ﺑﺎﺯﮔﺸﺖ ﺑﻪ ﺻﻔﺤﻪ ﻗﺒﻠﯽ
خرید پکیج
تعداد آیتم قابل مشاهده باقیمانده : 3 مورد
نسخه الکترونیک
medimedia.ir

Glimepiride: Drug information

Glimepiride: Drug information
(For additional information see "Glimepiride: Patient drug information")

For abbreviations, symbols, and age group definitions used in Lexicomp (show table)
Brand Names: US
  • Amaryl [DSC]
Brand Names: Canada
  • APO-Glimepiride [DSC];
  • GEN-Glimepiride;
  • SANDOZ Glimepiride
Pharmacologic Category
  • Antidiabetic Agent, Sulfonylurea
Dosing: Adult
Diabetes mellitus, type 2, treatment

Diabetes mellitus, type 2, treatment:

Note: May be used as an adjunctive agent or alternative monotherapy for patients in whom initial therapy with lifestyle intervention and metformin failed or who cannot take metformin. Sulfonylureas are associated with a greater risk of hypoglycemia than other noninsulin antidiabetic agents; if one is chosen, a sulfonylurea with a lower relative risk of hypoglycemia (eg, glimepiride, glipizide) is preferred (Ref).

Oral: Initial: 1 to 2 mg once daily with the first main meal; in patients whose glycemic levels are close to goal, use lower initial doses (eg, 1 mg once daily) to reduce the risk of hypoglycemia (Ref). In patients with severe hyperglycemia (eg, fasting glucose >250 mg/dL, HbA1c >9%) without ketonuria or spontaneous weight loss and in whom type 1 diabetes mellitus is unlikely, some experts use a higher initial dose of 4 to 8 mg once daily (Ref).

Dosage adjustment: May increase dose in 1 to 2 mg increments every 1 to 4 weeks if needed to achieve glycemic goals; usual maintenance dose: 2 to 4 mg/day (maximum: 8 mg/day) (Ref). Note: Increasing dosage from 4 to 8 mg/day may only provide modest glycemic benefit (Ref). The 8 mg/day dosage may be administered in 1 or 2 divided doses (Ref).

Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.

Dosing: Kidney Impairment: Adult

The renal dosing recommendations are based upon the best available evidence and clinical expertise. Senior Editorial Team: Bruce Mueller, PharmD, FCCP, FASN, FNKF; Jason Roberts, PhD, BPharm (Hons), B App Sc, FSHP, FISAC; Michael Heung, MD, MS.

Altered kidney function:

eGFR >60 mL/minute/1.73 m2: No dosage adjustment necessary.

eGFR 15 to 60 mL/minute/1.73 m2: Renal clearance of active metabolites may be reduced, leading to increased risk of hypoglycemia; consider initiating at a low dose (eg, 1 mg daily) and titrating cautiously (Ref).

eGFR <15 mL/minute/1.73 m2: Avoid use (Ref); agents other than sulfonylureas are preferred due to risk of hypoglycemia (Ref). However, if a sulfonylurea is used, agents with a shorter half-life and no active metabolites (eg, glipizide) may be preferred to reduce the risk of hypoglycemia (Ref).

Hemodialysis, intermittent (thrice weekly): Unlikely to be significantly dialyzable (highly protein bound) (Ref):

Avoid use (Ref); agents other than sulfonylureas are preferred due to risk of hypoglycemia (Ref). However, if a sulfonylurea is used, agents with a shorter half-life and no active metabolites (eg, glipizide) may be preferred to reduce the risk of hypoglycemia (Ref).

Peritoneal dialysis: Unlikely to be significantly dialyzable (highly protein bound) (Ref):

Avoid use (Ref); agents other than sulfonylureas are preferred due to risk of hypoglycemia (Ref). However, if a sulfonylurea is used, agents with a shorter half-life and no active metabolites (eg, glipizide) may be preferred to reduce the risk of hypoglycemia (Ref).

CRRT: Avoid use (Ref).

PIRRT (eg, sustained, low-efficiency diafiltration): Avoid use (Ref).

Dosing: Hepatic Impairment: Adult

There are no dosage adjustments provided in the manufacturer’s labeling (has not been studied). Titrate carefully due to potential for increased hypoglycemia in patients with hepatic impairment.

Dosing: Older Adult

Note: Use of sulfonylureas (eg, glimepiride) is associated with increased risk of hypoglycemia. The American Diabetes Association suggests using sulfonylureas with caution, and notes preference for glimepiride (or glipizide) due to lower relative risk of hypoglycemia compared to other sulfonylureas (Ref).

In cases where glimepiride is used, initiate at 1 mg once daily and monitor closely (Ref).

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.

>10%: Endocrine & metabolic: Hypoglycemia (4% to 20%)

1% to 10%:

Central nervous system: Dizziness (2%), headache

Gastrointestinal: Nausea (5%)

Hepatic: Increased serum ALT (2%)

Respiratory: Flu-like symptoms (5%)

Miscellaneous: Accidental injury (6%)

<1%, postmarketing, and/or case reports: Abnormal hepatic function tests, accommodation disturbance (early treatment), agranulocytosis, alopecia, anaphylaxis, angioedema, aplastic anemia, cholestatic jaundice, diarrhea, disulfiram-like reaction, dysgeusia, dyspnea, erythema, gastrointestinal pain, hemolytic anemia, hepatic failure, hepatic insufficiency, hepatic porphyria, hepatitis, hypersensitivity, hypersensitivity angiitis, hyponatremia, hypotension, immune thrombocytopenia, leukopenia, maculopapular rash, morbilliform rash, pancytopenia, porphyria cutanea tarda, pruritus, shock, SIADH, skin photosensitivity, Stevens-Johnson syndrome, thrombocytopenia, urticaria, vomiting, weight gain

Contraindications

Hypersensitivity to glimepiride, any component of the formulation, or sulfonamides

Note: Although the FDA-approved product labeling states this medication is contraindicated in patients with hypersensitivity to sulfonamide-containing drugs, the scientific basis of this cross-sensitivity has been challenged. See “Warnings/Precautions” for more detail.

Canadian labeling: Additional contraindications (not in US labeling): Pregnancy; breastfeeding; type 1 diabetes; diabetic ketoacidosis (with or without coma); severe renal or hepatic impairment

Warnings/Precautions

Concerns related to adverse effects:

• Cardiovascular mortality: Product labeling states oral hypoglycemic drugs may be associated with an increased cardiovascular mortality as compared to treatment with diet alone or diet plus insulin. Data to support this association are limited, and several studies, including a large prospective trial (UKPDS 1998), have not supported an association. In a prospective, active-controlled study comparing linagliptin to glimepiride in patients with high baseline cardiovascular risk, the rates of cardiovascular events were similar over ~6 years (Rosenstock 2019). In patients with established atherosclerotic cardiovascular disease, other agents (eg, with demonstrated cardiovascular risk reduction) are preferred (ADA 2023).

