glimepiride antidiabetic medication - Drugsera – Evidence-Based Drug Information

Amaryl is the brand name of glimepiride, an antidiabetic medication.

Table of Contents

What is glimepiride?

It is a medication that belongs to sulfonylurea category of antidiabetic medication.

It is metabolized in the liver and excreted from the body with urine and to a less extent in feces.

Indications of glimepiride

Glimepiride is indicated for the treatment of type 2 diabetes mellitus in order to adjust the level of the blood sugar.

When the blood glucose is controlled, the risk of the following diseases is lowered:

Heart diseases including ischemia and failure.
Vascular accidents of the brain namely stroke.
In addition, it reduces the long term organ complications such as kidney and liver impairment.

The patient should commit a healthy diet system as well as physical exercise in order to get the best control of the blood glucose.

Dosage

Usually, the physician prescribes Glimepiride as once daily with the first or the main meal.

The starting dose is 1-2 mg per day, while the maximum dose shouldn’t exceed 8 mg per day.

If the patient forgot a dose of glimepiride, he should take it once he remembered except if the next dose is close.

If the patient took an overdose of the medication, he should visit the nearest poison center for the risk of having a serious low blood glucose level.

Side effect of metformin pills

Lowering of the sugar level, especially if the patient is taking insulin or another antidiabetic medication. Moreover, it can happen if the patient is an alcoholic.
Allergic response in the form of swellings, itching, rash, and difficult breathing in severe cases.
Sunburn upon exposure to sun rays, so the patient should use sunblocks.
Headache.
Nausea and abdominal distention.
Weakness and dizziness.
Awareness of fast heartbeats.
Abdominal and stomach pain.
Bleeding from the gums or bleeding in the stool and urine.
Swelling around the eyes which may extend to be all over the body.
Difficult swallowing.
Diarrhea.
Wheezes and chest tightness.

Interactions with metformin pills

If the patient is taking colesevelam in addition to glimepiride, he should take them 4 hours apart.

This is because the first medication leads to less absorption of glimepiridem.

Moreover, glimepiride has many interactions with other medications, for example, aspirin, chloramphenicol, sulfsalazine, levofloxacine, and aminolevulinic acid.

Contraindications

Allergy to sulfa medications.
Severe kidney or liver disease.
Heart diseases.
Pregnancy or lactation because it can lead to low blood sugar to the baby.
Diabetic ketoacidosis.
Type 1 diabetes mellitus.
Thyroid gland diseases.
Glucose-6-phosphate dehydrogenase deficiency.
Complicated diabetes during pregnancy.

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Glimepiride: Comprehensive Guide to the Antidiabetic Medication – Uses, Mechanism, Dosage, Safety, FAQs

Uses & Indications

Glimepiride is a prescription oral antidiabetic agent (sulfonylurea class) approved for the treatment of type 2 diabetes mellitus (T2DM) in adults as an adjunct to diet and exercise. It may be used as monotherapy or in combination with other antihyperglycemic agents like metformin, insulin, or thiazolidinediones when glycemic control remains inadequate DrugBank المركز الوطني للتكنولوجيا الحيوية products.sanofi.us. It is not indicated for type 1 diabetes or diabetic ketoacidosis ميدلاين بلس products.sanofi.us.

How It Works

Glimepiride stimulates insulin secretion by pancreatic β-cells by binding to sulfonylurea receptors, thus promoting release of endogenous insulin and lowering blood glucose DrugBank FDA Access Data. Additionally, it may enhance peripheral insulin sensitivity by increasing glucose uptake and reducing hepatic glucose production FDA Access Data DrugBank. Among sulfonylureas, glimepiride is noted for a lower risk of hypoglycemia, less weight gain, and minimal negative cardiovascular effects such as impairment of myocardial ischemic preconditioning DrugBank PMC المركز الوطني للتكنولوجيا الحيوية.

Dosage and Administration

Initial dose: Typically 1–2 mg once daily, taken just before breakfast or the first meal Medscape products.sanofi.us MedCentral.
Titration: Increase by 1–2 mg every 1–2 weeks based on fasting glucose until reaching glycemic targets Medscape products.sanofi.us MedCentral.
Maximum dose: 8 mg once daily; doses beyond have not shown added benefit Medscape MedCentral PMC.
Special populations:
- Renal impairment: Start at 1 mg/day and titrate cautiously due to reduced metabolite clearance Medscape MedCentral+1 CARE Hospitals.
- Elderly or malnourished: Initiate at 1 mg/day; monitor closely for hypoglycemia Medscape MedCentral.

Side Effects

Common: Hypoglycemia, headache, nausea, dizziness nhs.uk ويكيبيديا MedCentral.
Less weight gain and lower hypoglycemia risk compared to other sulfonylureas like glyburide PMC.
Serious but rare:
- Severe hypoglycemia, especially if meals are missed, alcohol is consumed, or combined with other medications nhs.uk ويكيبيديا.
- Hepatotoxicity signs (jaundice), blood dyscrasias (e.g., thrombocytopenia, leukopenia, hemolytic anemia) nhs.uk ويكيبيديا.

Warnings and Precautions

Hypoglycemia risk: Especially in elderly, renal/liver impairment, erratic meal patterns, alcohol use, or with interacting drugs nhs.uk MedCentral. Always carry fast-acting carbohydrates nhs.uk.
Not for type 1 diabetes or ketoacidosis ميدلاين بلس products.sanofi.us.
Cardiovascular considerations: Unlike older sulfonylureas, glimepiride does not compromise ischemic preconditioning, suggesting a potentially safer profile for patients with cardiovascular disease المركز الوطني للتكنولوجيا الحيوية DrugBank.
Liver disease: Use cautiously or avoid in severe hepatic impairment due to lack of data Medscape MedCentral.

Drug Interactions

Metabolized majorly by CYP2C9.

Inhibitors (e.g., fluconazole) may increase glimepiride levels and hypoglycemia risk MedCentral.
Inducers (e.g., rifampin) may reduce effectiveness MedCentral.
Drugs that are highly protein bound (e.g., chloramphenicol, NSAIDs, salicylates, fluoxetine, coumarins) may enhance hypoglycemic effects; withdrawal may worsen glycemic control MedCentral.

Frequently Asked Questions (FAQs)

1. How long does glimepiride take to lower blood glucose?
Onset is typically within 2–3 hours, and effects can last about 24 hours nhs.uk FDA Access Data.

2. Can glimepiride be taken with metformin?
Yes. It can be used in combination when monotherapy is insufficient DrugBank products.sanofi.us MedCentral.

3. Does glimepiride cause weight gain?
It generally causes less weight gain than other sulfonylureas and may even be weight-neutral PMC.

4. What if I’m elderly or have kidney problems?
Use lower starting dose (1 mg), titrate conservatively, and monitor closely Medscape MedCentral.

5. Is glimepiride safe for patients with heart disease?
It may be safer than other sulfonylureas because it doesn’t impair cardiac ischemic preconditioning المركز الوطني للتكنولوجيا الحيوية DrugBank.

References

MedlinePlus. Glimepiride drug information – uses, mechanism, precautions.
DrugBank. Glimepiride: uses, interactions, mechanism of action.
StatPearls / NCBI Bookshelf. Glimepiride overview: indications, mechanism, safety.
Medscape (Amaryl). Detailed dosing and administration guidelines.
NHS UK. Common questions, side effects, precautions for glimepiride.
NCBI PMC article: Evidence-based comparisons—hypoglycemia, weight gain, dosing.

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