Dangerous Drug: Glimepiride(glye meh’ per ide)
Amaryl, CO-Glimepiride (CAN), ratio-Glimepiride (CAN)
PREGNANCY CATEGORY C
Drug Classes
Antidiabetic
Sulfonylurea (second generation)
Therapeutic Actions
Stimulates insulin release from functioning beta cells in the pancreas; may improve binding between insulin and insulin receptors or increase the number of insulin receptors; thought to be more potent in effect than first-generation sulfonylureas.
Indications
As an adjunct to diet and exercise to lower blood glucose in patients with type 2 diabetes mellitus whose hypoglycemia cannot be controlled by diet and exercise alone
In combination with metformin or insulin to better control glucose as an adjunct to diet and exercise in patients with type 2 diabetes mellitus
Contraindications and Cautions
Contraindicated with allergy to sulfonylureas; diabetes complicated by fever, severe infections, severe trauma, major surgery, ketosis, acidosis, coma (insulin is indicated in these conditions); type 1 or juvenile diabetes, serious hepatic or renal impairment, uremia, thyroid or endocrine impairment, glycosuria, hyperglycemia associated with primary renal disease; labor and delivery—if glimepiride is used during pregnancy, discontinue drug at least 1 mo before delivery; lactation, safety not established.
Use cautiously with pregnancy.
Available Forms
Tablets—1, 2, 4 mg
Dosages
Dose conservatively in elderly patients, debilitated or malnourished patients, and patients with renal or hepatic impairment.
Adults
Usual starting dose is 1–2 mg PO once daily with breakfast or first meal of the day; usual maintenance dose is 1–4 mg PO once daily, depending on patient response and glucose levels. Do not exceed an increase of 2 mg/dose at 1- to 2 wk intervals based on glucose levels; do not exceed total daily dose of 8 mg.
Combination with insulin therapy: 8 mg PO daily with first meal of the day with low-dose insulin.
Transfer from other hypoglycemics: No transition period is necessary.
Pediatric patients
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