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Glimepiride information from DrugsUpdate  

See Available Brands of Glimepiride in India

P - Caution when used during pregnancy
L - Caution when used during lactation
FI - Food *

Glimepiride is a medium-to-long acting sulfonylurea anti-diabetic drug. It is marketed as Amaryl by Sanofi-Aventis and Glyree by Ipca. Glimepiride is the first third-generation sulfonylurea, and is very potent.

It is sometimes classified as third-generation,and sometimes classified as second-generation.

Pharmacodynamics

Pharmacokinetics

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 hours.

Duration

24 hours.

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).

Glimepiride Indications / Glimepiride Uses

Information Not Available

Glimepiride Adverse Reactions / Glimepiride Side Effects

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.

Precautions

Monitor
Monitor fasting blood glucose to determine therapeutic response, monitor glycosylated hemoglobin every 3 to 6 months

Special 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.

Other 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.

Other Interactions

Food Interaction
May cause disulfiram-like reaction and hypoglycaemia when used with ethanol. Hypoglycaemic risk when used with chromium, garlic, gymnema.

Dosage

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.

Food(before/after)

Should be taken with food. (Take immediately before the 1st main meal of the day. Do not skip meals.)

List of Contraindications

Glimepiride and Pregnancy

Caution when used during pregnancy

Category C: Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.

Glimepiride and Lactation

Caution when used during lactation

Glimepiride and Children

Data are insufficient to recommend the use of glimepiride in children

Glimepiride and Geriatic

Increased risk for development of hypoglycemia. Hypoglycemia may be difficult to detect in elderly patients.

Glimepiride and Other Contraindications

Diabetic ketoacidosis with or without coma

Storage

Oral
Store at 15-30°C

Lab interference

Oral
Store at 15-30°C

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