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 07-05-2010

 
 glimepiride

  amaryl

 



  hormone, antidiabetic, sulfonylurea

 
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  an adjunct to diet to lower blood glucose in patients with type 2 (non-insulin dependent)
diabetes mellitus whose hypoglycemia cannot be controlled by diet and exercise alone

In combination with metformin or insulin to better control the glucose as an adjunct to diet and exercise
in patients with type 2 diabetes mellitus

2mg/tab 1tab OD in am 6am

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Adult: PO start with 1-2 mg once daily with breakfast or first main meal, may increase to usual
maintenance doseof 1-4 mg once daily (max mg/d)

  

  directly 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
leading to direct drop in blood glucose. Indirect action leads to increased sensitivity of peripheral insulin
receptors, resulting in increased insulin binding in peripheral tissues; thought to be more potent in
effect than the first generation sulfonylureas

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 increased risk of hypoglycemia with androgens, anticoagulants, azole antifungal,
chloramphenicol, clofibrate, fenfluramine, fluconazole, gemfribozil, H2 blockers, magnesium salts,
MAOIs, methyldopa, oxyphenbutazone, phenylbutazone, probenecid, salicylates, sulfinpyrazone,
sulfonamides, TCAs, urinary acidifiers

Decreased of both glimepiride and diaxozide if taken concurrently

Increased risk of hyperglycemia with rifampin, thiazides

Risk of hypoglycemia and hyperglycemia with ethanol; ͞disulfiram reaction͟ has also been reported

Possible decreased hypoglycemic effect with beta blockers, calcium channel blockers, cholestyramine,
corticosteroids, diazoxide, estrogens, hydantoins, hormonal contraceptives, isoniazide, nicotinic acid,
phenothiazines, rifampin, sympathomimetics, thiazide diuretics, thyroid agents, urinary alkalinizers






  hypersensitivity to glimepiride, diabetes complicated by fever, severe infection,
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 ʹ if glimepiride is
used during pregnancy, discontinue drug atleast 1 mo before delivery





CNS: drowsiness, asthenia, nervousness, tremor, insomnia

CV: increased risk of CV mortality (possible)

Endocrine: hypoglycemia, SIADH

GI: anorexia, nausea, vomiting, epigastric discomfort, heartbur, diarrhea

Hematologic: leukopenia, thrombocytopenia, anemia

Hypersensitivity: allergic skin reactions, eczema, pruritus, erythema, urticaria, photosensitivity, fever,
eosinophilia, jaundice

Other: diuresis, tinnitus, fatigue, weight gain


  
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a. Give drug 30 min before breakfast

b. Monitor urine or serum levels frequently to determine drug effectiveness and dosage
c. Do not discontinue this medication without consulting your health care provider
d. Avoid alcohol while using this drug
e. Report fever, sore throat, unusual bleeding or bruising mark, light-colored stools, hypoglycemic
or hyperglycemic reactions