Losu Dosage/Direction for Use

Children 10-18 year (unlabeled use): Initial: 1 mg once daily; maintenance: 1-4 mg once daily.
Adults: Initial: 1-2 mg once daily, administered with breakfast or the first main meal; usual maintenance dose: 1-4 mg once daily; after a dose of 2 mg once daily, increase in increments of 2 mg at 1- to 2 week intervals based upon the patient's blood glucose response to a maximum of 8 mg  once daily. If inadequate response to maximal dose, combination therapy with metformin may be consid­ered.
Combination with insulin therapy (fasting glucose level for instituting combination therapy is in the range of >150 mg/dL in plasma or serum depending on the patient): Initial recommended dose: 8 mg once daily with the first 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. Once stable, combination-therapy patients should monitor their capillary blood glucose on an ongoing basis, preferably daily.
Conversion from therapy with long half-life agents: Observe patient carefully for 1-2 weeks when converting from a longer half-life agent (eg, chlor­propamide) to glimepiride due to overlapping hypoglycemic effects.
Dosing adjustment/comments in renal impair­ment: Cl_cr <22 mL/minute: Initial starting dose should be 1 mg and dosage increments should be based on fasting blood glucose levels.
Dosing adjustment in hepatic impairment: No data available.
Elderly: Initial: 1 mg/day; dose titration and mainte­nance dosing should be conservative to avoid hypoglycemia.
Dietary Considerations Administer with breakfast or the first main meal of the day. Dietary modification based on ADA recommendations is a part of therapy. Decreases blood glucose concentration. Hypoglycemia may occur. Must be able to recognize symptoms of hypoglycemia (palpitations, sweaty palms, lightheadedness).
Monitoring Parameters: Urine for glucose and ketones; monitor for signs and symptoms of hypoglycemia (fatigue, excessive hunger, profuse sweating, numbness of extremities), fasting blood glucose, hemoglobin A_1c, fructosamine.
Reference Range Target range: Adults: Fasting blood glucose: <120 mg/dL. Glycosylated hemoglobin: <7%.
Administration: Administer once daily with breakfast or first main meal of the day. Patients who are NPO may need to have their dose held to avoid hypoglycemia.