Glimepiride | Side Effects, Dosage, Uses & More
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Glimepiride, Oral Tablet

Highlights

  1. Glimepiride (Amaryl) is an oral drug that’s used to treat type 2 diabetes. It helps to control blood sugar, along with a healthy diet and exercise.
  2. Taking glimepiride as directed, eating healthily, and exercising regularly can help to reduce your risk of complications from type 2 diabetes.
  3. The standard starting dose is 1 mg or 2 mg taken once per day with breakfast or your first main meal of the day.
  4. Before you start taking this drug, you should tell your doctor if you have kidney or liver disease, a severe infection, a sulfa allergy, a glimepiride allergy, glucose 6-phosphate dehydrogenase (G6PD) deficiency, or if you’re pregnant or nursing.
  5. Common side effects include headache, nausea, dizziness, weakness, weight gain, and low blood sugar (hypoglycemia).

Important Information

  • Low blood sugar: Glimepiride can cause low blood sugar (hypoglycemia). Symptoms may include:
    • trembling or shaking
    • nervousness or anxiety
    • irritability
    • sweating
    • lightheadedness or dizziness
    • headache
    • fast heart rate or palpitations
    • intense hunger
    • fatigue or tiredness
  • High blood sugar: If glimepiride isn’t working well enough to control your blood sugar, your diabetes won’t be under control. This will lead to high blood sugar (hyperglycemia). Call your doctor if you have any of these symptoms:
    • urinating more often than usual
    • feeling very thirsty
    • feeling very hungry even though you’re eating
    • extreme fatigue
    • blurred vision
    • cuts or bruises that are slow to heal
    • tingling, pain, or numbness in your hands or feet
  • Fatal heart problems: Glimepiride may increase your risk of fatal heart problems compared to treatment with diet alone or diet plus insulin. Ask your doctor if this drug is right for you.

Drug Features

Glimepiride is a prescription drug. It’s available as an oral tablet.

Glimepiride is available in its generic form. Generic drugs usually cost less. In some cases they may not be available in every strength or form as the brand. Talk to your healthcare provider to see if the generic form will work for you.

This drug may be used as part of a combination therapy. That means you need to take it with other drugs.

Why It's Used

Glimepiride is used to reduce high blood sugar levels in people with type 2 diabetes. It’s used along with a healthy diet and exercise. This medication may be used with insulin or other types of diabetes drugs to help control your high blood sugar.

How It Works

Glimepiride belongs to a class of drugs called sulfonylureas. A class of drugs refers to medications that work similarly. They have a similar chemical structure and are often used to treat similar conditions.

Glimepiride helps your pancreas to release insulin. Insulin is a chemical that your body makes to move sugar (glucose) from your bloodstream into your cells. Once the sugar enters your cells, they can use it as fuel for your body. In type 2 diabetes, your body doesn’t make enough insulin, or it can't properly use the insulin that it makes, so the sugar stays in your bloodstream. This causes high blood sugar levels (hyperglycemia).

Glimepiride Side Effects

More Common Side Effects

The most common side effects that occur with glimepiride include:

  • low blood sugar (hypoglycemia). Symptoms may include:
    • trembling or shaking
    • nervousness or anxiety
    • irritability
    • sweating
    • lightheadedness or dizziness
    • headache
    • fast heart rate or palpitations
    • intense hunger
    • fatigue or tiredness
  • headache
  • nausea
  • dizziness
  • weakness
  • unexplained weight gain

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious Side Effects

If you experience any of these serious side effects, call your doctor right away. If your symptoms are potentially life threatening, or if you think you’re experiencing a medical emergency, call 9-1-1.