• Hypoglycemia: All sulfonylurea drugs are capable of producing severe hypoglycemia. Hypoglycemia is more likely to occur when caloric intake is deficient, after severe or prolonged exercise, when ethanol is ingested, or when more than one glucose-lowering drug is used. It is also more likely in elderly patients, malnourished patients, and in patients with impaired renal or hepatic function; use with caution.

• Sulfonamide (“sulfa”) allergy: The FDA-approved product labeling for many medications containing a sulfonamide chemical group includes a broad contraindication in patients with a prior allergic reaction to sulfonamides. There is a potential for cross-reactivity between members of a specific class (eg, two antibiotic sulfonamides). However, concerns for cross-reactivity have previously extended to all compounds containing the sulfonamide structure (SO2NH2). An expanded understanding of allergic mechanisms indicates cross-reactivity between antibiotic sulfonamides and nonantibiotic sulfonamides may not occur or, at the very least, this potential is extremely low (Brackett 2004; Johnson 2005; Slatore 2004; Tornero 2004). In particular, mechanisms of cross-reaction due to antibody production (anaphylaxis) are unlikely to occur with nonantibiotic sulfonamides. T-cell-mediated (type IV) reactions (eg, maculopapular rash) are less well understood and it is not possible to completely exclude this potential based on current insights. In cases where prior reactions were severe (Stevens-Johnson syndrome/TEN), some clinicians choose to avoid exposure to these classes.

Disease-related concerns:

• Bariatric surgery:

– Altered absorption: Use IR formulations after surgery to minimize the potential effects of bypassing stomach and proximal small bowel with gastric bypass or more rapid gastric emptying and proximal small bowel transit with sleeve gastrectomy (Apovian 2015). ER formulations may have altered release and absorption patterns after gastric bypass or sleeve gastrectomy (but not gastric band). Compared to control, Tmax in a gastric bypass cohort administered tolbutamide was significantly shorter (1.4 ± 1.8 vs 5.1 ± 1.7 hours; P < 0.001), while Cmax and AUC0- were not altered (Tandra 2013).

– Hypoglycemia: Use an antidiabetic agent without the potential for hypoglycemia if possible; hypoglycemia may occur after gastric bypass, sleeve gastrectomy, and gastric band (Mechanick 2020). Insulin secretion and sensitivity may be partially or completely restored after these procedures (gastric bypass is most effective, followed by sleeve, and finally band) (Korner 2009; Peterli 2012). First-phase insulin secretion and hepatic insulin sensitivity have been shown to be significantly improved in the immediate days after gastric bypass and sleeve gastrectomy. The restorative effects of these procedures on peripheral insulin sensitivity may occur later in the 3- to 12-month period postsurgery (Mingrone 2016).

– Weight gain: Evaluate risk vs benefit and consider alternative therapy after gastric bypass, sleeve gastrectomy, and gastric banding; weight gain may occur (Apovian 2015).

• Glucose-6-phosphate dehydrogenase (G6PD) deficiency: Patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency may be at an increased risk of sulfonylurea-induced hemolytic anemia; however, cases have also been described in patients without G6PD deficiency during postmarketing surveillance. Use with caution and consider a nonsulfonylurea alternative in patients with G6PD deficiency.

• Hepatic impairment: Use with caution; patients with hepatic impairment are more likely to develop hypoglycemia.

• Renal impairment: Use with caution and reduce dosage; patients with renal impairment are more likely to develop hypoglycemia.

• Stress-related states: It may be necessary to discontinue therapy and administer insulin if the patient is exposed to stress (eg, fever, trauma, infection, surgery).

Special populations:

• CYP2C9 genotype: Systemic exposure of glimepiride is increased in patients with CYP2C9*3 allele (Niemi 2002).

• Older adult: Use with caution; older adult patients are more likely to develop hypoglycemia.

Other warnings/precautions:

• Appropriate use: Not indicated for use in patients with type 1 diabetes mellitus or with diabetic ketoacidosis.

• Hospitalized patients: Consider temporary discontinuation of noninsulin antidiabetic agents and initiation or continuation of insulin therapy during hospitalization (ADA 2023). In noncritically ill hospitalized patients, continued use of glimepiride may be considered if there are no contraindications, regular nutritional intake is expected, and blood glucose is well controlled; close monitoring and subsequent dosage adjustments are recommended (ADA/AACE [Moghissi 2009]; Bogun 2013; Inzucchi 2006).

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Tablet, Oral:

Amaryl: 1 mg [DSC] [scored]

Amaryl: 2 mg [DSC], 4 mg [DSC] [scored; contains fd&c blue #2 (indigo carm) aluminum lake]

Generic: 1 mg, 2 mg, 4 mg

Generic Equivalent Available: US

Yes

Pricing: US

Tablets (Glimepiride Oral)

1 mg (per each): $0.40 - $1.08

2 mg (per each): $0.64 - $1.75

4 mg (per each): $1.22 - $3.30

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.

Dosage Forms: Canada

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Tablet, Oral:

Generic: 1 mg, 2 mg, 4 mg

Administration: Adult

Oral: Administer once daily with breakfast or first main meal of the day. Patients that are NPO or require decreased caloric intake may need doses held to avoid hypoglycemia.

Use: Labeled Indications

Diabetes mellitus, type 2, treatment: As an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.

Medication Safety Issues
Sound-alike/look-alike issues:

Glimepiride may be confused with glipiZIDE.

Amaryl may be confused with Altace, Amerge.

High alert medication:

The Institute for Safe Medication Practices (ISMP) includes this medication among its list of drugs which have a heightened risk of causing significant patient harm when used in error.

Older Adult: High-Risk Medication:

Avoid routine use of sulfonylureas due to increased risk of hypoglycemia; however, if a sulfonylurea is needed, one with a lower relative risk of hypoglycemia (eg, gliclazide, glimepiride, glipizide) is preferred (ADA 2022; Beers Criteria [AGS 2023]; Diabetes Canada 2018).

International issues:

Amarel [France], Amaryl [US, Canada, and multiple international markets] may be confused with Reminyl brand name for galantamine [multiple international markets].

Amaryl [US, Canada, and multiple international markets] may be confused with Almarl brand name for arotinolol [Japan].

Metabolism/Transport Effects

Substrate of CYP2C9 (major), OATP1B1/1B3 (SLCO1B1/1B3); Note: Assignment of Major/Minor substrate status based on clinically relevant drug interaction potential

Drug Interactions

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the Lexicomp drug interactions program by clicking on the “Launch drug interactions program” link above.

