(glye' me pye ride)
P / L : Caution - pregnancy & lactation (breast feeding)
|| See TERMINOLOGY & ABBREVIATIONS ||
|Indication(s) & Dosage||Type 2 diabetes mellitus
Adult: Initially, 1-2 mg orally daily. Maintenance: 4 mg orally daily. Max: 6 mg daily.
Renal impairment: Initiate at 1 mg daily; subsequent increments should be based on fasting blood glucose levels.
Special Populations: Adjust dose in renal impairment: CrCl <22 mL/min: Initial dose is 1 mg, increased by increments based on fasting blood glucose levels.
|Administration||May be taken with or without food. May be taken after meals if GI discomfort occurs.
|Overdosage||Overdosage can cause hypoglycaemia. Treat mild hypoglycemic symptoms (without loss of consciousness or neurologic findings) with oral glucose and adjustments in drug dosage and/or meal patterns. Continue close monitoring until patient is out of danger. Severe hypoglycaemic reactions with coma, seizure, or other neurological impairment require immediate hospitalisation. Give patient rapid IV inj of 50% glucose solution, followed by continuous infusion of 10% glucose solution at a rate to maintain blood glucose level >100 mg/dL. Monitor closely for at least 24-48 hr, because hypoglycaemia may recur after apparent clinical recovery.|
|Contraindications||Diabetic ketoacidosis with or without coma.|
|Special Precautions||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.|
|Adverse Drug Reaction(s)||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.|
|Drug Interactions||NSAIDs, salicylates, sulphonamides, chloramphenicol, coumarin, probenecid, CYP2C9 inhibitors, fibric acid derivatives, pegvisomant, TCAs, MAOIs and Î²-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.
|Food Interaction||May cause disulfiram-like reaction and hypoglycaemia when used with ethanol. Hypoglycaemic risk when used with chromium, garlic, gymnema.|
|Pregnancy Category (US FDA)||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.|
|Storage||Oral: Store at 15-30°C.|
|Pharmacology||Glimepiride stimulates the insulin release from functioning pancreatic Î²-cells and inhibits gluconeogenesis at hepatic cells. It also increases insulin sensitivity at peripheral target sites.
Onset: Peak effect: 2-3 hr.
Duration: 24 hr.
Absorption: Completely absorbed from the GI tract after oral admin.
Distribution: Highly protein bound.
Metabolism: Metabolised hepatically to 2 main metabolites.
Excretion: 60% excreted in urine and 40% in faeces (as metabolites); about 9 hr (elimination half-life).
|ATC Classification||A10BB12 - glimepiride; Belongs to the class of sulfonamides, urea derivatives. Used in the treatment of diabetes.|
|Brand Name||Manufacturer/Marketer||Composition||Dosage Form||Pack Size & Price|
|ADGLIM||Unimed & Unihealth Manufacturers Ltd.||Glimepiride INN 1mg & 2mg||Tablet||30's each: 90.00 & 150.00 MRP|
|AMARYL||Sanofi||Glimepiride INN 1mg & 2mg & 3mg||Tablet||30's each: 184.80 & 360.20 & 466.80 MRP|
|CONDIA||R A K Pharmaceuticals Pvt. Ltd.||Glimepiride INN 1mg & 2mg,3mg||Tablet||30's each: 90.00 & 150.00 & 210.00 MRP|
|DACTUS||The Acme Laboratories Ltd.||Glimepiride INN 1mg & 2mg & 3mg||Tablet||1mg x50's, 2mg x40's, 3mg x30's: 150.00 & 200.40 & 210.60 MRP|
|DIALON||Eskayef Bangladesh Ltd||Glimepiride INN 1mg, 2mg & 4mg||Tablet||1mg x50's, 2mg x30's & 4mg x20's MRP: 125.00, 120.00 & 120.00|
|DIARYL 1||Beximco Pharmaceuticals Ltd||Glimepiride INN 1 mg||Tablet||30's: 135.00 MRP|
