Generic Name

Glimepiride

Precaution

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. Lactation: Excretion in milk unknown; avoid

Indication

Type 2 DM

Contra Indication

Diabetic ketoacidosis with or without coma.

Dose

N/A

Side Effect

>10% Hypoglycemia (4-20%) 1-10% Dizziness (1.7%),Asthenia (1.6%),Headache (1.5%),Nausea (1.1%) <1% Allergic skin reactions,Erythema,Morbilliform or maculopapular eruptions,Pruritus,Urticaria,Diarrhea,Gastrointestinal pain,Vomiting,Agranulocytosis,Anemia,Aplastic anemia,Leukopenia,Pancytopenia,Thrombocytopenia, hemolytic,Cholestasis,Elevation of liver enzyme levels,Hepatic porphyria reactions,Jaundice (rare),Disulfiram-like reactions,Hyponatremia

Pregnancy Category

Mode of Action

Glimepiride stimulates the insulin release from pancreatic beta-cells and reduces glucose output from the liver. It also increases insulin sensitivity at peripheral target sites.

Interaction

Salicylates, sulfonamides, chloramphenicol, clarithromycin, coumarin anticoagulants, probenecid, CYP2C9 inhibitors, fibric acid derivatives, disopyramide, fluoxetine, quinolones, ACE inhibitors, MAOIs and ?-blockers may potentiate the hypoglycaemic action of glimepiride. Thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, oestrogens, phenytoin, nicotinic acid, sympathomimetics and CYP2C9 inducers may reduce hypoglycaemic effect of glimepiride. Reduced plasma concentration w/ colesevelam.

Pregnancy Category Note

N/A

Adult Dose

Oral Type 2 diabetes mellitus Adult: Initially, 1-2 mg daily. May be increased in increments of 1-2 mg at intervals of 1-2 wk. Maintenance: 4 mg daily. Max: 6 mg daily. Elderly: Initially, 1 mg once daily. Hepatic impairment: Severe: Contraindicated.

Child Dose

Safety and efficacy not established

Renal Dose

Renal impairment: 1 mg PO qDay; titrate dose based on fasting blood glucose levels Severe: Contraindicated.

Administration

Should be taken with food. Take immediately before or during breakfast, or the 1st main meal of the day. Do not skip meals.