Ajmaline: Sulfonamides may enhance the adverse/toxic effect of Ajmaline. Specifically, the risk for cholestasis may be increased. Risk C: Monitor therapy

Alcohol (Ethyl): Sulfonylureas may enhance the adverse/toxic effect of Alcohol (Ethyl). A flushing reaction may occur. Risk C: Monitor therapy

Alpelisib: May decrease the serum concentration of CYP2C9 Substrates (High risk with Inducers). Risk C: Monitor therapy

Alpha-Glucosidase Inhibitors: May enhance the hypoglycemic effect of Sulfonylureas. Management: Consider a decrease in sulfonylurea dose when initiating therapy with an alpha-glucosidase inhibitor and monitor patients for hypoglycemia. Risk D: Consider therapy modification

Alpha-Lipoic Acid: May enhance the hypoglycemic effect of Antidiabetic Agents. Risk C: Monitor therapy

Aminolevulinic Acid (Systemic): Photosensitizing Agents may enhance the photosensitizing effect of Aminolevulinic Acid (Systemic). Risk X: Avoid combination

Aminolevulinic Acid (Topical): Photosensitizing Agents may enhance the photosensitizing effect of Aminolevulinic Acid (Topical). Risk C: Monitor therapy

Amiodarone: May enhance the hypoglycemic effect of Sulfonylureas. Risk C: Monitor therapy

Androgens: May enhance the hypoglycemic effect of Agents with Blood Glucose Lowering Effects. Risk C: Monitor therapy

Antidiabetic Agents: May enhance the hypoglycemic effect of Hypoglycemia-Associated Agents. Risk C: Monitor therapy

Beta-Blockers (Beta1 Selective): May enhance the hypoglycemic effect of Antidiabetic Agents. Risk C: Monitor therapy

Beta-Blockers (Nonselective): May enhance the hypoglycemic effect of Sulfonylureas. Beta-Blockers (Nonselective) may diminish the therapeutic effect of Sulfonylureas. Risk C: Monitor therapy

Bortezomib: May enhance the therapeutic effect of Antidiabetic Agents. Bortezomib may diminish the therapeutic effect of Antidiabetic Agents. Risk C: Monitor therapy

Carbocisteine: Sulfonylureas may enhance the adverse/toxic effect of Carbocisteine. Specifically, sulfonylureas may enhance adverse effects of alcohol that is present in liquid formulations of carbocisteine-containing products. Risk C: Monitor therapy

Chloramphenicol (Systemic): May increase the serum concentration of Sulfonylureas. Risk C: Monitor therapy

Clarithromycin: May enhance the hypoglycemic effect of Sulfonylureas. Risk C: Monitor therapy

Colesevelam: May decrease the serum concentration of Glimepiride. Management: Administer glimepiride at least 4 hours prior to colesevelam. Risk D: Consider therapy modification

CYP2C9 Inducers (Moderate): May decrease the serum concentration of Sulfonylureas. Risk C: Monitor therapy

CYP2C9 Inhibitors (Moderate): May increase the serum concentration of Sulfonylureas. Risk C: Monitor therapy

Dexketoprofen: May enhance the adverse/toxic effect of Sulfonamides. Risk C: Monitor therapy

Dipeptidyl Peptidase-IV Inhibitors: May enhance the hypoglycemic effect of Sulfonylureas. Management: Consider a decrease in sulfonylurea dose when initiating therapy with a dipeptidyl peptidase-IV inhibitor and monitor patients for hypoglycemia. Risk D: Consider therapy modification

Direct Acting Antiviral Agents (HCV): May enhance the hypoglycemic effect of Antidiabetic Agents. Risk C: Monitor therapy

Elexacaftor, Tezacaftor, and Ivacaftor: May increase the serum concentration of Glimepiride. Risk C: Monitor therapy

Etilefrine: May diminish the therapeutic effect of Antidiabetic Agents. Risk C: Monitor therapy

Fibric Acid Derivatives: May enhance the hypoglycemic effect of Sulfonylureas. Risk C: Monitor therapy

Glucagon-Like Peptide-1 Agonists: May enhance the hypoglycemic effect of Sulfonylureas. Management: Consider sulfonylurea dose reductions when used in combination with glucagon-like peptide-1 agonists. Risk D: Consider therapy modification

Guanethidine: May enhance the hypoglycemic effect of Antidiabetic Agents. Risk C: Monitor therapy

Herbal Products with Glucose Lowering Effects: May enhance the hypoglycemic effect of Hypoglycemia-Associated Agents. Risk C: Monitor therapy

Hyperglycemia-Associated Agents: May diminish the therapeutic effect of Antidiabetic Agents. Risk C: Monitor therapy

Hypoglycemia-Associated Agents: May enhance the hypoglycemic effect of other Hypoglycemia-Associated Agents. Risk C: Monitor therapy

Hypoglycemia-Associated Agents: Antidiabetic Agents may enhance the hypoglycemic effect of Hypoglycemia-Associated Agents. Risk C: Monitor therapy

Lumacaftor and Ivacaftor: May decrease the serum concentration of CYP2C9 Substrates (High Risk with Inhibitors or Inducers). Lumacaftor and Ivacaftor may increase the serum concentration of CYP2C9 Substrates (High Risk with Inhibitors or Inducers). Risk C: Monitor therapy

Maitake: May enhance the hypoglycemic effect of Agents with Blood Glucose Lowering Effects. Risk C: Monitor therapy

Mecamylamine: Sulfonamides may enhance the adverse/toxic effect of Mecamylamine. Risk X: Avoid combination

Methoxsalen (Systemic): Photosensitizing Agents may enhance the photosensitizing effect of Methoxsalen (Systemic). Risk C: Monitor therapy

Metreleptin: May enhance the hypoglycemic effect of Sulfonylureas. Management: Sulfonylurea dosage adjustments (including potentially large decreases) may be required to minimize the risk for hypoglycemia with concurrent use of metreleptin. Monitor closely for signs or symptoms of hypoglycemia. Risk D: Consider therapy modification

Miconazole (Oral): May enhance the hypoglycemic effect of Sulfonylureas. Miconazole (Oral) may increase the serum concentration of Sulfonylureas. Risk C: Monitor therapy

Mitiglinide: May enhance the adverse/toxic effect of Sulfonylureas. Risk X: Avoid combination

Monoamine Oxidase Inhibitors: May enhance the hypoglycemic effect of Agents with Blood Glucose Lowering Effects. Risk C: Monitor therapy

Pegvisomant: May enhance the hypoglycemic effect of Agents with Blood Glucose Lowering Effects. Risk C: Monitor therapy

Porfimer: Photosensitizing Agents may enhance the photosensitizing effect of Porfimer. Risk C: Monitor therapy

Probenecid: May increase the serum concentration of Sulfonylureas. Risk C: Monitor therapy

Prothionamide: May enhance the hypoglycemic effect of Agents with Blood Glucose Lowering Effects. Risk C: Monitor therapy

