GENERIC NAME: glimepiride
BRAND NAME: Amaryl
DRUG CLASS AND MECHANISM: Glimepiride is an oral
blood sugar-lowering drug in a class of medicines for controlling
diabetes called
sulfonylureas. Glimepiride is related to other sulfonylureas
including glyburide (Micronase; Diabeta), glipizide (Glucotrol),
tolbutamide (Orinase) and tolazamide (Tolinase).
Glimepiride
is used in type II diabetes, the most common type of diabetes that is found in
90% of patients with diabetes. In type II diabetes, insulin usually is not necessary to control the blood
sugar. Instead, diet and oral medications often are sufficient.
Intolerance to sugar that results in elevated blood sugar is caused
by reduced insulin secretion by the pancreas and resistance to
insulin's effects by the body's cells. Glimepiride lowers the sugar
level in the blood by stimulating insulin to be secreted from the
pancreas into the blood. Insulin causes sugar to leave the blood and
enter cells throughout the body.
Glimepiride was approved by the FDA in December of 1995.
GENERIC AVAILABLE: yes
PRESCRIPTION: yes
PREPARATIONS: Tablets: 1mg, 2mg, 4mg.
STORAGE: Tablets should be stored below 86°F
(30°C).
PRESCRIBED FOR: It is believed that control of blood sugar
in diabetics decreases the risks of eye, kidney, and nerve damage.
Glimepiride is used to treat type II diabetes that cannot be
controlled by a strict diabetic diet alone. If sulfonylureas are not
effective, other oral drugs or insulin may be used.
DOSING: Like other medicines used to treat diabetes, the
dose of glimepiride is individualized using periodic measurements of
blood sugar to
determine the best dose.
DRUG INTERACTIONS: Medicines that can increase blood sugar
can
reverse the action of glimepiride. These drugs include diuretics
[e.g.
hydrochlorothiazide, furosemide (Lasix)], corticosteroids such as
prednisone and
methylprednisolone (Medrol)], phenytoin (Dilantin), niacin, and
sympathomimetics such as pseudoephedrine (Sudafed).
Beta-blockers such as propranolol (Inderal) and atenolol (Tenormin)
can cause
low or high blood sugar. Additionally, they can directly reverse the
sugar-lowering effect of sulfonylureas and render them less
effective. Beta-blockers also can blunt some of the body's protective
responses to low blood sugar, thus making it difficult for patients
to recognize reactions due to low blood sugar. This notwithstanding,
beta-blockers have been used successfully in diabetic patients and
have been associated with improved survival in diabetics with high
blood pressure.
Rifampin increases the breakdown of two other sulfonylureas,
tolbutamide (Orinase) and glyburide (Diabeta, Micronase). This might interfere
with the effects of the drugs and result in higher levels of sugar in
the blood. Although this same interference has not yet been reported
with glimepiride, the possibility that it may occur should be kept in
mind.
PREGNANCY: In animal studies, glimepiride and other
sulfonylureas
have been associated with a higher risk of fetal death. However,
there have
been no good studies in women. On the other hand, abnormal blood
sugar concentrations (high or low) during pregnancy increase the risk
of abnormalities in the fetus. Therefore, physicians must carefully
weigh the benefits and risks of sulfonylurea treatment during
pregnancy.
NURSING MOTHERS: It is not known if glimepiride is
excreted in breast
milk like other sulfonylureas. Because of the risk of low blood
sugar in the infant, it is recommended that glimepiride be
discontinued in
nursing mothers. If therapy other than diet and exercise is needed,
insulin
is recommended.
SIDE EFFECTS: Low blood sugar can occur during
glimepiride therapy. Symptoms of low blood sugar include hunger,
nausea, tiredness, perspiration, headache, heart palpitations,
numbness
around the mouth, tingling in the fingers, tremors, muscle weakness,
blurred vision, cold temperature, excessive yawning, irritability,
confusion, or loss of consciousness. Other side effects include
dizziness (1 of every 60 persons),
headache (1 of every 75), and nausea or vomiting (1 of every 90). A rash occurs in fewer than 1 of every 100
persons who receive glimepiride.
Last Editorial Review: 11/17/2005
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
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