Glimepiride: Difference between revisions

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{{DrugProjectFormSinglePage
{{DrugProjectFormSinglePage
|authorTag=<!--Overview-->
|authorTag={{DB}}
|genericName=Glimepiride
|aOrAn=a
|aOrAn=a
|drugClass=hypoglycemic agent
|indicationType=treatment
|indication=type 2 diabetes mellitus
|hasBlackBoxWarning=Yes
|hasBlackBoxWarning=Yes
|adverseReactions=Endocrine metabolic: Hypoglycemia (adults, 4% to 19.7%; pediatrics, 4% )
|adverseReactions=hypoglycemia, headache, nausea, and dizziness
Gastrointestinal: Nausea (5% )
Neurologic: Asthenia, Dizziness (5% ), Headache (8.2% )
|blackBoxWarningTitle=Title
|blackBoxWarningTitle=Title
|blackBoxWarningBody=<i><span style="color:#FF0000;">ConditionName: </span></i>
|blackBoxWarningBody=<i><span style="color:#FF0000;">ConditionName: </span></i>
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<!--FDA-Labeled Indications and Dosage (Adult)-->
<!--FDA-Labeled Indications and Dosage (Adult)-->
|fdaLIADAdult======Condition1=====
|fdaLIADAdult======Type 2 Diabetes Mellitus=====


* Dosing Information
*Glimepiride is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.
 
:* Dosage
 
=====Condition2=====


* Dosing Information
'''Important Limitations of Use'''


:* Dosage
*Glimepiride tablets should not be used for the treatment of type 1 diabetes mellitus or diabetic ketoacidosis, as it would not be effective in these settings.


=====Condition3=====


* Dosing Information
* Dosing Information


:* Dosage
:*Glimepiride tablets should be administered with breakfast or the first main meal of the day.


=====Condition4=====
:*The recommended starting dose of glimepiride tablet is 1 mg or 2 mg once daily. Patients at increased risk for hypoglycemia (e.g., the elderly or patients with renal impairment) should be started on 1 mg once daily.


* Dosing Information
:*After reaching a daily dose of 2 mg, further dose increases can be made in increments of 1 mg or 2 mg based upon the patient’s glycemic response. Uptitration should not occur more frequently than every 1 to 2 weeks. A conservative titration scheme is recommended for patients at increased risk for hypoglycemia.


:* Dosage
:*The maximum recommended dose is 8 mg once daily.


<!--Off-Label Use and Dosage (Adult)-->
:*Patients being transferred to glimepiride from longer half-life sulfonylureas (e.g., chlorpropamide) may have overlapping drug effect for 1 to 2 weeks and should be appropriately monitored for hypoglycemia.


<!--Guideline-Supported Use (Adult)-->
:*When colesevelam is coadministered with glimepiride, maximum plasma concentration and total exposure to glimepiride is reduced. Therefore, glimepiride should be administered at least 4 hours prior to colesevelam.
|offLabelAdultGuideSupport======Condition1=====
|offLabelAdultGuideSupport======Condition1=====


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<!--Contraindications-->
<!--Contraindications-->
|contraindications=* Condition1
|contraindications= Glimepiride tablet is contraindicated in patients with a history of a hypersensitivity reaction to:
 
    Glimepiride or any of the product’s ingredients [see Warnings and Precautions ( 5.2 )].


<!--Warnings-->
Sulfonamide derivatives: Patients who have developed an allergic reaction to sulfonamide derivatives may develop an allergic reaction to glimepiride. Do not use glimepiride in patients who have a history of an allergic reaction to sulfonamide derivatives.
 
Reported hypersensitivity reactions include cutaneous eruptions with or without pruritus as well as more serious reactions (e.g. anaphylaxis, angioedema, Stevens-Johnson Syndrome, dyspnea) [see Warnings and Precautions (5.2) and Adverse Reactions (6.2)].
|warnings=* Description
|warnings=* Description


Line 266: Line 267:


<!--Administration and Monitoring-->
<!--Administration and Monitoring-->
|administration=* Oral
|administration='''Recommended Dosing'''
 
*Glimepiride tablets should be administered with breakfast or the first main meal of the day.
 
*The recommended starting dose of glimepiride tablet is 1 mg or 2 mg once daily. Patients at increased risk for hypoglycemia (e.g., the elderly or patients with renal impairment) should be started on 1 mg once daily.
 
*After reaching a daily dose of 2 mg, further dose increases can be made in increments of 1 mg or 2 mg based upon the patient’s glycemic response. Uptitration should not occur more frequently than every 1 to 2 weeks. A conservative titration scheme is recommended for patients at increased risk for hypoglycemia.
 
*The maximum recommended dose is 8 mg once daily.
 
*Patients being transferred to glimepiride from longer half-life sulfonylureas (e.g., chlorpropamide) may have overlapping drug effect for 1 to 2 weeks and should be appropriately monitored for hypoglycemia.
 