|DIARYL 2||Beximco Pharmaceuticals Ltd||Glimepiride INN 2 mg||Tablet||30's: 240.00 MRP|
|DIARYL 3||Beximco Pharmaceuticals Ltd||Glimepiride INN 3 mg||Tablet||30's: 300.00 MRP|
|DIETA||Pacific Pharmaceuticals Ltd.||Glimepiride INN 1mg & 2mg & 3mg & 4mg||Tablet||30's each: 90.00 & 150.00 & 210.00 & 240.00 MRP|
|GIPID||Alco Pharma Ltd||Glimepiride INN 1mg & 2mg||Tablet||30's each: 90.00 & 150.00 MRP|
|GLEMEP 1||Healthcare Pharmacuticals Ltd.||Glimepiride INN 1 mg||Tablet||30's MRP 90 Tk|
|GLEMEP 2||Healthcare Pharmacuticals Ltd.||Glimepiride INN 2 mg||Tablet||30's MRP 150 Tk|
|GLIMIRID||ACI Ltd.||Glimepiride INN 1mg & 2mg & 3mg & 4mg||Tablet||30's each: 90.30 & 150.60 & 210.00 & 240.00 MRP|
|GLIMS||Opsonin Pharma Limited||Glimepiride INN 1mg & 2mg||Tablet||30's each: 90.00 & 150.00 MRP|
|GLIRID||General Pharmaceuticals Ltd||Glimepiride INN 1mg & 2mg||Tablet||30's each: 90.30 & 150.60 MRP|
|GLLTIM||Techno Drugs||Glimepiride INN 1mg||Tablet||30's: 180.00 MRP|
|GLUCONOR||Aristopharma Ltd.||Glimepiride INN 1mg & 2mg||Tablet||1mg x50's, 2mg x30's: 150.00 each|
|LIMARYL||Popular Pharmaceuticals Ltd.||Glimepiride INN 1mg & 2mg & 3mg & 4mg||Tablet||30's each: 90.33 & 150.57 & 240.90 MRP|
|LIMEP||Kemiko Pharmaceuticals Ltd||Glimepiride INN 1mg & 2mg||Tablet||50's each: 150.00 & 250.00 MRP|
|LIMERID||Supreme Pharmaceuticals Ltd.||Glimepiride INN 1mg & 2mg||Tablet||30's each: 90.00 & 150.00 MRP|
|LIMPET||Drug International Ltd||Glimepiride INN 1mg & 2mg & 3mg||Tablet||1mg & 2mg x50's, 3mg x30's: 150.00 & 250.00 & 210.00 MRP|
|Losucon 1||Incepta Pharmaceuticals Limited||Glimepiride INN 1 mg||Tablet||10x5's:MRP 150 Tk|
|Losucon 2||Incepta Pharmaceuticals Limited||Glimepiride INN 2 mg||Tablet||10x5's:MRP 250 Tk|
|Losucon 3||Incepta Pharmaceuticals Limited||Glimepiride INN 3 mg||Tablet||10x3's:MRP 210 Tk|
|Losucon 4||Incepta Pharmaceuticals Limited||Glimepiride INN 4 mg||Tablet||10x3's:MRP 240 Tk|
|MEPID||Renata Limited||Glimepiride INN 1mg & 2mg||Tablet||30's each: 75.30 & 120.30 & 210.60 MRP|
|PRIDE||The White Horse Pharma||Glimepiride INN 1mg & 2mg||Tablet||50's each: 150.00 & 250.00 MRP|
|SECRIN 1||Square Pharmaceuticals Ltd.||Glimepiride 1mg||Tablet||60's: 270.00 MRP|
|SECRIN 1||Square Pharmaceuticals Ltd.||Glimepiride 1mg||Tablet||6x10|
|SECRIN 2||Square Pharmaceuticals Ltd.||Glimepiride 2mg||Tablet||6x10's: 481.80 MRP|
|SECRIN 3||Square Pharmaceuticals Ltd.||Glimepiride 3mg||Tablet||3x10's: 300.90 MRP|
|SECRIN 4||Square Pharmaceuticals Ltd.||Glimepiride 4mg||Tablet||3x10's: 360.90 MRP|
|STIMULIN||Orion Pharma Ltd.||Glimepiride INN 1mg & 2mg||Tablet||30's each: 90.30 & 150.60 MRP|
Why is this medication prescribed?
Glimepiride is used along with diet and exercise, and sometimes with other medications, to treat type 2 diabetes (condition in which the body does not use insulin normally and, therefore, cannot control the amount of sugar in the blood). Glimepiride lowers blood sugar by causing the pancreas to produce insulin (a natural substance that is needed to break down sugar in the body) and helping the body use insulin efficiently. This medication will only help lower blood sugar in people whose bodies produce insulin naturally. Glimepiride is not used to treat type 1 diabetes (condition in which the body does not produce insulin and, therefore, cannot control the amount of sugar in the blood) or diabetic ketoacidosis (a serious condition that may occur if high blood sugar is not treated).
How should this medicine be used?
