Glimepiride (Oral)

Overview

The prescription medication glimepiride is an effective treatment of the elevated blood sugar levels that can occur with type 2 diabetes. This medicine is sometimes used together with another oral pill such as metformin or with injectable insulin. Type 2 diabetes occurs when the pancreas-produced insulin is no longer effective in delivering sugar into the body's cells. Glimepiride will help the body convert sugar into energy more effectively and also reduce the patient's blood sugar levels.

If the patient is not able to control and manage their type 2 diabetes with modifications to their diet and increasing their exercise and activity levels, their physicians may opt to prescribe a medication such as glimepiride. Patients that do begin a course of treatment with glimepiride are advised to also continue with the changes that have made to their diet and exercise habits.

As the body adjusts to the medication, as well as the change in lifestyle habits, the amount of medication that is necessary may fluctuate. The prescribing physician will provide guidance on how to properly manage the medication levels to ensure maximum wellness. With the introduction of this medication and improvements to diet and exercise, it is likely that the patient's blood sugar levels will take some time to normalize. During this period of time, it is very important that the blood sugar is measured on a regular basis and that any changes to the prescription that are made are closely followed.

There are certain medications and medical conditions that can complicate the treatment of type 2 diabetes with the use of glimepiride. In some situations, the doctor may make adjustments to other medications that the patient is taking prior to beginning their glimepiride course of treatment. Be sure to alert your physician if any changes are made to the way that you take any of your medications as well as any changes to your overall health and wellness.

Pregnancy can cause diabetes and also cause changes in patients that are currently being treated for type 2 diabetes. It is important to review your comprehensive medical history with your physician should you become pregnant while taking glimepiride. Patients that experience severe complications due to diabetes and pregnancy may be ordered to observe a strict course of bed rest during parts of their pregnancy.

As it is possible to overdose while taking glimepiride, patients and their caregivers are advised to learn and understand the signs and symptoms of overdose and be prepared to seek immediate emergency medical treatment should they occur. Anaphylaxis has also been known to occur in certain cases and the patient, as well as their caregivers, must familiarize themselves with these signs and symptoms and understand that immediate emergency medical treatment must be sought should they occur.

Conditions Treated

  • Elevated blood sugar associated with type 2 diabetes

Type Of Medicine

  • 2nd Generation Sulfonylurea and Antidiabetic

Side Effects

Similar to many medications, glimepiride has been reported to cause unwanted side effects in some cases. Patients that are taking this drug and experience any of the following symptoms should contact their doctor, as further medical attention will be necessary:

Rare likelihood:

  • Difficulty with swallowing
  • Tightness in the chest
  • Fast heartbeat
  • Shortness of breath
  • Itching
  • Skin rash
  • Hives
  • Unusual tiredness or weakness
  • Dizziness
  • Wheezing

Unknown incidence:

  • Abdominal or stomach pain
  • Unusual bleeding or bruising
  • Back, leg, or stomach pains
  • Swelling of face, ankles, or hands
  • Bloating of abdomen
  • A sore throat
  • Chest pain
  • Sensitivity to the sun
  • Coma
  • Red skin lesions, often with a purple center
  • A cough or hoarseness
  • Rapid weight gain
  • Decreased urine output
  • Pale skin
  • Diarrhea
  • Joint or muscle pain
  • Nosebleeds
  • Fever with or without chills
  • Muscle twitching
  • General body swelling
  • Loss of appetite
  • Headaches
  • Lethargy
  • Hostility
  • Yellow eyes or skin
  • Irritability
  • Light-colored stools
  • High fever
  • Lower back or side pain
  • General tiredness and weakness
  • Nausea and vomiting
  • Fluid-filled skin blisters
  • Painful or difficult urination
  • A difficulty with breathing
  • Pinpoint red spots on the skin
  • Depression
  • Red, irritated eyes
  • Dark urine
  • Seizures
  • Confusion
  • Skin thinness
  • Chills
  • Stupor
  • Blood in the urine or stools
  • Swollen or painful glands
  • Bleeding gums
  • Upper right abdominal or stomach pain
  • Agitation

Seek immediate emergency medical care if you experience these signs of overdose:

  • Anxiety
  • Blurry vision
  • Nightmares
  • Increased hunger
  • Cold sweats
  • Shakiness
  • Cool, pale skin
  • Slurred speech

As the patient's system adjusts to the increased level of medication, they may experience some side effects that will likely go away on their own. If any of the below symptoms persist or become worse over time, it is advisable to seek further medical advice:

Less likely:

  • Lack or loss of strength

Unknown likelihood of incidence:

  • Severe sunburn
  • Redness or other discoloration of the skin

This list may not contain all side effects, and patients are advised to seek medical attention should they experience any symptoms that are worrisome or long-lasting.

Dosage

In conjunction with the glimepiride prescription, the patient will likely be advised to make adjustments to their diets and follow a meal plan that helps to minimize the effects of type 2 diabetes. Regular exercise is also advised as this can also help the patient to better manage their diabetes. Patients are advised to check their blood sugar levels regularly, both through urine and blood tests. If the prescribing doctor schedules any diagnostic tests, it is important that these appointments are kept.

