Glimepiride 1mg Tablets

Glimepiride lowers blood glucose by stimulating the release of insulin from functioning pancreatic beta cells. It binds to a specific receptor on the beta cell membrane, leading to closure of ATP-sensitive potassium channels, depolarization of the membrane, and opening of voltage-gated calcium channels. The resulting influx of calcium triggers insulin secretion. Glimepiride also appears to have extrapancreatic effects, including increased peripheral glucose uptake and utilization, and decreased hepatic glucose production.

Urgent Side Effects: Seek Medical Help Right Away

Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek immediate medical attention:

Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin (with or without fever)
+ Wheezing
+ Tightness in the chest or throat
+ Difficulty breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Severe dizziness or fainting
Shortness of breath
Low blood sugar (hypoglycemia), which may be more likely when taking this medication with other diabetes drugs. Symptoms of low blood sugar include:
+ Dizziness
+ Headache
+ Feeling sleepy or weak
+ Shaking
+ Fast heartbeat
+ Confusion
+ Hunger
+ Sweating
Severe skin reactions, including:
+ Stevens-Johnson syndrome (SJS)
+ Toxic epidermal necrolysis (TEN)
+ Other severe skin reactions, characterized by:
- Red, swollen, blistered, or peeling skin
- Skin irritation (with or without fever)
- Red or irritated eyes
- Sores in the mouth, throat, nose, or eyes

Other Possible Side Effects

Like all medications, this drug can cause side effects. Many people experience no side effects or only mild ones. If you notice any of the following side effects, or if they bother you or do not go away, contact your doctor:

Upset stomach
Dizziness, tiredness, or weakness
Headache
Flu-like symptoms
Weight gain

This is not an exhaustive list of possible side effects. If you have questions or concerns about side effects, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.

Before Taking This Medication: Important Information to Share with Your Doctor

It is essential to inform your doctor about the following:

Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the symptoms you experienced.
A known sulfa allergy.
Acidic blood problems, such as acidosis.
Type 1 diabetes, as this medication is not intended to treat this condition.

Additionally, please note that:

This medication is not suitable for children and should not be administered to pediatric patients.
This list is not exhaustive, and it is crucial to discuss all your medications (prescription, over-the-counter, natural products, and vitamins) and health issues with your doctor and pharmacist.
To ensure safe use, verify that it is acceptable to take this medication with your existing medications and health conditions.
Do not initiate, discontinue, or modify the dosage of any medication without consulting your doctor.

It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication. To manage your condition effectively, follow the diet and exercise plan recommended by your doctor.

Be aware that this drug can cause low blood sugar, which may lead to severe complications, including seizures, loss of consciousness, permanent brain damage, and even death. Consult your doctor to discuss ways to prevent and manage low blood sugar. Regularly check your blood sugar levels as instructed by your doctor.

If you have a deficiency of the enzyme glucose-6-phosphate dehydrogenase (G6PD), you may be at a higher risk of developing anemia. Individuals of African, South Asian, Middle Eastern, and Mediterranean descent are more likely to have low G6PD levels. Your doctor will monitor your condition through regular blood tests, so be sure to follow their instructions and discuss any concerns with them.

Avoid driving if you have experienced low blood sugar, as it can increase your risk of being involved in an accident. Before consuming alcohol, consult your doctor to understand the potential risks and interactions with this medication.

If you are taking colesevelam, take it at least 4 hours after taking this drug to minimize potential interactions. Be aware that stress, such as fever, infection, injury, or surgery, can affect your blood sugar control. Changes in physical activity, exercise, or diet can also impact your blood sugar levels.

This medication may increase the risk of death from heart disease. Discuss this potential risk with your doctor to understand the benefits and risks associated with this medication. If you are 65 or older, use this drug with caution, as you may be more susceptible to side effects.

If you are pregnant, plan to become pregnant, or are breastfeeding, inform your doctor. They will help you weigh the benefits and risks of taking this medication to ensure the best possible outcome for you and your baby.

