Glimepiride

Should be taken with food. Take immediately before or during breakfast, or the 1st main meal of the day. Do not skip meals.

Hypersensitivity to glimepiride, other sulfonylureas, or sulfonamides. Type 1 diabetes mellitus, diabetic coma, ketoacidosis. Severe renal or hepatic impairment.

Patient with G6PD deficiency, stress-related states (e.g. fever, trauma, infection, surgery). Patient with a predisposition to hypoglycaemia (e.g. debilitated or malnourished patient, or those with deficient caloric intake; patient with certain uncompensated endocrine disorders affecting carbohydrate metabolism or counter-regulation of hypoglycaemia such as adrenal or pituitary impairment, those who have undergone severe or prolonged exercise). Mild to moderate renal and hepatic impairment. Elderly. Pregnancy and lactation. Patient Counselling This drug may cause visual disturbances and an impaired ability to react due to hypoglycaemia; if affected, do not drive or operate machinery. Monitoring Parameters Monitor blood and urine glucose, glycosylated Hb level, renal function, signs and symptoms of hypoglycaemia. Regular hepatic and haematological monitoring (particularly leucocytes and thrombocytes).

Significant: Hypoglycaemia (may be severe), haemolytic anaemia (particularly in patients with G6PD deficiency), hypersensitivity reaction (e.g. anaphylaxis, angioedema, Stevens-Johnson syndrome), weight gain. Blood and lymphatic system disorders: Leucopenia, agranulocytosis, aplastic anaemia, pancytopenia, thrombocytopenia. Endocrine disorders: Syndrome of inappropriate antidiuretic hormone secretion (SIADH). Eye disorders: Visual disturbances. Gastrointestinal disorders: Abdominal pain, diarrhoea, nausea, vomiting, dysgeusia. Hepatobiliary disorders: Cholestasis, jaundice, hepatitis, liver failure, hepatic porphyria. Metabolism and nutrition disorders: Disulfiram-like reactions, hyponatraemia. Nervous system disorders: Headache, dizziness. Skin and subcutaneous tissue disorders: Photosensitivity, alopecia.

Increased hypoglycaemic effect with NSAIDs (e.g. phenylbutazone), insulin, oral antidiabetics (e.g. metformin), salicylates, fluoxetine, anabolic steroids and androgens, antibiotics (e.g. chloramphenicol, sulfonamides, tetracyclines, quinolones, clarithromycin), coumarin anticoagulants, disopyramide, fibrates, ACE inhibitors, MAOIs, allopurinol, probenecid, sulfinpyrazone, cyclophosphamide, fluconazole, miconazole and pentoxifylline. Decreased hypoglycaemic effect with estrogens, oral contraceptives, thiazide diuretics, glucocorticoids, phenothiazine derivatives (e.g. chlorpromazine), sympathomimetics (e.g. epinephrine, salbutamol, terbutaline), nicotinic acid (high doses) and nicotinic acid derivatives, laxative (prolonged use), phenytoin, diazoxide, glucagon, barbiturates, rifampicin and isoniazid. Signs of hypoglycaemia may be reduced or absent in patients taking sympatholytic drugs (e.g. β-blockers, clonidine, guanethidine, reserpine). May potentiate or weaken the blood glucose lowering effect with histamine (H₂) antagonists, β-blockers, clonidine, reserpine. Concurrent use with colesevelam may decrease the serum concentration of glimepiride; administer glimepiride at least 4 hours before colesevelam.

Antidiabetic Agents

A10BB12 - glimepiride ; Belongs to the class of sulfonylureas. Used in the treatment of diabetes.