It is recommended that glimepiride is taken with the day's first full meal.

Patients will receive the dosage that is most appropriate for their condition, as well as other factors such as their age and weight. The dosage information below reflects the typical levels that are used, but it is important that all directions provided by the prescribing physician are followed.

Children will have their dosage determined on a case by case doctor by their doctor or pediatrician. Adults are recommended to take 1-2 milligrams one time per day. It is likely that adjustments will be required as the blood sugar levels come under control. The maximum dosage that should not be exceeded is eight milligrams in one day.

If the patient misses a dosage it should be taken as soon as the mistake is realized. However, if it is close in time to the next scheduled dose, it is advised that the missed dose is skipped completely. If there is confusion regarding what to do following a missed dose, it is always best to consult with the pharmacist for further guidance as it can be dangerous to double dose.

Major Drug Interactions:

There are certain medications that should not be used concurrently with glimepiride as it can cause further complications. If the prescribing physician deems this to be the best course of treatment, alterations will likely be made to the dosage amount and frequency of one or both of the medications.

It is very important that the prescribing doctor is aware of all medications that are being taken, along with the frequency and amount of the dosages, prior to beginning glimepiride. This includes both prescription and non-prescriptions drugs as well as any herbal remedies or vitamin and mineral supplements.

  • Thioctic Acid
  • Besifloxacin
  • Rufloxacin
  • Disopyramide
  • Pefloxacin
  • Enoxacin
  • Pasireotide
  • Fleroxacin
  • Octreotide
  • Gatifloxacin
  • Nadifloxacin
  • Isoniazid
  • Miconazole
  • Levofloxacin
  • Aspirin
  • Lomefloxacin
  • Metreleptin
  • Lixisenatide
  • Moxifloxacin
  • Lanreotide
  • Norfloxacin
  • Gemifloxacin
  • Ofloxacin
  • Flumequine
  • Pazufloxacin
  • Entacapone
  • Prulifloxacin
  • Dulaglutide
  • Sparfloxacin
  • Ciprofloxacin
  • Tosufloxacin
  • Balofloxacin
  • Voriconazole

The use of glimepiride with any of the drugs in the following list may increase the likelihood of unwanted side effects, and changes may be made to the way they are prescribed:

  • Betaxolol
  • Safinamide
  • Bitter Melon
  • Psyllium
  • Carvedilol
  • Procarbazine
  • Colesevelam
  • Pindolol
  • Fenugreek
  • Penbutolol
  • Glucomannan
  • Nialamide
  • Iproniazid
  • Nadolol
  • Labetalol
  • Metoprolol
  • Linezolid
  • Sotalol
  • Metipranolol
  • Acebutolol
  • Methylene Blue
  • Moclobemide
  • Levobunolol
  • Nebivolol
  • Isocarboxazid
  • Oxprenolol
  • Guar Gum
  • Phenelzine
  • Furazolidone
  • Practolol
  • Esmolol
  • Propranolol
  • Celiprolol
  • Rasagiline
  • Carteolol
  • Selegiline
  • Bisoprolol
  • Timolol
  • Atenolol
  • Tranylcypromine

This medication should not be taken by patients who are exposed to Ethanol as it can create a dangerous situation.

It is important to inform the prescribing physician of any current medical conditions for which the patient is undergoing treatment. The conditions listed below have been known to cause further complications in patients who are being treated with glimepiride for treatment of type 2 diabetes. The medical team may opt for a different medication for those patients that suffer from:

  • Alcohol when taken to excess
  • Type 1 diabetes
  • Heart disease
  • Glucose-6-phosphate dehydrogenase (G6PD)
  • Undernourished condition
  • Weakened physical condition
  • Lower acting adrenal glands
  • Sulfonamide allergy
  • Infection
  • Fever
  • Trauma
  • Diabetic ketoacidosis
  • Kidney disease
  • Underactive pituitary gland
  • Recent surgery

Warnings

Patients who are being treated for type 2 diabetes should avoid drinking alcohol as it is known to causes decreases in blood sugar that can be severe. It is important that patients who drink regularly discuss the situation with their doctor prior to starting glimepiride.

Family members of type 2 diabetes patients should be aware of the changes that need to happen to help improve their loved one's health. Changes will be made to the diet and exercise and activity levels, and a meal plan will likely be advised. Caretakers should also familiarize themselves with the possible symptoms and side effects that can occur and how to deal with them. Patients that are pregnant or may become pregnant will also need to be aware of how pregnancy can impact their overall health and diabetes treatment.

When traveling it is important to keep a sufficient amount of medication on your person to avoid any complications due to lost medications and similar situations. Discuss travel to other time zones with your doctor as this may impact when you take your meals.

Patients are advised to wear an identification bracelet or another marker that will alert emergency medical personnel of their condition. There are many medical emergencies that can occur with patient's who suffer from type 2 diabetes. It is important for patients to familiarize themselves with the possibilities of emergencies and how to handle them. It is also recommended that an informational card with all medication data also be carried at all times.