*When colesevelam is coadministered with glimepiride, maximum plasma concentration and total exposure to glimepiride is reduced. Therefore, glimepiride should be administered at least 4 hours prior to colesevelam.
 
'''Dosage forms and strengths'''
 
* Glimepiride tablet is formulated as tablets of:


* Intravenous
:*1 mg tablets (pink coloured, oval shaped, biconvex, uncoated tablets debossed with ‘AHI 1’ on one side and break line on the other)
:*2 mg tablets (green coloured, oval shaped, biconvex, uncoated tablets debossed with ‘AHI 2’ on one side and break line on the other)
:*4 mg tablets (blue coloured, oval shaped, biconvex, uncoated tablets debossed with ‘AHI 4’ on one side and break line on the other)
|monitoring=There is limited information regarding <i>Monitoring</i> of {{PAGENAME}} in the drug label.
|monitoring=There is limited information regarding <i>Monitoring</i> of {{PAGENAME}} in the drug label.



Revision as of 13:34, 14 October 2014

Glimepiride
Black Box Warning
Adult Indications & Dosage
Pediatric Indications & Dosage
Contraindications
Warnings & Precautions
Adverse Reactions
Drug Interactions
Use in Specific Populations
Administration & Monitoring
Overdosage
Pharmacology
Clinical Studies
How Supplied
Images
Patient Counseling Information
Precautions with Alcohol
Brand Names
Look-Alike Names

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Deepika Beereddy, MBBS [2]

Disclaimer

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Black Box Warning

Title
See full prescribing information for complete Boxed Warning.
ConditionName:
  • Content

Overview

Glimepiride is a hypoglycemic agent that is FDA approved for the treatment of type 2 diabetes mellitus. There is a Black Box Warning for this drug as shown here. Common adverse reactions include hypoglycemia, headache, nausea, and dizziness.

Adult Indications and Dosage

FDA-Labeled Indications and Dosage (Adult)

Type 2 Diabetes Mellitus
  • Glimepiride is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.

Important Limitations of Use

  • Glimepiride tablets should not be used for the treatment of type 1 diabetes mellitus or diabetic ketoacidosis, as it would not be effective in these settings.


  • Dosing Information
  • Glimepiride tablets should be administered with breakfast or the first main meal of the day.
  • The recommended starting dose of glimepiride tablet is 1 mg or 2 mg once daily. Patients at increased risk for hypoglycemia (e.g., the elderly or patients with renal impairment) should be started on 1 mg once daily.
  • After reaching a daily dose of 2 mg, further dose increases can be made in increments of 1 mg or 2 mg based upon the patient’s glycemic response. Uptitration should not occur more frequently than every 1 to 2 weeks. A conservative titration scheme is recommended for patients at increased risk for hypoglycemia.
  • The maximum recommended dose is 8 mg once daily.
  • Patients being transferred to glimepiride from longer half-life sulfonylureas (e.g., chlorpropamide) may have overlapping drug effect for 1 to 2 weeks and should be appropriately monitored for hypoglycemia.
  • When colesevelam is coadministered with glimepiride, maximum plasma concentration and total exposure to glimepiride is reduced. Therefore, glimepiride should be administered at least 4 hours prior to colesevelam.

Off-Label Use and Dosage (Adult)

Guideline-Supported Use

Condition1
  • Developed by:
  • Class of Recommendation:
  • Strength of Evidence:
  • Dosing Information
  • Dosage
Condition2

There is limited information regarding Off-Label Guideline-Supported Use of Glimepiride in adult patients.

Non–Guideline-Supported Use

Condition1
  • Dosing Information
  • Dosage
Condition2

There is limited information regarding Off-Label Non–Guideline-Supported Use of Glimepiride in adult patients.

Pediatric Indications and Dosage

FDA-Labeled Indications and Dosage (Pediatric)

Condition1
  • Dosing Information
  • Dosage
Condition2

There is limited information regarding FDA-Labeled Use of Glimepiride in pediatric patients.

Off-Label Use and Dosage (Pediatric)

Guideline-Supported Use

Condition1
  • Developed by:
  • Class of Recommendation:
  • Strength of Evidence:
  • Dosing Information
  • Dosage
Condition2

There is limited information regarding Off-Label Guideline-Supported Use of Glimepiride in pediatric patients.

Non–Guideline-Supported Use

Condition1
  • Dosing Information
  • Dosage
Condition2

There is limited information regarding Off-Label Non–Guideline-Supported Use of Glimepiride in pediatric patients.

Contraindications

Glimepiride tablet is contraindicated in patients with a history of a hypersensitivity reaction to:

   Glimepiride or any of the product’s ingredients [see Warnings and Precautions ( 5.2 )]. 

