Class: Second-Generation Sulfonylurea, Antidiabetic
Dosage Forms. Tablet: 1 mg, 2 mg, 4 mg
Common FDA Label Indication, Dosing, and Titration.
1. Diabetes mellitus, Type II: 1-4 mg po daily; titrate to effect, max dose 8 mg po daily
Off-Label Uses. None
MOA. Sulfonylureas enhance insulin secretion from pancreatic β-cells and potentiate insulin action on several extrahepatic tissues. Long-term sulfonylureas increase peripheral utilization of glucose, suppress hepatic gluconeogenesis, and possibly increase the sensitivity and/or number of peripheral insulin receptors.
Drug Characteristics: Glimepiride
Medication Safety Issues: Glimepiride
Drug Interactions: Glimepiride
Adverse Reactions: Glimepiride
Efficacy Monitoring Parameters. Preprandial blood glucose between 70 and 130 mg/dL, HbA1c <7%.
Toxicity Monitoring Parameters. Symptoms of hypoglycemia include nausea, sweating, and loss of consciousness. Seek medical attention if yellowing of skin or eyes, severe skin rash, unusual bruising, or bleeding.
Key Patient Counseling Points. Monitor blood glucose in frequent intervals (2-4 times per day); if <70 mg/dL, eat candy or sugar and contact prescriber. Take with food or milk in the morning. Use a sunscreen and avoid sunlamps and tanning beds. Do not drink alcohol, may cause a disulfiram reaction.
Clinical Pearls. Metformin is first-line therapy for Type II diabetes. A sulfonylurea may be added if HbA1c goals are not achieved with metformin alone. Not for use in children. Hemolytic anemia is most likely to occur in patients with G6PD deficiency.