  • severe low blood sugar (less than 35–40 mg/dL). Symptoms may include:
    • mood changes, such as irritability, impatience, anger, stubbornness, or sadness
    • confusion, including delirium
    • lightheadedness or dizziness
    • sleepiness
    • blurred or impaired vision
    • tingling or numbness in your lips or tongue
    • headaches
    • weakness or fatigue
    • lack of coordination
    • nightmares or crying out in your sleep
    • seizures
    • unconsciousness
  • hypersensitivity (allergic) reactions. This drug can cause several types of allergic reactions, including:
    • anaphylaxis. This is a severe and possibly a life-threatening allergic reaction. Symptoms may include trouble breathing, swelling of your throat or tongue, hives, or difficulty swallowing.
    • angioedema. This involves swelling of your skin, the layers under your skin, and your mucous membranes (inside your mouth).
    • Stevens-Johnsons syndrome. This is a rare and serious disorder of your skin and mucous membranes (mouth and nose). It starts with flu-like symptoms and is followed by a painful red rash and blisters.
  •  liver damage. Symptoms may include:
    • yellowing of your skin and the whites of your eyes (jaundice)
    • stomach pain and swelling
    • swelling in your legs and ankles (edema)
    • itchy skin
    • dark-colored urine
    • pale stool or tar-colored stool
    • constant sleepiness
    • nausea
    • vomiting
    • bruising easily
  • low blood cell or platelet counts. Symptoms may include infections and bruising or bleeding that doesn’t stop as quickly as normal.
  • low sodium levels (hyponatremia) and syndrome of inappropriate antidiuretic hormone secretion (SIADH). In SIADH, your body is unable to get rid of excess water by urinating. This leads to lower sodium levels in your blood (hyponatremia), which is dangerous. Symptoms may include:
    • nausea and vomiting
    • headache
    • confusion
    • loss of energy and fatigue
    • restlessness and irritability
    • muscle weakness, spasms or cramps
    • seizures
    • coma

Glimepiride May Interact with Other Medications

Glimepiride can interact with other medications, herbs, or vitamins you might be taking. That’s why your doctor should manage all of your medications carefully. If you’re curious about how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Note: You can reduce your chances of drug interactions by having all of your prescriptions filled at the same pharmacy. That way, a pharmacist can check for possible drug interactions.

Alcohol Interaction

Drinking alcohol while taking glimepiride may affect your blood sugar levels. They can either increase or decrease. Avoid drinking alcohol while taking this medication.

Medications That Might Interact with This Drug

Quinolone antibiotics

  • ciprofloxacin (Cipro)
  • gatifloxacin (Zymar)
  • levofloxacin (Levaquin)

These drugs can increase the effect of glimepiride and cause low blood sugar (hypoglycemia).

Blood pressure and heart drugs (angiotensin-converting enzyme or ACE inhibitors)

  • benazepril (Lotensin)
  • captopril (Capoten)
  • enalapril (Vasotec)
  • enalaprilat
  • fosinopril (Monopril)
  • lisinopril (Prinivil)
  • moexipril (Univasc)
  • perindopril (Aceon)
  • quinapril (Accupril)
  • ramipril (Altace)
  • trandolapril (Mavik)

These drugs can increase the effect of glimepiride and cause low blood sugar (hypoglycemia).

Antifungals

  • fluconazole (Diflucan)
  • ketoconazole (Nizoral)

These drugs can increase the effect of glimepiride and cause low blood sugar (hypoglycemia).

Drugs that treat eye infections

  • chloramphenicol

This drug can increase the effect of glimepiride and cause low blood sugar (hypoglycemia).

Drugs that treat high cholesterol and triglycerides

  • clofibrate

This drug can increase the effect of glimepiride and cause low blood sugar (hypoglycemia).

Drugs that treat depression

  • Monoamine Oxidase Inhibitors (MAOIs), such as:
    • isocarboxazid (Marplan)
    • phenelzine (Nardil)
    • tranylcypromine (Pamate)

These drugs can increase the effect of glimepiride and cause low blood sugar (hypoglycemia).

Drugs that contain salicylate

  • aspirin
  • magnesium salicylate (Doan’s)
  • salsalate (Disalcid)

These drugs can increase the effect of glimepiride and cause low blood sugar (hypoglycemia).

