Type 2 DM
Should be taken with food. Take immediately before or during breakfast, or the 1st main meal of the day. Do not skip meals.
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.
Safety and efficacy not established
Renal impairment: 1 mg PO qDay; titrate dose based on fasting blood glucose levels Severe: Contraindicated.
Diabetic ketoacidosis with or without coma.
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.
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
>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
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.