Glimepiride belongs to a group of medications known as oral hypoglycemics. It is used to control blood sugar for people with type 2 diabetes. It is used when diet, exercise, and weight reduction have not been found to control blood sugar well enough on their own. Glimepiride increases the amount of insulin released by the pancreas and helps the body use insulin more efficiently.

Glimepiride may be used in combination with metformin or insulin when diet and exercise and the use of these medications on their own do not provide adequate control of blood sugar.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

The usual starting dose is 1 mg once daily to be taken with breakfast or the first main meal. After reaching a dose of 2 mg, further increases should be done in increments of no more than 1 mg at one-week to 2-week intervals, based on the response. The usual maintenance adult dose ranges from 1 mg to 4 mg once daily to be taken with breakfast or the first main meal of the day. The maximum daily dose is 8 mg.

Gilmepiride tablets should be swallowed whole with approximately ½ glass of liquid. Do not chew or crush this medication.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking this medication without consulting your doctor.

It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not take glimepiride if you:

• are allergic to glimepiride or any ingredients of the medication
• are allergic to sulfonamide antibiotics or other sulfonylurea diabetes medications
• are pregnant or breast-feeding
• have type 1 diabetes (i.e., insulin-dependent diabetes)
• have diabetic ketoacidosis, with or without coma

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• abnormal taste in mouth
• dizziness
• hair loss
• mild nausea
• vomiting
• weight gain

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• general feeling of illness (e.g., fever, chills, sore throat)
• increased skin sensitivity or skin rashes following sun exposure
• signs of bleeding (e.g., bleeding gums, blood in the urine, dark tarry stools, easy bruising, nosebleeds, vomiting blood)
• signs of high blood sugar (hyperglycemia; e.g., dry mouth, dry skin, flushing, frequent urination, loss of appetite, thirst, tiredness, trouble breathing)
• signs of low blood sugar (hypoglycemia; e.g., blurred vision, dizziness, fatigue, headache, numbness or tingling of the mouth, pale colour, rapid heartbeat, shakiness, sudden hunger, sweating or confusion, weakness)
• signs of liver damage (e.g., abdominal pain, dark urine, fatigue, fever, loss of appetite, yellow skin or eyes)
• skin redness, itching, or rash
• swelling of the hands or feet

Stop taking the medication and seek immediate medical attention if any of the following occur:

• signs of a severe skin reaction such as blistering, peeling, a rash covering a large area of the body, a rash that spreads quickly, or a rash combined with fever or discomfort
• signs of a serious allergic reaction (e.g., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)
• signs of very low blood sugar (e.g., convulsions or seizures, loss of consciousness)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Before you begin taking a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Allergy: Some people who are allergic to sulfonamide antibiotics or other similar diabetes medications also experience allergic reactions to glimepiride. Before you take glimepiride, inform your doctor about any previous adverse reactions you have had to medications, especially to antibiotics or other diabetes medications. Contact your doctor immediately if you experience signs of an allergic reaction, such as skin rash, itching, difficulty breathing or swelling of the face and throat.

Anemia: If you have a condition called glucose-6-phosphate dehydrogenase (G6PD) deficiency, glimepiride may cause hemolytic anemia (an abnormal breakdown of red blood cells). If you have G6PD deficiency, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Drowsiness/reduced alertness: Due to the effect of glimepiride on blood sugar, it may affect the mental or physical abilities needed to drive or operate machinery. Avoid driving, operating machinery, or performing other hazardous tasks until you have determined how this medication affects you.

Hypoglycemia (low blood sugar): Hypoglycemia is a condition in which blood sugar levels are abnormally low. Symptoms of hypoglycemia include:

• dizziness
• drowsiness
• headache
• lack of energy
• nervousness
• numbness or tingling of the mouth
• shakiness
• sweating
• weakness

People with more severe hypoglycemia can experience blurred vision, confusion, and an inability to concentrate. If left untreated, severe hypoglycemia can lead to convulsions (seizures) and unconsciousness within minutes. People who are more likely to become hypoglycemic include seniors, people with reduced liver or kidney function, people who are malnourished, or people taking beta-blockers or other medications that lower blood sugar. Low blood sugar is more likely to occur when food intake is inadequate, or after strenuous or prolonged physical exercise. Blood sugar should be monitored regularly and an emergency source of sugar (e.g., a sugar packet, orange juice, or hard candy) and glucagon kit should be made available in case the need arises to increase blood sugar levels.