Drugs that contain sulfonamide

  • sulfacetamide
  • sulfadiazine
  • sulfamethoxazole/trimethoprim (Bactrim)
  • sulfasalazine (Azulfidine)
  • sulfisoxazole

These drugs can increase the effect of glimepiride and cause low blood sugar (hypoglycemia).

Drugs that treat cholesterol and type 2 diabetes

  • colesevelam (Welchol)

Colesevelam may stick with glimepiride in your gastrointestinal tract. This can decrease the amount of glimepiride that’s absorbed by your body. This means that the drug may not work as well and it may cause high blood sugar (hyperglycemia).

Drugs that treat low blood sugar

  • diazoxide (Proglycem)

This drug can decrease the effect of glimepiride and cause high blood sugar (hyperglycemia).

Drugs that treat tuberculosis

  • rifabutin (Myobutin)
  • rifampin (Rifadin)
  • rifapentine (Priftin)

These drugs can decrease the effect of glimepiride and cause high blood sugar (hyperglycemia).

Thiazide diuretics

  • chlorothiazide (Diuril)
  • chlorthalidone
  • hydrochlorothiazide (Hydrodiuril)
  • indapamide (Lozol)
  • metolazone (Zaroxolyn)

These drugs can decrease the effect of glimepiride and cause high blood sugar (hyperglycemia).

Glimepiride Warnings

  • People with G6PD deficiency: Glimepiride can cause hemolytic anemia (destruction of red blood cells) in people with the genetic problem Glucose 6-Phosphate Dehydrogenase (G6PD) deficiency. Your doctor may switch you to another diabetes drug if you have this condition.
  • People with kidney disease: Glimepiride is removed from your body by your kidneys. If your kidneys aren’t working as well, glimepiride may build up in your body and cause low blood sugar (hypoglycemia). Your doctor may start you at a lower dose and slowly increase your dose if needed.
  • People with liver disease: Glimepiride hasn’t been fully studied in patients with liver disease. If you have liver disease, you may be more sensitive to glimepiride. Your doctor may start you at a lower dose and slowly increase your dose if needed.
  • Pregnant women: Glimepiride is a category C pregnancy drug. That means two things:
    1. Research in animals has shown adverse effects to the fetus when the mother takes the drug.
    2. There haven’t been enough studies done in humans to be certain how the drug might affect the fetus.
    Tell your doctor if you’re pregnant or plan to become pregnant. Glimepiride should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
  • Women who are nursing: It isn’t known if glimepiride passes through breast milk. If it does, it may cause serious effects in a breastfeeding child. You and your doctor may need to decide if you’ll take glimepiride or breastfeed.
  • For Seniors: As you age, your organs, such as your kidneys and liver, may not work as well as they did when you were younger. This means that you may be more sensitive to the effects of this medication. It may also be more difficult for you to recognize the symptoms of low blood sugar (hypoglycemia). Your doctor may start you at a lower dose of glimepiride for these reasons.
  • For Children: Glimepiride isn’t recommended in people under 18 years old because it may affect body weight and cause low blood sugar (hypoglycemia). Keep glimepiride and all medications out of the reach of children. Lancets (a needle used to prick your finger to get drops of blood) are used to test your blood sugar while you’re taking glimepiride. Don’t throw out individual lancets into trashcans or recycling bins, and never flush them down the toilet. Ask your pharmacist for a safe container for disposing used lancets. Your community may have a program for throwing away lancets. If disposing the container in the trash, label it “do not recycle.”
  • Allergies: This drug is chemically similar to a class of medications called sulfonamides (sulfa drugs). If you’re allergic to sulfa medications, you may be allergic to glimepiride. If you have a sulfa allergy, tell your doctor before taking this drug. Glimepiride can cause a severe allergic reaction. Symptoms may include:
    • trouble breathing
    • swelling of your throat or tongue
    • hives
    Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal.

How to Take Glimepiride (Dosage)

All possible dosages and forms may not be included here. Your dose, form, and how often you take it will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What Are You Taking This Medication For?