Quinolones: May enhance the hypoglycemic effect of Agents with Blood Glucose Lowering Effects. Quinolones may diminish the therapeutic effect of Agents with Blood Glucose Lowering Effects. Specifically, if an agent is being used to treat diabetes, loss of blood sugar control may occur with quinolone use. Risk C: Monitor therapy

Rifapentine: May decrease the serum concentration of CYP2C9 Substrates (High risk with Inducers). Risk C: Monitor therapy

Ritodrine: May diminish the therapeutic effect of Antidiabetic Agents. Risk C: Monitor therapy

Salicylates: May enhance the hypoglycemic effect of Agents with Blood Glucose Lowering Effects. Risk C: Monitor therapy

Selective Serotonin Reuptake Inhibitors: May enhance the hypoglycemic effect of Agents with Blood Glucose Lowering Effects. Risk C: Monitor therapy

Sodium-Glucose Cotransporter 2 (SGLT2) Inhibitors: May enhance the hypoglycemic effect of Sulfonylureas. Management: Consider a decrease in sulfonylurea dose when initiating therapy with a sodium-glucose cotransporter 2 (SGLT2) inhibitor and monitor patients for hypoglycemia. Risk D: Consider therapy modification

Sulfonamide Antibiotics: May enhance the hypoglycemic effect of Sulfonylureas. Risk C: Monitor therapy

Tetracyclines: May enhance the hypoglycemic effect of Sulfonylureas. Risk C: Monitor therapy

Tezacaftor and Ivacaftor: May increase the serum concentration of Glimepiride. Risk C: Monitor therapy

Thiazide and Thiazide-Like Diuretics: May diminish the therapeutic effect of Antidiabetic Agents. Risk C: Monitor therapy

Thiazolidinediones: May enhance the hypoglycemic effect of Sulfonylureas. Management: Consider sulfonylurea dose adjustments in patients taking thiazolidinediones and monitor for hypoglycemia. Risk D: Consider therapy modification

Verteporfin: Photosensitizing Agents may enhance the photosensitizing effect of Verteporfin. Risk C: Monitor therapy

Vitamin K Antagonists (eg, warfarin): Sulfonylureas may enhance the anticoagulant effect of Vitamin K Antagonists. Vitamin K Antagonists may enhance the hypoglycemic effect of Sulfonylureas. Risk C: Monitor therapy

Voriconazole: May increase the serum concentration of Sulfonylureas. Risk C: Monitor therapy

Reproductive Considerations

Sulfonylureas are not recommended for patients with type 2 diabetes mellitus planning to become pregnant. Patients who could become pregnant should use effective contraception during therapy. Transition to a preferred therapy should be initiated prior to conception and contraception should be continued until glycemic control is achieved (ADA 2023; Alexopoulos 2019; Egan 2020)

Pregnancy Considerations

Information related to the use of glimepiride during pregnancy is limited (Balaguer Santamaría 2000; Kalyoncu 2005). Severe hypoglycemia lasting 4 to 10 days has been noted in infants born to mothers taking a sulfonylurea at the time of delivery. If exposure during pregnancy occurs, discontinue at least 2 weeks prior to delivery.

Poorly controlled diabetes during pregnancy can be associated with an increased risk of adverse maternal and fetal outcomes, including diabetic ketoacidosis, preeclampsia, spontaneous abortion, preterm delivery, delivery complications, major malformations, stillbirth, and macrosomia. To prevent adverse outcomes, prior to conception and throughout pregnancy, maternal blood glucose and HbA1c should be kept as close to target goals as possible but without causing significant hypoglycemia (ADA 2023; Blumer 2013).

Agents other than glimepiride are currently recommended to treat diabetes mellitus in pregnancy (ADA 2023).

Breastfeeding Considerations

It is not known if glimepiride is present in breast milk.

According to the manufacturer, the decision to breastfeed during therapy should consider the risk of infant exposure, the benefits of breastfeeding to the infant, and benefits of treatment to the mother. Monitor the breastfed infant for signs of hypoglycemia.

Dietary Considerations

Take with breakfast or the first main meal of the day. Individualized medical nutrition therapy based on American Diabetes Association recommendations is an integral part of therapy.

Monitoring Parameters

Monitor for signs and symptoms of hypoglycemia (fatigue, excessive hunger, profuse sweating, numbness of extremities), blood glucose; renal function.

HbA1c: Monitor at least twice yearly in patients who have stable glycemic control and are meeting treatment goals; monitor quarterly in patients in whom treatment goals have not been met, or with therapy change. Note: In patients prone to glycemic variability (eg, patients with insulin deficiency), or in patients whose HbA1c is discordant with serum glucose levels or symptoms, consider evaluating HbA1c in combination with blood glucose levels and/or a glucose management indicator (ADA 2023; KDIGO 2020).

Reference Range

Recommendations for glycemic control in patients with diabetes:

Nonpregnant adults with diabetes (AACE [Samson 2023], ADA 2023):

HbA1c: <7% (a more aggressive [<6.5%] or less aggressive [<8%] HbA1c goal may be targeted based on patient-specific characteristics). Note: In patients using a continuous glucose monitoring system, a goal of time in range >70% with time below range <4% is recommended and is similar to a goal HbA1c <7%.

Preprandial capillary blood glucose: 80 to 130 mg/dL (SI: 4.4 to 7.2 mmol/L) (more or less stringent goals may be appropriate based on patient-specific characteristics).

Peak postprandial capillary blood glucose (~1 to 2 hours after a meal): <180 mg/dL (SI: <10 mmol/L) (more or less stringent goals may be appropriate based on patient-specific characteristics).

Older adults (≥65 years of age) (ADA 2023): Note: Consider less strict targets in patients who are using insulin and/or insulin secretagogues (sulfonylureas, meglitinides) (ES [LeRoith 2019]).

HbA1c: <7% to 7.5% (healthy); <8% (complex/intermediate health). Note: Individualization may be appropriate based on patient and caregiver preferences and/or presence of cognitive impairment. In patients with very complex or poor health (ie, limited remaining life expectancy), consider making therapy decisions based on avoidance of hypoglycemia and symptomatic hyperglycemia rather than HbA1c level.

Preprandial capillary blood glucose: 80 to 130 mg/dL (SI: 4.4 to 7.2 mmol/L) (healthy); 90 to 150 mg/dL (SI: 5 to 8.3 mmol/L) (complex/intermediate health); 100 to 180 mg/dL (SI: 5.6 to 10 mmol/L) (very complex/poor health).

Bedtime capillary blood glucose: 80 to 180 mg/dL (SI: 4.4 to 10 mmol/L) (healthy); 100 to 180 mg/dL (SI: 5.6 to 10 mmol/L) (complex/intermediate health); 110 to 200 mg/dL (SI: 6.1 to 11.1 mmol/L) (very complex/poor health).

Classification of hypoglycemia (ADA 2023):

Level 1: 54 to 70 mg/dL; hypoglycemia alert value; initiate fast-acting carbohydrate (eg, glucose) treatment.

