Glimepiride: 7 things you should know

Medically reviewed by Carmen Pope, BPharm. Last updated on Aug 7, 2024.

1. How it works

• Glimepiride may be used to treat type 2 diabetes.
• Glimepiride works by stimulating the release of insulin from beta cells within the pancreas. It does this by binding to the sulfonylurea receptor in the pancreatic beta-cell plasma membrane, leading to the closure of the ATP-sensitive potassium channel, thereby stimulating the release of insulin.
• Glimepiride belongs to the class of medicines known as sulfonylureas.

2. Upsides

• May be used to improve blood sugar control in adults with type 2 diabetes.
• Used in addition to diet and exercise.
• Taken orally (by mouth).
• Available in 1mg, 2mg, and 4mg tablets.
• Generic glimepiride is available.

3. Downsides

If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:

• Low blood sugar levels (hypoglycemia), dizziness, lack of energy, headache, and nausea.
• May cause severe hypoglycemia (low blood sugar) which may affect your ability to drive or perform hazardous tasks. Hypoglycemia is more likely to occur with low-calorie diets, after severe or prolonged exercise, or when glimepiride is taken with alcohol. Always keep simple sugars on hand in case of hypoglycemia.
• May cause weight gain, similar to other sulfonylureas.
• Sulfonylureas and other oral drugs used to control blood sugar levels in people with diabetes have been associated with an increased risk of dying from heart-related conditions compared to diet alone or diet plus insulin.
• The dosage of glimepiride should be reduced in people with kidney disease.
• May induce hemolytic anemia in people with glucose 6-phosphate dehydrogenase deficiency.
• Not effective for the treatment of type 1 diabetes or to treat diabetic ketoacidosis (because it relies on the pancreas being able to produce some insulin).
• Not suitable for people who are allergic to sulfonamides, with moderate-to-severe burns, or with certain other conditions.
• May interact with some other medications including NSAIDs, beta-blockers, anticoagulants, corticosteroids, and several other drugs.

Note: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. View complete list of side effects

4. Bottom Line

• Glimepiride is used to help maintain blood sugar control in people with type 2 diabetes. It may cause nausea and people who take glimepiride should always be alert for symptoms of hypoglycemia (low blood sugar).

5. Tips

• Administer with breakfast or the first meal of the day. Try to take glimepiride at the same time each day.
• Your doctor will advise you which dose to take. However, 1mg is usually the initial starting dose for those at increased risk for hypoglycemia (low blood sugar) such as the elderly or people with renal impairment.
• Take glimepiride exactly as directed by your doctor. Taking more than directed could lead to potentially fatal hypoglycemia, taking less than directed may lead to high blood sugar levels (hyperglycemia) which can cause damage to the heart and blood vessels, kidneys, and eyes. Discuss a "Sick Day Plan" with your doctor before you get sick because fever, infection, injury, or surgery can all affect your blood sugar control.
• If you miss a dose of glimepiride, take it as soon as you remember, unless it is almost time for your next dose, then skip the missed dose and go back to your usual dosing schedule.
• Do not drive or perform hazardous tasks if glimepiride makes you drowsy, light-headed, or dizzy. Avoid alcohol.
• Ensure you wear an alert bracelet or carry a card that says you have diabetes and are taking glimepiride.
• Follow the diet and exercise program given to you by your doctor.
• Make sure you eat regular meals and always carry a reliable source of glucose with you (such as glucose tablets). Be alert for the symptoms of hypoglycemia (such as dizziness, headache, sweating, and shaking).
• Glimepiride may make your skin more sun-sensitive, increasing the risk of becoming sunburned. Always wear an SPF 30-50+ sunblock when going outdoors. Avoid tanning booths.
• Tell your dentist that you take glimepiride before receiving any dental care.

6. Response and effectiveness

• Glimepiride takes about two to three hours to reach its maximal effect after a single dose.

7. Interactions

Medicines that interact with glimepiride may either decrease its effect, affect how long it works, increase side effects, or have less of an effect when taken with glimepiride. An interaction between two medications does not always mean that you must stop taking one of the medications; however, sometimes it does. Speak to your doctor about how drug interactions should be managed.

Common medications that may interact with glimepiride include:

• aloe vera
• antidepressants such as amitriptyline, clomipramine, or SSRIs
• antifungal agents, such as fluconazole, miconazole, or voriconazole
• beta-blockers, such as acebutolol and metoprolol
• cimetidine or ranitidine
• colesevelam
• eye drops for glaucoma, such as timolol
• fluoroquinolone antibiotics, such as ciprofloxacin, enoxacin, or levofloxacin
• furosemide
• heart medications such as captopril, or benazepril
• HIV medications, such as atazanavir or ritonavir
• salicylates
• thiazide or thiazide-like diuretics
• vitamin K antagonists (eg, warfarin)
• other medications that affect blood sugar levels or are used for diabetes, such as chlorpropamide, metformin, or glipizide.

Alcohol may worsen the side effects of glimepiride, such as flushing, headache, and nausea.

Note that this list is not all-inclusive and includes only common medications that may interact with glimepiride. You should refer to the prescribing information for glimepiride for a complete list of interactions.

References

• Glimepiride. Revised 04/2024. Distributed by Cardinal Health. https://www.drugs.com/pro/glimepiride.html

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use glimepiride only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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