Glimepiride

Glimepiride is a prescription medication used to treat type 2 diabetes. This medication belongs to a group of drugs called sulfonylureas, which help to lower blood sugar by causing the pancreas to produce insulin (a natural substance that is needed to break down sugar in the body). It also helps the body use insulin efficiently.

Glimepiride comes in tablet form. It is usually taken once daily with breakfast.

Common side effects include headache, weakness, and nausea. Glimepiride can cause dizziness. Do not drive or operate heavy machinery until you know how it affects you.

G6PD is an enzyme in your body that is responsible for helping red blood cells to work properly. Some patients are born with less of this enzyme in their bodies, leading to the destruction of red blood cells. When glimepiride is used in patients with G6PD deficiency, they have a higher chance of experiencing hemolytic anemia (a condition in which the body does not have enough red blood cells to deliver oxygen to your tissues).

G6PD testing may be done to determine whether you are at a higher risk of experiencing hemolytic anemia if you are to be treated with glimepiride.

Glimepiride is a prescription medication used to treat type 2 diabetes.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Glimepiride may be found in some form under the following brand names:

• Amaryl

• Avandaryl

• Duetact

Common side effects include:

• headache
• weakness
• nausea
• dizziness
• low blood sugar

This is not a complete list of glimepiride side effects. Ask your doctor or pharmacist for more information.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your doctor if you take:

• colesevelam
• miconazole (Monistat)
• medications that block a protein in the body CYP2C9 such as fluconazole (Diflucan)
• medications that increase the activity of the enzyme CYP2C9 such as rifampin
• H2 receptor antagonists such as cimetidine and ranitidine

• anticoagulants ('blood thinners') such as warfarin (Coumadin)
• aspirin
• oral anti-diabetic medications, pramlintide acetate, and insulin
• angiotensin converting enzyme (ACE) inhibitors
• nonsteroidal anti-inflammatory medications (NSAIDs) such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn)
• beta blockers such as atenolol (Tenormin), labetalol (Normodyne), metoprolol (Lopressor, Toprol XL), nadolol (Corgard), and propranolol (Inderal)
• chloramphenicol
• clarithromycin (Biaxin)
• disopyramide (Norpace)
• diuretics ('water pills')
• fluoxetine (Prozac, Sarafem)
• hormone replacement therapy and hormonal contraceptives (birth control pills, patches, rings, implants, and injections)
• insulin or other medications to treat high blood sugar or diabetes
• isoniazid (INH)
• MAO inhibitors such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate)
• medications for asthma and colds
• medications for mental illness and nausea
• niacin
• oral steroids such as dexamethasone (Decadron, Dexone), methylprednisolone (Medrol), and prednisone (Deltasone)
• phenytoin (Dilantin)
• probenecid (Benemid)
• quinolone and fluoroquinolone antibiotics such as ciprofloxacin (Cipro), gatifloxacin (Tequin), levofloxacin (Levaquin), moxifloxacin (Avelox), ofloxacin (Floxin)
• salicylate pain relievers
• sulfa antibiotics such as sulfamethoxazole/ trimethoprim (Bactrim, Septra)
• sulfasalazine (Azulfidine)
• thyroid medications

This is not a complete list of glimepiride drug interactions. Ask your doctor or pharmacist for more information.

Serious side effects have been reported with glimepiride including the following:

• Glimepiride can cause low blood sugar levels (hypoglycemia) in patients. Tell your doctor if you have a history of kidney or liver disease or drink alcohol. Symptoms of low blood sugar include:
  • shakiness
  • tremors
  • cold sweat
  • fast heart rate
  • headache
  • moodiness
  • dizziness
  • blurred vision
  • confusion
• A severe allergic reaction to glimepiride is possible. Tell your healthcare provider right away if you have some or all of the following symptoms of a hypersensitivity reaction:
  • difficulty breathing or swallowing
  • hoarseness
  • rash or hives
  • swelling
• Glimepiride can decrease the number of red blood cells in people with glucose-6-phosphate dehydrogenase (G6PD) deficiency.  Alert your doctor if you have a history of G6PD deficiency or anemia.
• Increased risk of cardiovascular mortality with Sulfonylureas. The administration of oral hypoglycemic drugs has been reported to be associated with increased cardiovascular mortality as compared to treatment with diet alone or diet plus insulin. Ask your doctor about the risks and benefits of 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.

Avoid unnecessary or prolonged exposure to sunlight, and 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.

Do not take glimepiride if you:

• are allergic to glimepiride or to any of its ingredients
• who have a history of an allergic reaction to sulfonamide derivatives. Patients who have developed an allergic reaction to sulfonamide derivatives may develop an allergic reaction to glimepiride.

Medications can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of glimepiride, there are no specific foods that you must exclude from your diet when receiving this medication.

Before taking glimepiride, tell your doctor about all of your medical conditions. Especially tell your doctor if you:

• are allergic to glimepiride or to any of its ingredients
• 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
• have heart, kidney, or liver disease
• are pregnant or plan to become pregnant. If you become pregnant while taking glimepiride, call your doctor.
• are breast-feeding
• are having surgery, including dental surgery

Ask your doctor about the safe use of alcoholic beverages while you are taking glimepiride. Alcohol can make the side effects from glimepiride worse.

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Glimepiride falls into category C. There are no well-controlled studies that have been done in pregnant women. Glimepiride should be used during pregnancy only if the possible benefit outweighs the possible risk to the unborn baby.

Tell your doctor if you are breastfeeding or plan to breastfeed.

It is not known if glimepiride crosses into human milk. Because many medications can cross into human milk and because of the possibility for serious adverse reactions in nursing infants with use of this medication, a choice should be made whether to stop nursing or stop the use of this medication. Your doctor and you will decide if the benefits outweigh the risk of using glimepiride.

Take glimepiride exactly as prescribed.

Glimepiride comes in tablet form. It is usually taken once daily with breakfast.

If you miss a dose, take the missed dose as soon as you remember. If it is almost time for the next dose, skip the missed dose and take your next dose at the regular time. Do not take two doses of glimepiride at the same time.

Take this medication exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

The dose your doctor recommends may be based on the following:

• the condition being treated
• other medical conditions you have
• other medications you are taking
• how you respond to this medication
• your kidney function

The recommended dose range of glimepiride  is 1-8 mg/day (8 mg/day being the maximum recommended dose).

If you take too much glimepiride, call your healthcare provider or local Poison Control Center, or seek emergency medical attention right away.

• Store glimepiride 25°C (77°F).
• Keep this and all medicines out of the reach of children.