We’ll be finishing up the sulfonylurea class of medications today with the drug glimepiride. There are a few other drugs in the category, but they are so rarely used because of their side effects, so I’m only going to list them for your knowledge. I’ve never seen them used in my practice. If you do have questions on them, please feel free to message me in the comments below. The other sulfonylureas are:
- acetohexamide (brand name Dymelor)
- chlorpropamide (brand name Diabinese)
- tolazamide (brand name Tolinase)
- tolbutamide (brand name Orinase)
But back to glimepiride, otherwise known by the brand name Amaryl. Yes, it is available as a generic.
If you want a refresher on sulfonylureas, and the other classes of diabetes medications, you can find out more in my previous post here.
How does it lower blood sugar: Like the other sulfonylureas, glimepiride lowers your blood sugar by increasing the amount of insulin that your pancreas puts into your blood. Remember, insulin is the hormone that is put into the blood to “push” sugar into your cells and out of your bloodstream – making your blood sugar lower!
The effect on your numbers: Glimepiride may lower your A1c by 1-2% (so if your starting A1c was 12, it might go down to 11 or 10 after being on glimepiride). Glimepiride is known to cause some weight gain.
Dosing: The starting dose for glimepiride is generally 1 or 2 mg once daily with breakfast or the first meal of the day. We can increase this dose, usually every 1 to 2 weeks, up to a maximum of 8 mg daily. Glimepiride works in your body for 24 hours, so it really only needs to be taken once a day – a good thing because who wants to remember more pills!
As with all of the other meds in this class, glimepiride must be taken with food to avoid hypoglycemia (dangerously low blood sugar). If you want to read more about hypoglycemia, including what it feels like and how to treat it, please visit this link.
Side effects: The most common side effect of glimepiride is hypoglycemia. We want your blood sugar to be a certain level, not too high and not too low, because too low can cause many problems (remember, sugar is energy for your body). The lower your fasting blood sugar is before you start taking glimepiride for the first time, the more likely you will be to have hypoglycemia when on the medication. Also, if you exercise frequently or lose a lot of weight, you may find that you start having too low of blood sugars when on glimepiride. And no, I am not telling you that so that you don’t exercise or lose weight – please know that a healthy weight is what I want for you! But know that if you lose the weight and are consistent with your exercise, your doctor might need to change your med at some point.
Who should not take glimepiride: If you have a sulfa allergy, you should not take glimepiride because it contains a sulfa molecule. If your diet is inconsistent or you have a history of low blood sugars, you should probably not take glimepiride because of the chance of hypoglycemia. If you are pregnant, breastfeeding, or have kidney or liver problems, your doctor will probably use a different medication other than glimepiride for your diabetes.
Drug interactions: Some medications that can interact with glimepiride and make it work better or worse include certain blood pressure medications, diuretics (“water pills”), blood thinners, salicylates (like aspirin), and certain antidepressants. You should not drink alcohol when taking this medication.
Remember, check with your local pharmacist or doctor before starting any new medications, both prescription and over-the-counter. And make sure your pharmacy is aware of all medications that you take so that your pharmacist can check for drug interactions when you come in with a prescription.
Monitoring: As always, you will have to check your blood sugars daily while on glimepiride. Your doctor will need to check your A1c once or twice a year at least – this tells them how well your medications and daily habits are working to treat your diabetes.
Place in therapy for diabetes: Glimepiride is usually used when metformin has not worked or is not an option for you. When type 2 diabetes gets severe or progresses, sometimes your body no longer produces insulin, so then glimepiride might not be the option for you.
If you would like to read more about glimepiride, you can do so here.
Next week we will continue into a new class of medications. Aren’t you excited? I am! Stay tuned!
As a disclaimer, I am your “virtual” pharmacist, here to provide you with information and answers to questions. However, I am not your local pharmacist and could, in no way, be aware of your specific medical needs. Remember to always check with your medical provider and pharmacist before stopping or starting any new medications. My posts are based on general pharmacy principles and should not considered as your “first opinion” when it comes to your health. Please consult with your doctor and pharmacist about anything regarding your health.