If any of the following symptoms occur, seek immediate emergency medical treatment as it may be a symptom of a heart attack or other serious heart ailment:

  • Chest pain or discomfort
  • Sweating
  • Shortness of breath
  • Pain or discomfort in the neck arms, back, or jaw
  • Vomiting
  • Nausea

This medication has been reported to cause hypoglycemia, a condition that occurs when the blood sugar becomes too low. It is important that the symptoms of hypoglycemia are treated swiftly before the patient loses consciousness. Patients that suffer from type 2 diabetes will begin to understand more completely how their bodies react to certain foods and activities and will become better prepared to manage a stable blood sugar level.

As the patient is adjusting to the treatment of their type 2 diabetes it is important that they ask their doctor or pharmacist to clarify any questions that they may have. Ongoing issues may require an adjustment to the dosage that they are taking.

Hypoglycemia typically causes the following signs and symptoms:

  • Restless sleep
  • Blurry vision
  • Nervousness
  • Headaches
  • Cool, pale skin
  • Excessive hunger
  • Drowsiness
  • Anxiety
  • Fast heartbeat
  • Difficulty in thinking
  • Nausea
  • Confusion
  • Nightmares
  • Cold sweats
  • Shakiness
  • Slurry speech
  • Behavior change similar to being drunk
  • Unexplained tiredness or weakness.

The treatment of hypoglycemia generally entails adding sugar to the system. This can be achieved by drinking fruit juice, a non-diet soda or glucose tablets when the signs of low blood sugar occur. In an emergency, glucagon can be administered in severe cases when the patients faint, loses consciousness or experiences seizures. It is important that the patient carries a glucagon kit with them at all times and that their family and close friends are trained on how to use it safely and effectively.

Prior to driving or operating other large machinery that requires full concentration, it is important that patients understand how they react to taking glimepiride.

Before taking any new medications be sure to discuss them with the prescribing physician, this includes both prescription and non-prescription medications, herbal remedies and vitamin and mineral supplements.

Patients should familiarize themselves with the signs and symptoms of anaphylaxis shock as this possible reaction can prove harmful and even life-threatening in some instances. Seek immediate emergency medical help should this reaction occur.

Overdose is also possible with this medication and emergency medical treatment should be sought if any of the following signs and symptoms occur:

  • Anxiety
  • Nightmares
  • Increased hunger
  • Cold sweats
  • Shakiness
  • Blurred vision
  • Cool, pale skin
  • Slurred speech

The patient, as well as any caretaker, should familiarize themselves with this list of the signs and symptoms of overdose. It is of vital importance that emergency medical attention is sought immediately. Discuss any and all concerns that you may have with taking this medication with your doctor prior to beginning the course of treatment. Take this drug exactly as your doctor prescribes it and do not make any changes to your dosage or how often you take glimepiride without speaking to your doctor first. This medication must be taken as directed. Do not ever take a double dose of this drug as it can prove to be very harmful and could lead to overdose in some cases.

The treatment of type 2 diabetes can cause serious side effects, and any severe reactions that occur when taking glimepiride should be told to the prescribing physician as soon as possible. Regular diagnostic tests will also be necessary when taking this medication, and all tests should be performed as directed, whether self-administered or conducted at a lab. Additionally, patients must be sure to keep all medical appointments that are scheduled while they are taking this medication.

Storage

It is advisable to keep all medications in the original packaging. Store glimepiride at room temperature in an environment with little moisture. Avoid exposure to extreme heat and cold and do not allow the medication to freeze.

Keep this and all medications out of the reach of children and pets, especially as there is the possibility of overdose with the use of glimepiride.

If at the end of your course of treatment you are left with unused or expired medication it is important that it is disposed of properly. Due to the possibility of overdosing on glimepiride, it is advised that you consult your pharmacist or prescribing physician to ensure that the disposal process is safe and effective.

Summary

Glimepiride is an effective medication for the treatment of type 2 diabetes that is available with a prescription. This drug can help to control and manage the patient's blood sugar level and aid in getting back to normal levels. Patients who are prescribed this drug will also be counseled to make certain lifestyle changes that will be helpful in the treatment of this condition.

In addition to prescribing glimepiride, the doctor will also likely recommend a meal plan that can be helpful in regulating the patient's sugar intake. Adjustments to the patient's overall diet will also be put in place and should be adhered to as closely as possible. Regular exercise is another helpful lifestyle change that should be implemented as increases in daily activity levels have proven effective in the overall treatment of type 2 diabetes.

Patients that suffer from type 2 diabetes must be aware of the chance of fainting due to low blood sugar and carry fruit juice, sugar cubes, or other similar items at all times. In some cases, it may be necessary to carry a glucagon kit and be trained, along with close family members and friends, on how to administer this medicine in the case of fainting or seizures.

It is possible to overdose on glimepiride, as well as experience a potentially dangerous reaction known as anaphylaxis when taking this drug. Patients are strongly advised to learn the signs and symptoms of these two conditions and seek immediate emergency attention should they occur. Close family members or caretakers must also know the signs and what to do in case they occur.