Level 2: <54 mg/dL (SI: <3 mmol/L); threshold for neuroglycopenic symptoms; requires immediate action.

Level 3: Hypoglycemia associated with a severe event characterized by altered mental and/or physical status requiring assistance.

Mechanism of Action

Stimulates insulin release from the pancreatic beta cells; reduces glucose output from the liver; insulin sensitivity is increased at peripheral target sites

Pharmacokinetics (Adult Data Unless Noted)

Onset of action: Peak effect: Blood glucose reductions: 2 to 3 hours

Duration: 24 hours

Absorption: 100%

Distribution: Vd: 8.8 L

Protein binding: >99.5%

Metabolism: Hepatic oxidation via CYP2C9 to M1 metabolite (~33% activity of parent compound); further oxidative metabolism to inactive M2 metabolite

Half-life elimination: 5 to 9 hours

Time to peak, plasma: 2 to 3 hours

Excretion: Urine (60%, 80% to 90% as M1 and M2 metabolites); feces (40%, 70% as M1 and M2 metabolites)

Pharmacokinetics: Additional Considerations (Adult Data Unless Noted)

Altered kidney function: As renal function declines, glimepiride serum levels decrease and metabolite (M1 and M2) AUC and half-lives increase. Patients with CrCl <20 mL/minute had 2.3-fold higher AUC of M1 (an active metabolite) compared to patients with CrCl >50 mL/minute.

Brand Names: International
International Brand Names by Country
For country code abbreviations (show table)

