glimepiride, Amaryl (cont.)

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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. The usual starting dose is 1 or 2 mg given orally once daily with breakfast or the first major meal of the day. The dose may be increased by 1-2 mg in 1-2 weeks interval up to 8mg maximum based on blood sugar response and given once daily.

DRUG INTERACTIONS: Some medications when given with glimepiride may reduce its ability to lower blood sugar. These drugs include diuretics, for example, hydrochlorothiazide (Microzide, and many combinations with other drugs), loop diuretics (for example, furosemide [Lasix]), corticosteroids such as prednisone and methylprednisolone (Medrol), phenytoin (Dilantin), colesevelam (Welchol), danazol and somatropin (Genotropin). Rifampin increases the breakdown of glimepiride by liver enzymes. This might reduce the effect of glimepiride and result in higher levels of sugar in the blood.

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 (hypoglycemia).

Certain drugs when given with glimepiride may increase the risk of low blood sugar (hypoglycemia). These include nonsteroidal anti-inflammatory drugs [for example ibuprofen], sulfa drugs, warfarin (Coumadin), miconazole (Oravig), fluconazole (Diflucan), chloramphenicol, cimetidine (Tagamet HB), ranitidine (Zantac), clarithromycin (Biaxin), MAO Inhibitors (for example, isocarboxazid [Marplan] and phenelzine [Nardil]), mifepristone (Mifeprex), probenecid, quinolone antibiotics and Selective Serotonin Reuptake Inhibitors (for example paroxetine [Paxil], fluoxetine [Prozac] and sertraline [Zoloft]) and voriconazole (Vfend). Blood sugar should be closely monitored when interacting drugs are given with glimepiride.

Medically Reviewed by a Doctor on 11/17/2014


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