Glimepiride

Glimepiride - Use | Dose | Side Effects

Glimepiride is a drug from a group of drugs called sulfonylureas and is used to treat noninsulin-dependent diabetes (type 2). It works by increasing the intracellular concentration of calcium in the pancreas, which leads to an increase in secretion of insulin and lowering blood glucose level.

Contraindications and precautions

Glimepiride is contraindicated in the following conditions:

  • Type 1 diabetes (insulin-dependent diabetes)
  • Diabetic ketoacidosis
  • Diabetic coma
  • Severe hepatic or renal impairment

It is very important that you eat regularly and do not miss any meals while taking this drug. Glimepiride should be taken half an hour before or immediately after a meal. If you are skipping meals, you're at greater risk to experience hypoglycemia. If you notice signs of hypoglycemia (e.g. confusion, a strong hunger, aphasia, speech disorders, fatigue, drowsiness and loss of self-control) you should immediately eat something sweet (that's why you should always carry fast-acting sugar with you). You should also regularly measure your blood sugar while using this drug.

It is recommended to take regular blood tests (in order to determine the number of platelets and leukocytes in the blood), as glimepiride is associated with side effects, such as: agranulocytosis and thrombocytopenia. These side effects quickly disappear after the discontinuation of the therapy.

Glimepiride, pregnancy and breastfeeding

Since Glimepiride can cause hypoglycemia in fetuses as well as in infants, its use is not recommended in pregnant or breastfeeding women. It belongs to the group C, and studies in animals have shown that this drug have some level of toxicity during pregnancy. It is very important that pregnant women keep under control their blood sugar levels during pregnancy, because the abnormal blood glucose levels increase the risk of congenital anomalies in infants.

There have been reported cases of prolonged and severe hypoglycemia in infants whose mothers took this drug during breastfeeding.

Dosage

The dosage is determined individually based on the patient's nutrition and on the level of the physical activity. Adequate dose of Glimepiride may be determined after measuring blood glucose levels. Glimepiride therefore exist in different dosage forms (1 mg, 2 mg, 3 mg and 4 mg).

Glimepiride is sometimes combined with metformin, where metformin is used at maximum dose while glimepiride is introduced gradually (lowest possible dose of Glimepiride is given at first, and then, if necessary, dose may be gradually increased).

If maximum dose of the Glimepiride does not achieve adequate glycemic control, then insulin should be considered in such patients.

Glimepiride is usually taken after the first main meal of the day (usually after breakfast). If you skip breakfast, do not take this medicine on an empty stomach. Take this medicine after the first main meal you have during the day.

If you're taking minimum dose (1 mg daily) but you experience hypoglycemia, this means that you don't have to use drugs and that you can control your glucose levels by changing your lifestyle.

There are no data on the use of this medicine in children younger than 8 years.

Interactions

Hypoglycemia is more likely to occur if Glimepiride is used simultaneously with the following medicines:

  • Other hypoglycemic
  • Non-steroidal anti-inflammatory drugs (e.g. phenylbutazone, oxyphenbutazone and azapropazone)
  • Drugs used for weight loss (e.g. sibutramine and fenfluramine)
  • Drugs used for lowering triglyceride levels (clofibrate, bezafibrate and fenofibrate)
  • Antidepressants (e.g., paroxetine, fluoxetine, fluvoxamine, sertraline, isocarboxazid and moclobemide)
  • Medicines used to treat gout (allopurinol and probenecid)
  • Antifungals (e.g. fluconazole and miconazole)
  • Anti-arrhythmics (e.g. disopyramide)
  • Chloramphenicol
  • Anabolic steroids
  • Drugs used in the treatment of peripheral vascular diseases (e.g. pentoxifylline)
  • Oral contraceptives
  • Diuretics (e.g. hydrochlorothiazide and acetazolamide)
  • Laxatives
  • Adrenalin

Tell your doctor about all the medicines you are taking.

Side effects

Glimepiride may lead to the following side effects:

  • Leukopenia
  • Thrombocytopenia
  • Agranulocytosis
  • Erythrocytopenia (anemia)
  • Pancytopenia
  • Visual disturbances
  • Diarrhoea and bloating in the stomach
  • Hyponatremia
  • Increase in liver enzymes in the blood
  • Hypoglycemia