  • (AE) United Arab Emirates: Adglim | Amaryl | Diapride | Econid | G pride | Glim | Glimepirid hexal | Glimulin | Glypride | Melital;
  • (AR) Argentina: Adiuvan | Amaryl | Anotul | Endial | Glemaz | Gliperid | Gluceride | Glucopirida | Hipoglut | Islopir | Lomet;
  • (AT) Austria: Amaryl | Glimepirid | Glimepirid Actavis | Glimepirid stada | Glimestad;
  • (AU) Australia: Amaryl | Apo-Glimepiride | Aylide | Dimirel | Glimepiride an | Glimepiride ga | Pharmacor Glimepiride;
  • (BD) Bangladesh: Adglim | Amaryl | Condia | Dactus | Dialon | Diaryl | Dieta | Gipid | Glemep | Glimirid | Glims | Glirid | Gluconor | Glucorid | Glutim | Limep | Limpet | Losucon | Mepid | SB glim | Secrin | Senride | Stimulin;
  • (BE) Belgium: Amarylle | Dialosa | Glimepiride accord | Glimepiride Apotex;
  • (BF) Burkina Faso: Adride | Amarel | Diabetan | Fairglim | Glimed | Irys | Odia;
  • (BG) Bulgaria: Amaryl | Fertin | Glimecon | Glimegamma | Gliper | Meglimid;
  • (BR) Brazil: Amaglyn | Amaryl | Azulix | Betes | Bioglic | Diabemed | Diamellits | Diamicron | Gliansor | Glimepibal | Glimepil | Glimepirida | Glimeprid | Glimeran | Glimesec | Glycopirida | Glymryl | Hipomeril;
  • (CH) Switzerland: Amaryl | Glimepirid Helvepharm | Glimepirid sandoz | Glimepirid teva | Glimepiride zentiva | Glimerax | Glimeryl Mepha;
  • (CI) Côte d'Ivoire: Adride | Amarel | Diaglim | Glema | Glimed | Glimepiride denk | Glimepiride winthrop | Glimepro | Glimid | Glimsy 1 | Glimsy 2 | Glipiryl | Glyree | Limper | Odia;
  • (CL) Chile: Amaryl | Glemaz | Glimekem;
  • (CN) China: A mo li | Amaryl | AN DUO MEI | An ni ping | Di bei | Jia he luo | Ke de ping | Li yi ping | Rui ping | Sheng ping | Wan su ping | Ya mo li | Yi rui | You su;
  • (CO) Colombia: Amaryl | Glimepirida | Glimepirida denk | Glimepirida mk | Glimerid | Glucomet | Glucox;
  • (CZ) Czech Republic: Amaryl | Apo glimepirid | Eglymad | Glimegamma | Glimepirid +Pharma | Glimepirid aurovitas | Glimepirid sandoz | Glymexan | Medopirid | Metis | Oltar;
  • (DE) Germany: Amaryl | Glimegamma | Glimepirid | Glimepirid 1 a pharma | Glimepirid Aaa-Pharma | Glimepirid aristo | Glimepirid aurobindo | Glimepirid Heumann | Glimepiride accord | Glimepiride denk | Glimerid | Magna | Solosa;
  • (DO) Dominican Republic: Amaryl | Amyline | Aramil | Diapride | Efinex | Euroglimep | Glandin | Glimepirida | Glimepirida mk | Glimepiril | Glimeryl | Glipiride | Glunor | Glutamical | Panabutol | Piglifar | Sinperan | Zoryl;
  • (EC) Ecuador: Amaryl | Glemaz | Gliansor | Glicivin | Glimepax | Glimepirida | Glimepirida mk;
  • (EE) Estonia: Amaryl | Glimepirid Accord | Meglimid;
  • (EG) Egypt: Amaryl | Amypride | Diabenor | Diabetless | Diabeto | Diabride | Dolcyl | Gedimadel | Glaryl | Glemax | Glimadel | Glimaryl | Glimeryl | Glimitoid | Gliperide | Glucoless | Glucoryl | Reglidib | Sugarfall;
  • (ES) Spain: Amaryl | Glimepirida Actavis | Glimepirida Apotex | Glimepirida aurobindo | Glimepirida Edigen | Roname;
  • (ET) Ethiopia: Amaryl | Euglim | Glimepiride denk | Glimeryl | Glimsure | Glimulin | Glypride | Nafuril | Piramyl | S glim;
  • (FI) Finland: Amaryl | Glimepirid bmm pharma | Glimepirid orion | Glimepirid Ratiopharm | Pirtad;
  • (FR) France: Amarel | Glimepiride accord healthcare | Glimepiride actavis | Glimepiride Cristers | Glimepiride evolugen;
  • (GB) United Kingdom: Amaryl;
  • (GH) Ghana: Dexel;
  • (GR) Greece: Adinsulin-S | Anovis | Glidil | Glimepirid teva | Glimepirid/Teva | Glimepiride actavis | Glimepiride/mylan | Glimepiron | Glimespes | Glincil | Gliperin | Glirid | Raltone | Solosa | Sucryl | Tetig | Tipo II;
  • (GT) Guatemala: Daol;
  • (HK) Hong Kong: Amaryl | Diapride | Getryl | Glimaryl | Glimeryl | NIKP Glimepiride;
  • (HR) Croatia: Amaryl | Betaglid | Diapirid | Dibiglim | Glimepirid PharmaS | Meglimid | Melpamid;
  • (HU) Hungary: Amaryl | Glempid | Glimebene | Glimegamma | Glimepirid Zentiva;
  • (ID) Indonesia: Actaryl | Amadiab | Amaryl | Glamarol | Gliaride | Glimepix | Glimetic | Glimexal | Gliperid | Glucokaf | Glucoryl | Gluvas | Metrix | Pimaryl | Relide | Simryl | Velacom | Versibet;
  • (IE) Ireland: Amaryl | Glimepiride accord;
  • (IL) Israel: Amaryl;
  • (IN) India: Adride | Amaryl | Apriglim | Azulix | Betaglim | Blisto | Diaglim | Diapride | Dibiglim | Emperide | Enristas 1 | Enristas 2 | Euglim | Flexiglim | Geminor | Gepride | Glador | Glilar | Glim | Glimcare | Glimchek | Glimcip | Glimcom | Glimda | Glimefine | Glimeglu | Glimenorm | Glimer | Glimerin | Glimestar | Glimetop | Glimfirst | Glimfit | Glimicare | Glimicer | Glimicure | Glimicut | Glimid | Glimifix | Glimigraf | Glimimore | Gliminyle | Glimiprex | Glimiprime | Glimisave | Glimitab | Glimital | Glimiteo | Glimitrol | Glimixia | Glimkap | Glimp | Glimpid | Glimsite | Glimtab | Glimulin | Glimy | Glimz | Glipride | Glisen | Glisimet | Glitaray | Glucoryl | Glusens 2 | Glycipride | Glycirid | Glyfix | Glynamic | Glypar | Glypride | Glyree | Glytab | Gmr | Gp | GP 2 | Grid | Gride | Ilet | Imediab | Isryl | K-glim | Karmelitus | Limer | Maydine | Mepride | Mypride | Nabal | Normaglim | Olglimide | Prichek | Prides | Rioglim | Secretag | Semi amaryl | Sulfoglim | Supride | Ziglim | Zoryl;
  • (IT) Italy: Amaryl | Diamel | Glimepiride Acc | Glimepiride actavis | Glimepiride eg | Solosa;
  • (JO) Jordan: Amaryl | Diapride | Glemax | Piramyl;
  • (JP) Japan: Amaryl | Glimepiride amel | Glimepiride emec | Glimepiride ffp | Glimepiride isei | Glimepiride kn | Glimepiride ko | Glimepiride kyorin | Glimepiride me | Glimepiride mochida | Glimepiride Mylan | Glimepiride nissin | Glimepiride ohara | Glimepiride Pfizer | Glimepiride sandoz | Glimepiride sawai | Glimepiride takata | Glimepiride teva kowa | Glimepiride towa | Glimepiride ze | Glimepiride Zydus;
  • (KE) Kenya: Amaryl | Azulix | Diaglim | Diapride | Getryl | Glide | Glimaryl | Glimeco | Glimed | Glimepiride denk | Glimestar | Glimiday | Glimulin | Glisen | Glorion | Glypin | Glyree | Limaryl | Perglim | Secrin | Ziglim;
