Glimepiride

Indications
Oral
Type 2 diabetes mellitus
Adult: Initially, 1-2 mg daily. Maintenance: 4 mg daily. Max: 6 mg daily.
Renal impairment: Initiate at 1 mg daily; subsequent increments should be based on fasting blood glucose levels.

Special Populations: Adjust dose in renal impairment: CrCl <22 mL/min: Initial dose is 1 mg, increased by increments based on fasting blood glucose levels.
Contraindications
Diabetic ketoacidosis with or without coma.
Warnings / Precautions
Increased risk of CV mortality. Elderly; hepatic and renal impairment. Syndrome of inappropriate secretion of antidiuretic hormone (SIADH) in patients with CHF or hepatic cirrhosis. Monitor blood-glucose concentration. Pregnancy, lactation.
Adverse Reactions
Vomiting, GI pain, diarrhoea; pruritus, erythema, urticaria, morbilliform, maculopapular eruptions; leukopenia, agranulocytosis, thrombocytopenia, haemolytic anaemia, aplastic anaemia and pancytopenia; hyponatraemia; changes in accommodation, blurred vision, jaundice.
Overdose Reactions
Overdosage can cause hypoglycaemia. Treat mild hypoglycemic symptoms (without loss of consciousness or neurologic findings) with oral glucose and adjustments in drug dosage and/or meal patterns. Continue close monitoring until patient is out of danger. Severe hypoglycaemic reactions with coma, seizure, or other neurological impairment require immediate hospitalisation. Give patient rapid IV inj of 50% glucose solution, followed by continuous infusion of 10% glucose solution at a rate to maintain blood glucose level >100 mg/dL. Monitor closely for at least 24-48 hr, because hypoglycaemia may recur after apparent clinical recovery.
Drug Interactions
NSAIDs, salicylates, sulphonamides, chloramphenicol, coumarin, probenecid, CYP2C9 inhibitors, fibric acid derivatives, pegvisomant, TCAs, MAOIs and β-adrenergic blockers may potentiate the hypoglycaemic action of glimepiride. Thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, oestrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, rifampicin, CYP2C9 inducers and isoniazid may reduce hypoglycaemic effect of glimepiride. May increase the serum levels of ciclosporin. Serum levels may be increased by fluconazole.
See Below for More glimepiride Drug Interactions
Food Interactions
May cause disulfiram-like reaction and hypoglycaemia when used with ethanol. Hypoglycaemic risk when used with chromium, garlic, gymnema.
Mechanism of Actions
Glimepiride stimulates the insulin release from functioning pancreatic β-cells and inhibits gluconeogenesis at hepatic cells. It also increases insulin sensitivity at peripheral target sites.
Onset: Peak effect: 2-3 hr.
Duration: 24 hr.
Absorption: Completely absorbed from the GI tract after oral admin.
Distribution: Highly protein bound.
Metabolism: Metabolised hepatically to 2 main metabolites.
Excretion: 60% excreted in urine and 40% in faeces (as metabolites); about 9 hr (elimination half-life).
Administration
Should be taken with food. (Take immediately before or during breakfast, or the 1st main meal of the day. Do not skip meals.)
Storage Conditions
Oral: Store at 15-30°C.
ATC Classification
A10BB12 - glimepiride ; Belongs to the class of sulfonamides, urea derivatives. Used in the treatment of diabetes.
Storage
Oral: Store at 15-30°C.
Available As
  • Glimepiride 0.5 mg
  • Glimepiride 1 mg
  • Glimepiride 1.5 mg
  • Glimepiride 2 mg
  • Glimepiride 3 mg
  • Glimepiride 4 mg
  • Glimepiride 500 mg
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