Loss of blood sugar control: People on glimepiride may experience loss of blood sugar control during illness or stressful situations such as fever, infection, trauma, or surgery. Under these conditions, your doctor may consider stopping the medication and prescribing insulin until your blood sugar is controlled and within target levels. For some people, their doctor may prescribe insulin or metformin in combination with glimepiride to control blood sugar.

Proper diet: Glimepiride is a treatment to be used in combination with a proper diet. Glimepiride is not a substitute for a proper diet.

Worsening of condition: Over time, glimepiride may become less effective because of the worsening of diabetes. Talk to your doctor if glimepiride no longer controls your blood glucose to target levels. Your doctor may ask you to stop this medication, or continue this medication and take an additional antidiabetic medication to help control your blood sugar.

Pregnancy: This medication should not be used during pregnancy. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: It is not known if glimepiride passes into breast milk. If you are breast-feeding and taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children.

Seniors: The side effects of this medication may be more noticeable in seniors. People who are over 65 years old should discuss with their doctor how this medication may affect them and whether any special monitoring is needed.

There may be an interaction between glimepiride and any of the following:

• acetylsalicylic acid (ASA)
• alcohol
• amiodarone
• antipsychotics (e.g., cariprazine, chlorpromazine, clozapine, olanzapine, quetiapine, risperidone)
• beta-blockers (e.g., atenolol, metoprolol, propranolol)
• bismuth subsalicylate
• bortezomib
• bromocriptine
• buserelin
• CF transmembrane regulators (e.g., elexacaftor, ivacaftor, lumacaftor, tezacaftor)
• clarithromycin
• colesevelam
• corticosteroids (e.g., dexamethasone, hydrocortisone, prednisone)
• other diabetes medications (e.g., acarbose, canagliflozin, gliclazide, insulin, liraglutide, metformin, sitagliptin)
• diazoxide
• disopyramide
• diuretics (e.g., furosemide, hydrochlorothiazide)
• dolutegravir
• enzalutamide
• estrogens (e.g., conjugated estrogens)
• everolimus
• fibrates (e.g., fenofibrate, gemfibrozil)
• fluconazole
• glucagon
• goserelin
• hepatitis C antivirals (e.g., glecaprevir, ledipasvir, sofosbuvir, velpatasvir, voxilaprevir)
• herbal medications (e.g., garlic, ginger, ginseng)
• HIV protease inhibitors (e.g., atazanavir, lopinavir, ritonavir)
• hydroxychloroquine
• leuprolide
• linezolid
• mifepristone
• monoamine oxidase inhibitors (MAOIs; e.g., moclobemide, phenelzine, rasagiline, selegiline, tranylcypromine)
• milk thistle
• niacin
• nilotinib
• pegvisomant
• progestogens (e.g., medroxyprogesterone)
• protein kinase inhibitors (e.g., ceritinib, dabrafenib, sunitinib)
• quinine
• quinolone antibiotics (e.g., ciprofloxacin, norfloxacin, ofloxacin)
• rifampin
• selective serotonin reuptake inhibitors (SSRIs; e.g., citalopram, escitalopram, fluoxetine, paroxetine, sertraline, vortioxetine)
• sirolimus
• somatostatin analogues (e.g., lanreotide, octreotide, pasireotide)
• somatrogon
• somatropin
• sulfonamides (e.g., sulfadiazine, sulfamethoxazole)
• tacrolimus
• terbutaline
• testosterone
• tetracyclines (e.g., doxycycline, minocycline)
• thyroid replacements (e.g., desiccated thyroid, levothyroxine)
• tramadol
• venetoclax
• voriconazole
• vorinostat
• warfarin

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.