Adult Dosing
Type II diabetes mellitus (NIDDM)
- Initial: 1-2 mg PO qd with the first main meal; start 1 mg PO qd in patients sensitive to hypoglycemic drugs
- Titrate: Increase in increments not exceeding 2 mg at 1-2 week intervals based on the patient's glucose response
- Usual maintenance dose range: 1-4 mg PO qd
- Max: 8 mg/day
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established
[Outline]
See Supplemental Patient Information
- Glimepiride therapy has been associated with an increased CV mortality compared to treatment with diet alone or diet plus insulin
- Inform patients about the potential risks and advantages of glimepiride and of alternative modes of therapy
- Patients allergic to other sulfonamide derivatives may develop an allergic reaction to glimepiride as well
- There is no conclusive evidence of macrovascular risk reduction with glimepiride therapy
- Sulfonylurea drugs may cause severe hypoglycemia; thus, proper patient selection, dosage, and instructions are important to avoid hypoglycemic episodes
- In elderly, debilitated, or malnourished patients, and those with pituitary, renal and hepatic insufficiency, the initial dosing, dose increments, and maintenance dosage should be conservative based upon blood glucose levels prior to and after initiation of treatment to avoid hypoglycemic reactions
- It may be difficult to recognize hypoglycemia in patients with autonomic neuropathy, the elderly and in people taking beta-adrenergic blocking drugs or sympatholytic agents
- If a patient on any diabetic treatment is exposed to stress such as fever, trauma, infection, or surgery, a loss of glycemic control may occur. In such case, it may be necessary to add insulin in combination with glimepiride or even use insulin monotherapy
- If secondary failure develops with glimepiride monotherapy, initiate combined therapy with glimepiride and metformin or glimepiride and insulin
- Therapy may cause hemolytic anemia in patients with glucose 6-phosphate dehydrogenase (G6DP) deficiency
- Periodically monitor fasting blood glucose to determine minimum effective dose for the patient and to detect primary and secondary failure; monitor glycosylated hemoglobin levels (A1c), every 3-6 months, to evaluate patient's long-term response to therapy
Cautions: Use cautiously in
- Hepatic impairment
- Severe cardiovascular disease
- Hypersensitive to sulfonamides
- Adrenal insufficiency
Supplemental Patient Information
- Inform patients about the importance of adherence to dietary instructions, regular exercise program, and of regular blood glucose and HbA1c testing
Pregnancy Category:C
Breastfeeding: Safety unknown. An alternate drug may be preferred, especially while nursing a newborn or preterm infant because no information is available on the use of glimepiride during breastfeeding. This information is (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 11 March 2011). According to the manufacturer, because there is a potential for hypoglycemia in nursing infants, therapy with this drug should be discontinued in nursing women.
US Trade Name(s)
US Availability
glimepiride (generic)
- TABS: 1, 2, 3, 4, 6, 8 mg
Amaryl
Canadian Trade Name(s)
Canadian Availability
glimepiride (generic)
Amaryl
UK Trade Name(s)
UK Availability
glimepiride (generic)
Amaryl
Australian Trade Name(s)
- Amaryl
- Aylide
- Diapride
- Dimirel
Australian Availability
glimepiride (generic)
Amaryl, Aylide, Diapride, Dimirel
[Outline]
Pricing data from www.DrugStore.com in U.S.A.
- Amaryl 1 MG TABS [Bottle] (SANOFI-AVENTIS U.S.)
30 mg = $28.99
90 mg = $65.97 - Glimepiride 4 MG TABS [Bottle] (DR.REDDY'S LABORATORIES)
INC. mg = $30
mg = $90 - Amaryl 2 MG TABS [Bottle] (SANOFI-AVENTIS U.S.)
30 mg = $39.99
90 mg = $99.97 - Glimepiride 2 MG TABS [Bottle] (DR.REDDY'S LABORATORIES)
INC. mg = $90
mg = $180 - Amaryl 4 MG TABS [Bottle] (SANOFI-AVENTIS U.S.)
30 mg = $66.99
90 mg = $179.98 - Glimepiride 1 MG TABS [Bottle] (PERRIGO PHARMACEUTICALS)
30 mg = $12.99
60 mg = $19.98
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