• Bosentan (increased risk of hepatotoxicity)
• Miconazole (oral, severe hypoglycemia)
• Fluconazole (increased glimepiride levels, severe hypoglycemia)
• Other sulfonylureas (additive effects, increased hypoglycemia risk)

• Beta-blockers (mask hypoglycemia symptoms, impair glucose recovery)
• NSAIDs (enhance hypoglycemic effect)
• Salicylates (enhance hypoglycemic effect)
• Warfarin (potential for altered INR)
• Corticosteroids (hyperglycemic effect, may require dose adjustment of glimepiride)
• Thiazide diuretics (hyperglycemic effect, may require dose adjustment of glimepiride)
• Alcohol (potentiates hypoglycemic effect, disulfiram-like reaction possible)
• Chloramphenicol (enhances hypoglycemic effect)
• Clofibrate (enhances hypoglycemic effect)
• Probenecid (enhances hypoglycemic effect)
• Sulfonamides (enhances hypoglycemic effect)
• MAO inhibitors (enhances hypoglycemic effect)
• ACE inhibitors (enhances hypoglycemic effect)
• Sympathomimetics (e.g., epinephrine, albuterol - hyperglycemic effect)
• Thyroid hormones (hyperglycemic effect)
• Oral contraceptives (hyperglycemic effect)

• Certain herbal supplements (e.g., ginseng, fenugreek, bitter melon - may have additive hypoglycemic effects)

• Symptoms of hypoglycemia: sweating, tremor, dizziness, confusion, hunger, irritability, headache, blurred vision, rapid heartbeat, anxiety, weakness, slurred speech, seizures, loss of consciousness.
• Symptoms of hyperglycemia (if glycemic control is poor): increased thirst, increased urination, fatigue, blurred vision.

Glimepiride is classified as Pregnancy Category C. It is generally not recommended for use during pregnancy due to the potential for fetal hypoglycemia. Insulin is typically the preferred treatment for diabetes during pregnancy.

Glimepiride is not recommended during breastfeeding. It is excreted into breast milk and has the potential to cause hypoglycemia in the breastfed infant. Insulin or other antidiabetic agents with better safety profiles during lactation are preferred.

Safety and effectiveness in pediatric patients have not been established. Use is generally not recommended in children due to increased risk of hypoglycemia and lack of long-term data.

Use with caution in elderly patients. They may be more susceptible to the hypoglycemic effects of glimepiride due to impaired renal function, polypharmacy, and reduced counter-regulatory responses. Start with a low dose (1 mg) and titrate slowly, monitoring closely for hypoglycemia.

• Always take glimepiride with breakfast or the first main meal to reduce the risk of hypoglycemia.
• Educate patients thoroughly on the symptoms of hypoglycemia and how to treat it immediately.
• Patients should carry a source of fast-acting sugar at all times.
• Renal and hepatic function should be assessed before starting therapy and monitored periodically.
• Be aware of drug interactions, especially with other medications that can affect blood glucose levels (e.g., beta-blockers, NSAIDs, corticosteroids).
• Glimepiride has a long duration of action (24 hours), allowing for once-daily dosing, but also means hypoglycemia can be prolonged.
• Consider switching to insulin during pregnancy or lactation due to risks to the fetus/infant.

• Other Sulfonylureas (e.g., Glipizide, Glyburide)
• Biguanides (e.g., Metformin)
• DPP-4 Inhibitors (e.g., Sitagliptin, Saxagliptin)
• SGLT2 Inhibitors (e.g., Canagliflozin, Dapagliflozin)
• GLP-1 Receptor Agonists (e.g., Liraglutide, Semaglutide)
• Thiazolidinediones (e.g., Pioglitazone, Rosiglitazone)
• Meglitinides (e.g., Repaglinide, Nateglinide)
• Insulin therapy

If your symptoms or health issues persist or worsen, it is essential to contact your doctor for further guidance. To ensure your safety, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so it's a good idea to check with your pharmacist. If you have any questions or concerns about this medication, don't hesitate to reach out to your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek medical attention. When seeking help, be prepared to provide detailed information about the overdose, including the medication taken, the amount, and the time it occurred.