label says glimepiride is used as an add-on to diet and exercise to improve blood sugar control in adults with type 2 diabetes. The label says it should not be used to treat type 1 diabetes or diabetic ketoacidosis, because it would not be effective in those situations.

How it works

How it is usually taken

• •The label says glimepiride should be taken with breakfast or the first main meal of the day. The dose may be raised gradually, but no more often than every 1 to 2 weeks, based on how the patient's blood sugar responds. Patients at higher risk of low blood sugar, such as older adults or people with kidney problems, are usually started more slowly. The label says it should be taken at least 4 hours before colesevelam, a medicine that can reduce how much glimepiride the body absorbs. Follow the instructions from your prescriber or pharmacist.

Comes as

• •1 mg tablets (pink, oblong, scored)
• •2 mg tablets (light green to green, oblong, scored)
• •4 mg tablets (light blue to blue, oblong, scored)

⚠️ Glimepiride side effects

🛑 Who should not take Glimepiride, and who should be careful

The label says not to take it if

• 🚨You have had a hypersensitivity (allergic) reaction to glimepiride or any of its ingredients.
• 🚨You have had an allergic reaction to sulfonamide derivatives.
• 🚨You have type 1 diabetes or diabetic ketoacidosis. The label says it is not for these conditions.

Tell your doctor before taking it if

• •Tell your prescriber about any history of an allergic reaction to glimepiride, its ingredients, or sulfonamide medicines.
• •Tell your prescriber if you have G6PD deficiency. The label says to use caution in this case and that a non-sulfonylurea alternative may be considered.
• •Tell your prescriber if you are pregnant, may become pregnant, or are breastfeeding.
• •The label notes that older adults, people with kidney problems, people who are debilitated or malnourished, and people with adrenal, pituitary, or liver problems may be more likely to have low blood sugar.
• •The label says your ability to concentrate and react may be affected by low blood sugar. Use caution when driving or operating machinery.
• •The label includes a warning that oral diabetes medicines have been linked to increased cardiovascular death compared with diet alone or diet plus insulin. Talk with your prescriber about the risks, benefits, and other treatment options.

🔀 Glimepiride with other medicines, food and alcohol

The label says to discuss these with your doctor or pharmacist

• •Oral miconazole: the label says severe low blood sugar can occur when the two are used together.
• •Colesevelam: it may reduce how much glimepiride is absorbed. The label says glimepiride should be taken at least 4 hours before colesevelam.
• •Medicines that can increase the blood-sugar-lowering effect, such as other diabetes medicines, insulin, ACE inhibitors, fluconazole, certain antibiotics, NSAIDs, and some antidepressants. The label says to watch closely for low blood sugar.
• •Medicines that can reduce the blood-sugar-lowering effect, such as corticosteroids, thiazide and other diuretics, estrogens, oral contraceptives, thyroid hormones, and some antipsychotics. The label says to watch closely for worsening blood sugar control.
• •CYP2C9 inhibitors and inducers: these may change glimepiride levels and affect blood sugar control.
• •Alcohol: the label says low blood sugar is more likely when alcohol is consumed.

Alcohol and food

The label says glimepiride should be taken with breakfast or the first main meal of the day. It also says low blood sugar is more likely when calorie intake is low, after severe or prolonged exercise, or when alcohol is consumed.

🤰 Glimepiride in pregnancy and breastfeeding

Pregnancy

The label says published studies and postmarketing experience have not identified drug-associated risks for major birth defects, miscarriage, or adverse maternal outcomes. It also says sulfonylureas, including glimepiride, cross the placenta and have been associated with neonatal low blood sugar. The label says glimepiride should be discontinued at least two weeks before expected delivery. It also notes that poorly controlled diabetes in pregnancy carries risks for both mother and baby. Tell your prescriber right away if you are pregnant or think you may be.

Breastfeeding

The label advises breastfeeding women taking glimepiride to watch breastfed infants for signs of low blood sugar, such as jitters, blue skin color, pauses in breathing, low body temperature, excessive sleepiness, poor feeding, or seizures.

🗓️ Storage, missed doses and taking too much

Storage

The label says to store at 20° to 25°C (68° to 77°F). It also says to keep the tablets in well-closed containers with safety closures.

If a dose is missed

The label does not say.

If too much is taken

The label says an overdose can cause severe low blood sugar. Mild low blood sugar can be treated with oral glucose. Severe reactions are medical emergencies that need immediate treatment, such as glucagon or intravenous glucose. The label notes that low blood sugar may come back after it seems to have recovered, so continued observation and extra carbohydrate intake may be needed.

🗒️ Questions to ask about Glimepiride

• What should I do if I have symptoms of low blood sugar, and how should I treat them?
• Should I check my blood sugar at home, and how often?
• How will you decide when to adjust my dose, given the label's guidance on gradual increases?
• Are any of my other medicines or supplements known to interact with glimepiride?
• Does my G6PD status or kidney function affect whether this medicine is right for me?
• What should I do if I drink alcohol or change how much I exercise or eat?
• What is my plan if I become pregnant or am planning a pregnancy?

❓ Glimepiride: frequently asked questions