  • (KR) Korea, Republic of: Aberin | Ama | Amadiem | Amagreen | Amapil | Amaria | Amarid | Amaryl | Amed | Ameriad | Amerid | Amide | Amorin | Aprogen glimepiride | Aramyl | Armaphil | Aromyl | Aukomaryl | Bearyl | Celpiride | Climeril | Corinil | Crimeryl | Ctryl | Dagli | Daipiril | Dairid | Diabe | Diagril | Diamedy | Diaride | Diaryl | Dimaryl | Dimerid | Dimeril | Dmerid | Dymeryl | Dyryl | Emaryl | Euglex | Geride | Geripide | Gladiem | Gladin | Gladm | Gledin | Gliben | Glibeta | Glico | Glid | Glid m | Glida | Glidin | Glimarine | Glimaryl | Glimax | Glime | Glimed | Glimede | Glimedi | Glimel | Glimen | Glimep | Glimepid | Glimepide | Glimepidid | Glimepigen | Glimepil | Glimepin | Glimepiril | Glimepisyu | Glimeril | Glimerin | Glimeryl | Glimetin | Glimets | Glimetz | Glimewin | Glimid | Glimil | Glimin | Glion | Glipa | Glipam | Glipan | Glipico | Glipid | Glipidine | Glipil | Glipin | Glipion | Glipirin | Glipiron | Glipril | Glipydin | Glique | Glitec | Glopid | Glpid | Glube | Gludine | Gluless | Glupen | Glupid | Glyco | Glyone | Grid | Gril | Gripid | Hanmaryl | Iglid | Imaryl | Jeimaryl | Jr glimepiride | K Maril | Lax | Lipid | Lonaim | Lotra | Lowglico | Madmil | Mearyl | Mebid | Medirol | Mepigryl | Mepirid | Mepiril | Mepirin | Mepril | Mericle | Miaryl | Midia | Neomaryl | Neomaryl m | Newglipild | Newgril | Newmepirin | Pirame | Rax | Rimede | Samsung glimepiride | Unimaryl | Withus glimepiride;
  • (KW) Kuwait: Amaryl | Diapride | G pride | Glim | Glimepirid hexal;
  • (LB) Lebanon: Alpiride | Amaryl | Amepride | Diaberyl | Diaglim | Dialosa | Diameril | Diapride | Glemax | Glim | Glitra | Glypride | Irys | Orbide;
  • (LT) Lithuania: Amaryl | Glimasol | Glimepirid Accord | Glimestada;
  • (LU) Luxembourg: Amarylle | Glimepiride eg;
  • (LV) Latvia: Amaryl | Fertin | Glimasol | Glimepiride accord | Meglimid;
  • (MA) Morocco: Aglim | Amarel | Glema | Glimewin | Glimiryl | Miliprel;
  • (MX) Mexico: Adiripem | Amaryl | Apralix | Brimedan | Diapride | Esliby | Gleurix | Glimal | Glimepirida | Glimepirida Antibioticos | Glimepirida kendrick | Glimepirida loeffler | Lyramy | Zukedib;
  • (MY) Malaysia: Amaryl | Ameride | Axcel glimepiride | Getryl | Glenix | Glimaryl | Glimetor | Glimin | Glimpid | Glimulin | Intaszoryl | Limeral | Pricheck;
  • (NG) Nigeria: Amaryl | Avropryl | Danprimide | Diapride | Getryl | Glemax | Glepid | Glibenax | Glimeryl | Glimestar | Glumril | Hobetic | Jempride | Meprid | Neroaryl | Perglim | Sam glimepiride;
  • (NL) Netherlands: Amaryl | Glimepiride a | Glimepiride cf | Glimepiride Merck | Glimepiride PCH | Glimepiride sandoz;
  • (NO) Norway: Amaryl | Glimepirid hexal | Glimepirid teva;
  • (NZ) New Zealand: Amaryl;
  • (PE) Peru: Amaglen | Amaryl | Amytrip | Diabeless | Diabemaryl | Glemaz | Glimebiotech | Glimepin | Glimepirida | Glimestalip | Glimide | Glyree | Novoglubin | Zoryl;
  • (PH) Philippines: Acotril | Aforglim | Arya | Asaglim | Azutrol | Climeril | Diabeats | Diaberid | Diameride | Diamex | Geopride | Glimarex | Glimaryl | Glimauno | Glime m2 | Glimec | Glimep | Glimeryl | Glimesaph t2 | Glimesyn | Glimetrol | Glivarid | Glucozen | Glyper | Glyree | Kalbetic | Losugar | Neoglim | Norizec | Perglim | Rimepril | Soladin | Solosa | Stimulin | Syngly;
  • (PK) Pakistan: Actigon | Amarox | Amaryl | Detove | Diabold | Diabryl | Diaglim | Diatrol | Dibi | Diryl | Econid | Evopride | Genlip | Getryl | Glactil | Glemex | Glemiwel | Glimefold | Glimera | Glimtide | Gliride | Glitop | Glory | Glow | Gluconorm | Glyset | Gulofin | Initial | Limerid | Limoride | Magpride | Maripride | Medipride | Megapride | Melnorm | Norlim | Orinase | Pamaryl | Raypride | Safgo | Steady | Sugral | Vpride | Zeprid | Zoryl;
  • (PL) Poland: Amaryl | Avaron | Betaglid | Diaril | Glibezid | Glidiamid | Glimehexal | Glimepiride 1a pharma | Glimepiride accord | Glimepiride Arrow | Glimepiride Aurovitas | Glimepiride genoptim | Glimesan | Glimorion | Glitoprel | Pemidal | Symglic;
  • (PR) Puerto Rico: Amaryl;
  • (PT) Portugal: Amaryl | Diapiride | Glimepirida | Glimepirida Accord | Glimepirida aurobindo | Glimepirida aurovitas | Glimial;
  • (PY) Paraguay: Amaryl | Dasten | Diencil | Glemaz | Glimedex | Glimepirida | Glimepirida dasanti | Glimepirida fapasa | Glimepirida milefar | Glipisin | Glu g | Hexan | Lipantyl | Panabutol | Pexeba;
  • (QA) Qatar: Amaryl | Azulix | Diameril | Diapride | G-Pride | Glemax | Glim | Glimaryl | Glimpid | Glymride | Glypride | Piramyl;
  • (RO) Romania: Amaryl | Amyx | Dibiglim | Glempid | Glime tad | Glimepirid | Glimepirid lph | Glimeran | Gliprex | Meglimid;
  • (RU) Russian Federation: Amaryl | Diamerid | Glemauno | Glemaz | Glimepiride Canon | Glimepiride Canonpharma | Glimepiride sz | Glimepiride teva | Glumedex | Instolit | Meglimid;
  • (SA) Saudi Arabia: Amaglime | Amaryl | G pride | Glemax | Glide | Glim | Glimaryl | Glimephan | Glitra | Glypride | Piramyl;
  • (SE) Sweden: Amaryl | Glimepirid 2care4 | Glimepirid Actavis | Glimepirid alternova | Glimepirid bmm pharma | Glimepirid copyfarm | Glimepirid krka | Glimepirid mylan | Glimepirid orion | Glimepirid sandoz | Glimepirid stada;
  • (SG) Singapore: Amaryl | Dialosa | Diapride;
  • (SI) Slovenia: Amaryl | Betaglid | Glimegamma;
  • (SK) Slovakia: Amaryl | Glimegamma | Glimep;
  • (TH) Thailand: Amarax | Amaryl | Diaglip | Glazer | Glimepiride sandoz | Gliparil | Glypride | Losu | NIKP Glimepiride | Solosa;
  • (TN) Tunisia: Amarel | Glimerel;
  • (TR) Turkey: Amaryl | Diameprid | Glimax;
  • (TW) Taiwan: Amalin | Amaride | Amarine | Amaryl | Glimaryl | Glimepine | Glipid | Glufar | Glusafe | Grumed | Lowmalin | Nonin;
  • (UA) Ukraine: Amaryl | Dimaril | Eglim | Glemaz | Glianov | Glimaryl | Glimax | Glimepirid | Glimepirid teva | Glimepiride indar | Glinova | Melpamid;
  • (UG) Uganda: Amaryl | Azulix | Diapride | Euglim | Glimepiride denk | Glimeryl | Glypride | Perglim;
  • (UY) Uruguay: Adiuvan | Amaryl | Euclamide | Glimepirida | Manarel;
  • (VE) Venezuela, Bolivarian Republic of: Amaryl | Diabutil | Dimavyl | Glimepir | Glimepirida | Glimirid | Glimy | Gliperim | Glucodan | Glypride | Piglifar;
  • (VN) Viet Nam: Agludril | Amapileo | Amapirid | Binexamorin | Canzeal | Flodilan | Genprid | Geride | Glimegim | Glimvaz | Glumerif | Mekoaryl | Necaral | Oramep | Savdiaride;
  • (ZA) South Africa: Accord Glimepiride | Amaryl | Aspen glimepiride | Austell glimepirid | Austell glimepiride | Glamaryl | Sulphonur | Zydus glimepiride;
  • (ZM) Zambia: Amaryl | Azulix | Diapride | Gimetab | Glimcip | Glimepiride denk | Glimestar | Glimulin | Glyree;
  • (ZW) Zimbabwe: Amaryl | Azulix | Glimulin 1 | Glimulin 2 | Glipiryl
  1. 2023 American Geriatrics Society Beers Criteria Update Expert Panel. American Geriatrics Society 2023 updated AGS Beers Criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2023;71(7):2052-2081. doi:10.1111/jgs.18372 [PubMed 37139824]
