Getryl Dosage/Direction for Use

In initiating treatment for NIDDM, diet and exercise should be emphasized as the primary form of treatment. There is no fixed dosage regimen for the management of diabetes mellitus with Getryl or any other hypoglycemic agent. The patient's fasting blood glucose and HbA_1c must be measured periodically to determine the minimum effective dose for the patient.
Short-term administration of Getryl may be sufficient during periods of transient loss of control in patients usually controlled well on diet and exercise.
Usual Starting Dose: 1-2 mg once daily, administered with breakfast or the 1st main meal. Those patients who may be more sensitive to hypoglycemic drugs should be started at 1 mg once daily and should be titrated carefully. The maximum starting dose of glimepiride should not be >2 mg.
Usual Maintenance Dose: 1-4 mg once daily. The maximum recommended dose is 8 mg once daily. After reaching a dose of 2 mg, dose increases should be made in increments of >2 mg at 1-2 week intervals based upon the patient's blood glucose response. Long-term efficacy should be monitored by measurement of HbA_1c levels eg, every 3-6 months.
Getryl-Metformin Combination Therapy: If patients do not respond adequately to the maximum dose of Getryl monotherapy, addition of metformin may be considered.
With concomitant Getryl and metformin therapy, the desired control of blood glucose may be obtained by adjusting the dose of each drug.
Getryl-Insulin Combination Therapy: Combination therapy with Getryl and insulin may also be used in secondary failure patients. The fasting glucose level for instituting combination therapy is in the range of >150 mg/dL in plasma or serum depending on the patient.
Recommended Getryl Dose: 8 mg once daily administered with the 1st main meal. After starting with low dose insulin, upward adjustments of insulin can be done approximately weekly as guided by frequent measurements of fasting blood glucose.
Special Populations: In elderly, debilitated or malnourished patients, or in patients with hepatic insufficiency, the initial dosing, dose increments and maintenance dosage should be conservative to avoid hypoglycemic reactions.
Renally Impaired Patients: In patients with mild to moderate renal impairment, a starting dose of 1 mg once daily must not be exceeded. The dose may then be carefully titrated upwards if necessary based on fasting blood glucose levels in increments of 1 mg at intervals of 1-2 weeks.