Type 2 diabetes

Form: Oral tablet
Strengths: 1 mg, 2 mg, and 4 mg

Adult Dosage (ages 18-64 years)

  • The recommended starting dose is 1 mg or 2 mg taken once per day with breakfast or the first main meal of the day.
  • After reaching a dose of 2 mg per day, your doctor may increase your dose by 1 mg or 2 mg based on your blood sugar levels. They may increase your dose every 1–2 weeks until your blood sugar levels are controlled.
  • The maximum recommended dose is 8 mg taken once per day.

Child Dosage (ages 0-17 years)
Glimepiride isn’t recommended for people under 18 years old because it may affect body weight and cause low blood sugar (hypoglycemia).

Senior Dosage (ages 65 years and older)

  • The starting dose is 1 mg taken once per day with breakfast or the first main meal of the day.
  • Your doctor may adjust your dose based on your blood sugar levels. Since seniors may be more sensitive to glimepiride and are more likely to have decreased kidney function, your doctor may increase your dose more slowly.
  • The maximum recommended dose is 8 mg taken once per day.

Special Considerations

Kidney disease: Because you’re at risk for low blood sugar (hypoglycemia), your dose of glimepiride will be decreased.  

  • The starting dose is 1 mg taken once per day with breakfast or the first main meal of the day.
  • Your dose of glimepiride may be adjusted based on your blood sugar levels.
  • The maximum recommended dose is 8 mg taken once per day.

Liver disease: If you have liver disease, you may be more sensitive to the effects of glimepiride. Your doctor may start you at a lower dose and slowly increase your dose if needed.

Important Considerations for Taking Glimepiride

  • Glimepiride should be taken with breakfast or the first meal of the day
  • You can crush or cut the tablet
  • Store glimepiride at room temperature Keep it at temperatures from 68­–77ºF (20–25°C). Don’t freeze glimepiride. Keep it away from light and high temperatures. Keep your drugs away from areas where they could get wet, such as bathrooms. Store your drugs away from moisture and damp locations. Keep all medications away from children.
  • This prescription is refillable
  • When traveling with your medication:
    • Always carry your medication with you or in your carry-on bag.
    • Don’t worry about airport X-ray machines. They can’t hurt this medication.
    • You may need to show your pharmacy’s label to clearly identify the medication. Keep the original prescription label with you.
    • Don’t leave this medication in the car, especially when the temperature is hot or freezing.
    • Check for special rules about traveling with medicine and lancets. Lancets need to be used to check your blood sugar.
  • You may need to test your blood sugar levels at home using a blood glucose monitor. You’ll need to learn how to do the following:
    • use a blood glucose monitor to test your blood sugar regularly at home
    • recognize the signs and symptoms of high and low blood sugar
    • treat low and high blood sugar reactions
  • While taking glimepiride, you’ll need to regularly check your blood sugar levels. You’ll need to have:
    • sterile alcohol wipes
    • lancing device and lancets (to prick your finger to test your blood sugar)
    • blood sugar test strips
    • blood glucose monitor
    • needle container for safe disposal of lancets
  • Before you start and while you’re taking glimepiride, your doctor may check your:
    • blood sugar levels
    • glycosylated hemoglobin (A1C) levels. This test measures your blood sugar control over the last 2–3 months.
    • liver function
    • kidney function
  • Your Diet: Glimepiride is used to treat diabetes along with diet changes and exercise. Talk to your doctor about how to change your eating habits.
  • Sun Sensitivity Glimepiride may cause increased sensitivity to the sun (photosensitivity). Use sunscreen, wear protective clothing, and limit how often you’re in the sun while taking this medication.
  • Hidden Costs Besides the medicine, you’ll need to purchase the following:
    • sterile alcohol wipes
    • lancing device and lancets (to prick your finger to test your blood sugar)
    • blood sugar test strips
    • blood glucose monitor
    • needle container for safe disposal of lancets

Are There Any Alternatives?

There are other drugs available to treat your condition. Some may be more suitable for you than others. Talk to your doctor about possible alternatives.

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