Sulfonamide derivatives: Patients who have developed an allergic reaction to sulfonamide derivatives may develop an allergic reaction to glimepiride. Do not use glimepiride in patients who have a history of an allergic reaction to sulfonamide derivatives.

Reported hypersensitivity reactions include cutaneous eruptions with or without pruritus as well as more serious reactions (e.g. anaphylaxis, angioedema, Stevens-Johnson Syndrome, dyspnea) [see Warnings and Precautions (5.2) and Adverse Reactions (6.2)].

Warnings

Title
See full prescribing information for complete Boxed Warning.
ConditionName:
  • Content
  • Description

Precautions

  • Description

Adverse Reactions

Clinical Trials Experience

There is limited information regarding Clinical Trial Experience of Glimepiride in the drug label.

Body as a Whole
Cardiovascular
Digestive
Endocrine
Hematologic and Lymphatic
Metabolic and Nutritional
Musculoskeletal
Neurologic
Respiratory
Skin and Hypersensitivy Reactions
Special Senses
Urogenital
Miscellaneous

Postmarketing Experience

There is limited information regarding Postmarketing Experience of Glimepiride in the drug label.

Body as a Whole
Cardiovascular
Digestive
Endocrine
Hematologic and Lymphatic
Metabolic and Nutritional
Musculoskeletal
Neurologic
Respiratory
Skin and Hypersensitivy Reactions
Special Senses
Urogenital
Miscellaneous

Drug Interactions

  • Drug
  • Description

Use in Specific Populations

Pregnancy

Pregnancy Category (FDA):

  • Pregnancy Category


Pregnancy Category (AUS):

  • Australian Drug Evaluation Committee (ADEC) Pregnancy Category

There is no Australian Drug Evaluation Committee (ADEC) guidance on usage of Glimepiride in women who are pregnant.

Labor and Delivery

There is no FDA guidance on use of Glimepiride during labor and delivery.

Nursing Mothers

There is no FDA guidance on the use of Glimepiride with respect to nursing mothers.

Pediatric Use

There is no FDA guidance on the use of Glimepiride with respect to pediatric patients.

Geriatic Use

There is no FDA guidance on the use of Glimepiride with respect to geriatric patients.

Gender

There is no FDA guidance on the use of Glimepiride with respect to specific gender populations.

Race

There is no FDA guidance on the use of Glimepiride with respect to specific racial populations.

Renal Impairment

There is no FDA guidance on the use of Glimepiride in patients with renal impairment.

Hepatic Impairment

There is no FDA guidance on the use of Glimepiride in patients with hepatic impairment.

Females of Reproductive Potential and Males

There is no FDA guidance on the use of Glimepiride in women of reproductive potentials and males.

Immunocompromised Patients

There is no FDA guidance one the use of Glimepiride in patients who are immunocompromised.

Administration and Monitoring

Administration

Recommended Dosing

  • Glimepiride tablets should be administered with breakfast or the first main meal of the day.
  • The recommended starting dose of glimepiride tablet is 1 mg or 2 mg once daily. Patients at increased risk for hypoglycemia (e.g., the elderly or patients with renal impairment) should be started on 1 mg once daily.
  • After reaching a daily dose of 2 mg, further dose increases can be made in increments of 1 mg or 2 mg based upon the patient’s glycemic response. Uptitration should not occur more frequently than every 1 to 2 weeks. A conservative titration scheme is recommended for patients at increased risk for hypoglycemia.
  • The maximum recommended dose is 8 mg once daily.
  • Patients being transferred to glimepiride from longer half-life sulfonylureas (e.g., chlorpropamide) may have overlapping drug effect for 1 to 2 weeks and should be appropriately monitored for hypoglycemia.
  • When colesevelam is coadministered with glimepiride, maximum plasma concentration and total exposure to glimepiride is reduced. Therefore, glimepiride should be administered at least 4 hours prior to colesevelam.

Dosage forms and strengths

  • Glimepiride tablet is formulated as tablets of:
  • 1 mg tablets (pink coloured, oval shaped, biconvex, uncoated tablets debossed with ‘AHI 1’ on one side and break line on the other)
  • 2 mg tablets (green coloured, oval shaped, biconvex, uncoated tablets debossed with ‘AHI 2’ on one side and break line on the other)
  • 4 mg tablets (blue coloured, oval shaped, biconvex, uncoated tablets debossed with ‘AHI 4’ on one side and break line on the other)

Monitoring

There is limited information regarding Monitoring of Glimepiride in the drug label.

  • Description

IV Compatibility

There is limited information regarding IV Compatibility of Glimepiride in the drug label.

Overdosage

Acute Overdose

Signs and Symptoms

  • Description

Management

  • Description

Chronic Overdose

There is limited information regarding Chronic Overdose of Glimepiride in the drug label.

Pharmacology

There is limited information regarding Glimepiride Pharmacology in the drug label.