Glimepiride comes as a tablet to take by mouth. It is usually taken once a day with breakfast or the first main meal of the day. To help you remember to take glimepiride, take it at around the same time every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take glimepiride exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Your doctor will probably start you on a low dose of glimepiride and gradually increase your dose if needed. After you have taken glimepiride for some time, glimepiride may not control your blood sugar as well as it did at the beginning of your treatment. Your doctor may adjust the dose of your medication as needed so that the medication will work best for you. Be sure to tell your doctor how you are feeling and if your blood sugar test results have been higher or lower than normal at any time during your treatment.
Glimepiride helps control blood sugar but does not cure diabetes. Continue to take glimepiride even if you feel well. Do not stop taking glimepiride without talking to your doctor.
Other uses for this medicine
This medication is sometimes prescribed for other uses; ask your doctor for more information.
What special precautions should I follow?
Before taking glimepiride,
- tell your doctor if you are allergic to glimepiride, any other medications, or any of the ingredients in glimepiride. Ask your pharmacist for a list of the ingredients.
- tell your doctor what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention anticoagulants ('blood thinners') such as warfarin; aspirin and other nonsteroidal anti-inflammatory medications (NSAIDs) such as ibuprofen and naproxen; beta blockers such as atenolol, labetalol, metoprolol, nadolol and propranolol; chloramphenicol; clarithromycin; disopyramide; diuretics; fluconazole; fluoxetine; hormone replacement therapy and hormonal contraceptives; insulin or other medications to treat high blood sugar or diabetes; isoniazid; MAO inhibitors such as isocarboxazid, phenelzine, selegiline, and tranylcypromine; medications for asthma and colds; medications for mental illness and nausea; miconazole; niacin; oral steroids such as dexamethasone, methylprednisolone, and prednisone; phenytoin; probenecid; quinolone and fluoroquinolone antibiotics such as cinoxacin, ciprofloxacin, enoxacin, gatifloxacin, levofloxacin, lomefloxacin, moxifloxacin, nalidixic acid, norfloxacin, ofloxacin, sparfloxacin, trovafloxacin and alatrofloxacin combination; rifampin; salicylate pain relievers such as choline magnesium trisalicylate, choline salicylate, diflunisal, magnesium salicylate, and salsalate; sulfa antibiotics such as co-trimoxazole; sulfasalazine; and thyroid medications. Also be sure to tell your doctor or pharmacist if you stop taking any medications while taking glimepiride. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- tell your doctor if you have or have ever had G6PD deficiency (an inherited condition causing premature destruction of red blood cells or hemolytic anemia); if you have hormone disorders involving the adrenal , pituitary, or thyroid gland; or if you have heart, kidney, or liver disease.
- tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking glimepiride, call your doctor.
- if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking glimepiride.
- ask your doctor about the safe use of alcoholic beverages while you are taking glimepiride. Alcohol can make the side effects from glimepiride worse. Consuming alcohol while taking glimepiride also may cause symptoms such as flushing (reddening of the face), headache, nausea, vomiting, chest pain, weakness, blurred vision, mental confusion, sweating, choking, breathing difficulty, and anxiety.
- plan to avoid unnecessary or prolonged exposure to sunlight and to wear protective clothing, sunglasses, and sunscreen. Glimepiride may make your skin sensitive to sunlight.
- ask your doctor what to do if you get sick, develop an infection or fever, experience unusual stress, or are injured. These conditions can affect your blood sugar and the amount of glimepiride you may need.
What special dietary instructions should I follow?
Be sure to follow all exercise and dietary recommendations made by your doctor or dietitian. It is important to eat a healthy diet, exercise regularly, and lose weight if necessary.
What should I do if I forget a dose?
Before you start to take glimepiride, ask you doctor what you should do if you forget to take a dose. Write these directions down so that you can refer to them later.
As a general rule, take the missed dose as soon as you remember it. If it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.
What side effects can this medication cause?
This medication may cause changes in your blood sugar. You should know the symptoms of low and high blood sugar and what to do if you have these symptoms.
Glimepiride may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately:
yellowing of the skin or eyes
pain in the upper right part of the stomach
unusual bruising or bleeding
Glimepiride may cause other side effects. Consult your doctor if you have any unusual problems while taking this medication.
What other information should I know?
Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your response to this medicine.
Do not let anyone else use your medication. If you still have symptoms and need further treatment, consult your doctor.
It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.
This information is provided for reference only and not a replacement for and should only be used in conjunction with full consultation with a registered medical practitioner. It may not contain all the available information you require and cannot substitute professional medical care, nor does it take into account all individual circumstances. Although great effort has been made to ensure content accuracy, mph-bd shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise.