To view updated drug label links, paste the RSS feed address (URL) shown below into a RSS reader, or use a browser which supports RSS feeds, such as Safari for Mac OS X. Files, All Mapping Signs of low blood sugar include fast heartbeat, sweating, pale skin, shakiness, confusion and irritability. May make this condition worse. Distribution: After intravenous dosing in healthy subjects, the volume of distribution (Vd) was 8.8 L (113 mL/kg), and the total body clearance (CL) was 47.8 mL/min. Table 1 summarizes adverse events, other than hypoglycemia, that were reported in 11 pooled placebo-controlled trials, whether or not considered to be possibly or probably related to study medication. Glimepiride Tablets, USP contain the active ingredient glimepiride, USP and the following inactive ingredients: lactose monohydrate, magnesium stearate, povidone . Duplication for commercial use must be authorized by ASHP. Do not double doses. For non-prescription products, read the label or package ingredients carefully. Final daily doses of glimepiride were 1, 2, 3, 4, 6, or 8 mg [see Clinical Studies ( 14.1)]. You could also ask your pharmacist for advice on other ways to remember to take your medicines. Along with its needed effects, a medicine may cause some unwanted effects. Metformin is a biguanide that suppresses basal hepatic glucose uptake and increases insulin-mediated glucose uptake in peripheral muscle. Your doctor may adjust the dose of your medication as needed so that the medication will work best for you. 1 mg (N=78) 4 mg (N=76) 8 mg (N=76) If a hypersensitivity reaction is suspected, promptly discontinue glimepiride, assess for other potential causes for the reaction, and institute alternative treatment for diabetes. tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you find it difficult to swallow tablets, use the score line in the middle of the tablet to break it in 2, then take both halves. Mild episodes of hypoglycemia can be treated with oral glucose. It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. Glimepiride tablets should be administered with breakfast or the first main meal of the day. 13.1 Carcinogenesis, Mutagenesis, and Impairment of Fertility. (1.4, 2.7) 2.8* In animals, M1 possesses about one- third of the pharmacological activity of glimepiride, but it is unclear whether M1 results in clinically meaningful effects on blood glucose in humans. Glimepiride comes as 1mg, 2mg, 3mg and 4mg tablets. Glimepiride is present in rat milk [see Data]. Warfarin: In an open-label, two-way, crossover study, healthy subjects received 4 mg of glimepiride daily for 10 days. The recommended starting dose of glimepiride tablet is 1 mg or 2 mg once daily . Citations, Report Adverse When colesevelam is coadministered with glimepiride, maximum plasma concentration and total exposure to glimepiride is reduced. Despite controversy regarding the interpretation of these results, the findings of the UGDP study provide an adequate basis for this warning. n=67 n=76 n=75 n=73 Call your doctor if you have any unusual problems while taking this medication. It may be used alone, or in combination with insulin or another oral medicine such as metformin. Patients randomized to glimepiride 4 mg or 8 mg underwent forced-titration from an initial dose of 1 mg to these final doses, as tolerated [see Clinical Studies ( 14.1)]. It is a good idea to wear a medical identification (ID) bracelet or neck chain at all times. These side effects may go away during treatment as your body adjusts to the medicine. Single 25 mg doses of warfarin were administered 6 days before starting glimepiride and on Day 4 of glimepiride administration. Do not stop taking glimepiride without talking to your doctor. However, elderly patients are more likely to have low blood sugar and age-related kidney problems, which may require caution and an adjustment in the dose for patients receiving glimepiride. Protein binding was greater than 99.5%. People take berberine for heart failure. UGDP reported that patients treated for 5 to 8 years with diet plus a fixed dose of tolbutamide (1.5 grams per day) had a rate of cardiovascular mortality approximately 2 and a half times that of patients treated with diet alone. Glimepiride Placebo Npoje s vysokm obsahom antioxidantov, ako s vitamny C a E, preukzatene zlepuj erektiln funkciu tm, e brnia pokodeniu buniek, produkujcich oxid dusnat," hovor Pearlmanov. Serious Interactions of Glimepiride include: Glimepiride has moderate interactions with at least 146 different drugs. The glimepiride doses were separated by a 14-day washout period. Ask your healthcare professional how you should dispose of any medicine you do not use. Baseline (mean) 85.7 84.3 86.1 85.5 Table 3: 14-week Monotherapy Trial Comparing Glimepiride to Placebo in Patients Previously Treated With Sulfonylurea Therapy a Glimepiride tablets, USP are formulated as tablets of: 1 mg tablets (pink coloured, oval shaped, biconvex, uncoated tablets debossed with AHI 1 on one side and break line on the other) The pharmacokinetics, efficacy and safety of glimepiride have been evaluated in pediatric patients with type 2 diabetes as described below. Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. Glimepiride resulted in a statistically significant decrease in the pharmacodynamic response to warfarin. Change from Baseline Fluconazole may inhibit the metabolism of glimepiride, causing increased plasma concentrations of glimepiride which may lead to hypoglycemia. Breastfed infants of lactating women using glimepiride should be monitored for symptoms of hypoglycemia (see Clinical Considerations). There have been postmarketing reports of hypersensitivity reactions in patients treated with glimepiride, including serious reactions such as anaphylaxis, angioedema, and Stevens- Johnson Syndrome [ see Adverse Reactions ( 6.2)]. Mayo Clinic is a nonprofit organization and proceeds from Web advertising help support our mission. Make sure you tell your doctor if you have any other medical problems, especially: Carefully follow the special meal plan your doctor gave you. Treatment begins with 1 mg daily and is increased by1 mg every 1-2 weeks. Continued observation and additional carbohydrate intake may be necessary because hypoglycemia may recur after apparent clinical recovery [see Warnings and Precautions ( 5.1) ]. Hypoglycemic events documented by blood glucose values <36 mg/dL were observed in 4% of pediatric patients treated with glimepiride and in 1% of pediatric patients treated with metformin. Dizziness 5.0 2.4 Your doctor and other healthcare providers will talk to you about the best way to manage your diabetes. For oral dosage form (tablets): For type 2 diabetes: AdultsAt first, 1 to 2 milligrams (mg) once a day. When glimepiride was administered 4 hours prior to colesevelam, there was no significant change in glimepiride AUC 0- or C max, -6% and 3%, respectively [see DOSAGE AND ADMINISTRATION (2.1)and DRUG INTERACTIONS (7.4)]. A multiple-dose titration study was conducted in 16 patients with type 2 diabetes and renal impairment using doses ranging from 1 mg to 8 mg daily for 3 months. Glimepiride is available under the following different brand names: Initial: 1-2 mg orally each morning after breakfast or with a first meal; may increase the dose by 1-2 mg every 1-2 weeks; not to exceed 8 mg/day, Observe patients carefully for 1-2 weeks when being converted from long half-life sulfonylureas to glimepiride, because of the potential for overlapping of hypoglycemic effects, Use in monotherapy or, if the glycemic response to glimepiride is inadequate at the maximum dose, with insulin or, 1 mg orally once per day; titrate dose at weekly intervals to avoid hypoglycemia, Renal impairment: 1 mg orally once daily; titrate dose based on, Hepatic impairment: Not studied; not recommended in severe impairment; initiate therapy with 1 mg orally per day and titrate carefully, serious hypersensitivity reactions, including severe allergic reaction, rapid swelling (, liver impairment (reduction of bile flow, jaundice), as well as hepatitis, which may progress to, reduced white blood cells (leukopenia), reduced immunity (, thrombocytopenia (including severe cases with a platelet count under 10,000/mcl) and thrombocytopenic, kidney enzyme deficiency (hepatic porphyria) reactions and disulfiram-like reactions (flushing, fast heartbeat, nausea, thirst, chest pain, vertigo, and low blood pressure). Glimepiride is used along with diet and exercise, and sometimes with other medications, to treat type 2 diabetes (condition in which the body does not use insulin normally and, therefore, cannot control the amount of sugar in the blood). Follow your doctor's instructions when taking this medicine. 95% confidence interval 2.7 What special precautions should I follow? The patient's ability to concentrate and react may be impaired as a result of hypoglycemia. Cimetidine and ranitidine: In a randomized, open-label, 3-way crossover study, healthy subjects received either a single 4 mg dose of glimepiride alone, glimepiride with ranitidine (150 mg twice daily for 4 days; glimepiride was administered on Day 3), or glimepiride with cimetidine (800 mg daily for 4 days; glimepiride was administered on Day 3). Difference from Placebo Check with your doctor immediately if any of the following side effects occur: Get emergency help immediately if any of the following symptoms of overdose occur: Some side effects may occur that usually do not need medical attention. & Articles, All Data sources include IBM Watson Micromedex (updated 5 June 2023), Cerner Multum (updated 5 June 2023), ASHP (updated 10 Apr 2023) and others. Severe hypoglycemia with coma, seizure, or neurological impairment can be treated with glucagon or intravenous glucose. Concomitant Use with Colesevelam: Safety and efficacy have not been established in patients younger than 18 years. Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of glimepiride in the elderly. Glimepiride lowers blood sugar by causing the pancreas to produce insulin (a natural substance that is needed to break down sugar in the body) and helping the body use insulin efficiently. Do not take other medicines unless they have been discussed with your doctor. If you are a consumer or patient please visit However, the dose is usually not more than 8 mg per day. What Are Side Effects Associated with Using Glimepiride? No changes were observed in warfarin plasma protein binding. Patients discontinued their sulfonylurea therapy then entered a 3-week placebo washout period followed by randomization into 1 of 4 treatment groups: placebo (n=74), glimepiride 1 mg (n=78), glimepiride 4 mg (n=76) and glimepiride 8 mg (n=76). Make allowances for changing time zones and keep your meal times as close as possible to your usual meal times. 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