Mechanism of Action

Structure

File:Glimepiride01.png
This image is provided by the National Library of Medicine.

Pharmacodynamics

There is limited information regarding Pharmacodynamics of Glimepiride in the drug label.

Pharmacokinetics

There is limited information regarding Pharmacokinetics of Glimepiride in the drug label.

Nonclinical Toxicology

There is limited information regarding Nonclinical Toxicology of Glimepiride in the drug label.

Clinical Studies

There is limited information regarding Clinical Studies of Glimepiride in the drug label.

How Supplied

Storage

There is limited information regarding Glimepiride Storage in the drug label.

Images

Drug Images

{{#ask: Page Name::Glimepiride |?Pill Name |?Drug Name |?Pill Ingred |?Pill Imprint |?Pill Dosage |?Pill Color |?Pill Shape |?Pill Size (mm) |?Pill Scoring |?NDC |?Drug Author |format=template |template=DrugPageImages |mainlabel=- |sort=Pill Name }}

Package and Label Display Panel

{{#ask: Label Page::Glimepiride |?Label Name |format=template |template=DrugLabelImages |mainlabel=- |sort=Label Page }}

Patient Counseling Information

There is limited information regarding Patient Counseling Information of Glimepiride in the drug label.

Precautions with Alcohol

  • Alcohol-Glimepiride interaction has not been established. Talk to your doctor about the effects of taking alcohol with this medication.

Brand Names

Amaryl

Look-Alike Drug Names

Drug Shortage Status

Price

References

The contents of this FDA label are provided by the National Library of Medicine.

  1. "http://www.ismp.org". External link in |title= (help)

{{#subobject:

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 |Pill Color=|+sep=;
 |Pill Shape=
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{{#subobject:

 |Label Page=Glimepiride
 |Label Name=Glimepiride11.png

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{{#subobject:

 |Label Page=Glimepiride
 |Label Name=Glimepiride11.png

}}

Synonyms / Brand Names: Glimepirid, Glimepirida, Glimepiridum, Glimepride, Amarel, Amaryl, Endial, Novo-glimepiride, PMS-glimepiride, Ratio-glimepiride, Sandoz glimepiride

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [3]

Dosing and Administration

The usual starting dose of Glimepiride as initial therapy is 1 to 2 mg once daily, administered with breakfast or the first main meal. Those patients who may be more sensitive to hypoglycemic drugs should be started at 1 mg once daily, and should be titrated carefully.
No exact dosage relationship exists between Glimepiride and the other oral hypoglycemic agents. The maximum starting dose of Glimepiride should be no more than 2 mg.
Failure to follow an appropriate dosage regimen may precipitate hypoglycemia. Patients who do not adhere to their prescribed dietary and drug regimen are more prone to exhibit unsatisfactory response to therapy.



FDA Package Insert Resources
Indications, Contraindications, Side Effects, Drug Interactions, etc.

Calculate Creatine Clearance
On line calculator of your patients Cr Cl by a variety of formulas.

Convert pounds to Kilograms
On line calculator of your patients weight in pounds to Kg for dosing estimates.

Publication Resources
Recent articles, WikiDoc State of the Art Review, Textbook Information

Trial Resources
Ongoing Trials, Trial Results

Guidelines & Evidence Based Medicine Resources
US National Guidelines, Cochrane Collaboration, etc.

Media Resources
Slides, Video, Images, MP3, Podcasts, etc.

Patient Resources
Discussion Groups, Handouts, Blogs, News, etc.

International Resources
en Español






FDA Package Insert Resources

Indications

Contraindications

Side Effects

Drug Interactions

Precautions

Overdose

Instructions for Administration

How Supplied

Pharmacokinetics and Molecular Data

FDA label

FDA on Glimepiride

Return to top

Publication Resources

Most Recent Articles on Glimepiride

Review Articles on Glimepiride

Articles on Glimepiride in N Eng J Med, Lancet, BMJ

WikiDoc State of the Art Review

Textbook Information on Glimepiride

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Trial Resources

Ongoing Trials with Glimepiride at Clinical Trials.gov

Trial Results with Glimepiride

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Guidelines & Evidence Based Medicine Resources

US National Guidelines Clearinghouse on Glimepiride

Cochrane Collaboration on Glimepiride

Cost Effectiveness of Glimepiride

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Media Resources

Powerpoint Slides on Glimepiride

Images of Glimepiride

Podcasts & MP3s on Glimepiride

Videos on Glimepiride

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Patient Resources

Patient Information from National Library of Medicine

Patient Resources on Glimepiride

Discussion Groups on Glimepiride

Patient Handouts on Glimepiride

Blogs on Glimepiride

Glimepiride in the News

Glimepiride in the Marketplace

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International Resources

Glimepiride en Español

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Adapted from the FDA Package Insert.