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.
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.
Peak effect: 2-3 hours.
Completely absorbed from the GI tract after oral admin.
Highly protein bound.
Metabolised hepatically to 2 main metabolites.
60% excreted in urine and 40% in faeces (as metabolites); about 9 hr (elimination half-life).
Information Not Available
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.
Monitor fasting blood glucose to determine therapeutic response, monitor glycosylated hemoglobin every 3 to 6 months
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.
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.
May cause disulfiram-like reaction and hypoglycaemia when used with ethanol. Hypoglycaemic risk when used with chromium, garlic, gymnema.
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.
Should be taken with food. (Take immediately before the 1st main meal of the day. Do not skip meals.)
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.
Caution when used during lactation
Data are insufficient to recommend the use of glimepiride in children
Increased risk for development of hypoglycemia. Hypoglycemia may be difficult to detect in elderly patients.
Diabetic ketoacidosis with or without coma
Store at 15-30°C
Store at 15-30°C