  2. Alexopoulos AS, Blair R, Peters AL. Management of preexisting diabetes in pregnancy: a review. JAMA. 2019;321(18):1811-1819. doi:10.1001/jama.2019.4981 [PubMed 31087027]
  3. Amaryl (glimepiride) [prescribing information]. Bridgewater, NJ: Sanofi-Aventis; December 2018.
  4. American Diabetes Association (ADA). Standards of care in diabetes–2023. Diabetes Care. 2023;46(suppl 1):S1-S291. https://diabetesjournals.org/care/issue/46/Supplement_1. Accessed January 4, 2023.
  5. American Diabetes Association (ADA). Standards of medical care in diabetes–2022. Diabetes Care. 2022;45(suppl 1):S1-S258. https://diabetesjournals.org/care/issue/45/Supplement_1. Accessed October 13, 2022.
  6. Apo-Glimepiride (glimepiride) [product monograph]. Toronto, Ontario, Canada: Apotex Inc; October 2018.
  7. Apovian CM, Aronne LJ, Bessesen DH, et al; Endocrine Society. Pharmacological management of obesity: an Endocrine Society clinical practice guideline [published correction appears in J Clin Endocrinol Metab. 2015;100(5):2135-2136]. J Clin Endocrinol Metab. 2015;100(2):342-362. doi: 10.1210/jc.2014-3415 [PubMed 25590212]
  8. Balaguer Santamaría JA, Feliu Rovira A, Escribano Subias J, et al. Persistent hyperinsulinemic hypoglycemia in newborn associated with glimepiride treatment at the beginning of pregnancy. Rev Clin Esp. 2000;200(7):399-400. [PubMed 10994361]
  9. Blumer I, Hadar E, Hadden DR, et al. Diabetes and pregnancy: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2013;98(11):4227-4249. [PubMed 24194617]
  10. Bogun M, Inzucchi SE. Inpatient management of diabetes and hyperglycemia. Clin Ther. 2013;35(5):724-733. doi:10.1016/j.clinthera.2013.04.008 [PubMed 23688537]
  11. Brackett CC, Singh H, Block JH. Likelihood and mechanisms of cross-allergenicity between sulfonamide antibiotics and other drugs containing a sulfonamide functional group. Pharmacotherapy. 2004;24(7):856-870. [PubMed 15303450]
  12. Davies MJ, D'Alessio DA, Fradkin J, et al. Management of hyperglycemia in type 2 diabetes, 2018. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care. 2018;41(12):2669-2701. doi:10.2337/dci18-0033 [PubMed 30291106]
  13. DeFronzo RA. Pharmacologic therapy for type 2 diabetes mellitus. Ann Intern Med. 1999;131(4):281-303. doi:10.7326/0003-4819-131-4-199908170-00008 [PubMed 10454950]
  14. Del Prato S, Camisasca R, Wilson C, Fleck P. Durability of the efficacy and safety of alogliptin compared with glipizide in type 2 diabetes mellitus: a 2-year study. Diabetes Obes Metab. 2014;16(12):1239-1246. doi:10.1111/dom.12377 [PubMed 25132212]
  15. Diabetes Canada Clinical Practice Guidelines Expert Committee. Diabetes Canada 2018 clinical practice guidelines for the prevention and management of diabetes in Canada. Can J Diabetes. 2018;42(suppl 1):S1-S325.
  16. “Effect of Intensive Blood-Glucose Control With Metformin on Complications in Overweight Patients With Type 2 Diabetes (UKPDS 34). UK Prospective Diabetes Study (UKPDS) Group,” Lancet, 1998, 352(9131):854-65. [PubMed 9742977]
  17. Egan AM, Dow ML, Vella A. A review of the pathophysiology and management of diabetes in pregnancy. Mayo Clin Proc. 2020;95(12):2734-2746. doi:10.1016/j.mayocp.2020.02.019 [PubMed 32736942]
  18. Expert opinion. Senior Renal Editorial Team: Bruce Mueller, PharmD, FCCP, FASN, FNKF; Jason A. Roberts, PhD, BPharm (Hons), B App Sc, FSHP, FISAC; Michael Heung, MD, MS.
  19. Garber AJ, Handelsman Y, Grunberger G, et al. Consensus statement by the American Association of Clinical Endocrinologists and American College of Endocrinology on the comprehensive type 2 diabetes management algorithm - 2020 executive summary. Endocr Pract. 2020;26(1):107-139. doi:10.4158/CS-2019-0472 [PubMed 32022600]
  20. Gianchandani RY, Neupane S, Iyengar JJ, Heung M. Pathophysiology and management of hypoglycemia end-stage renal disease patients: a review. Endocr Pract. 2017;23(3):353-362. doi:10.4158/EP161471.RA [PubMed 27967230]
  21. Goldberg RB, Holvey SM, Schneider J. A dose-response study of glimepiride in patients with NIDDM who have previously received sulfonylurea agents. The Glimepiride Protocol #201 Study Group. Diabetes Care. 1996;19(8):849-856. doi:10.2337/diacare.19.8.849 [PubMed 8842603]
  22. Inzucchi SE. Clinical practice. Management of hyperglycemia in the hospital setting. N Engl J Med. 2006;355(18):1903-1911. doi:10.1056/NEJMcp060094 [PubMed 17079764]
  23. Johnson KK, Green DL, Rife JP, Limon L. Sulfonamide cross-reactivity: fact or fiction? [published correction appears in Ann Pharmacother. 2005;39(7-8):1373]. Ann Pharmacother. 2005;39(2):290-301. [PubMed 15644481]
  24. Kalyoncu NI, Yaris F, Kadioglu M, et al. Pregnancy outcome following exposure to orlistat, ramipril, glimepiride in a woman with metabolic syndrome. Saudi Med J. 2005;26(3):497-499. [PubMed 15806235]
  25. Kidney Disease: Improving Global Outcomes (KDIGO) Diabetes Work Group. KDIGO 2020 clinical practice guideline for diabetes management in chronic kidney disease. Kidney Int. 2020;98(4S):S1-S115. doi:10.1016/j.kint.2020.06.019 [PubMed 32998798]
  26. Korner J, Inabnet W, Febres G, et al. Prospective study of gut hormone and metabolic changes after adjustable gastric banding and Roux-en-Y gastric bypass. Int J Obes (Lond). 2009;33(7):786-795. doi: 10.1038/ijo.2009.79 [PubMed 19417773]
  27. LeRoith D, Biessels GJ, Braithwaite SS, et al. Treatment of diabetes in older adults: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2019;104(5):1520-1574. doi: 10.1210/jc.2019-00198. [PubMed 30903688]
  28. Mechanick JI, Apovian C, Brethauer S, et al. Clinical practice guidelines for the perioperative nutrition, metabolic, and nonsurgical support of patients undergoing bariatric procedures - 2019 update: cosponsored by American Association of Clinical Endocrinologists/American College of Endocrinology, the Obesity Society, American Society for Metabolic & Bariatric Surgery, Obesity Medicine Association, and American Society of Anesthesiologists. Surg Obes Relat Dis. 2020;16(2):175-247. doi:10.1016/j.soard.2019.10.025 [PubMed 31917200]
  29. Mingrone G, Cummings DE. Changes of insulin sensitivity and secretion after bariatric/metabolic surgery. Surg Obes Relat Dis. 2016;12(6):1199-1205. doi: 10.1016/j.soard.2016.05.013. [PubMed 27568471]
  30. Moghissi ES, Korytkowski MT, DiNardo M, et al; American Association of Clinical Endocrinologists; American Diabetes Association. American Association of Clinical Endocrinologists and American Diabetes Association consensus statement on inpatient glycemic control. Endocr Pract. 2009;15(4):353-369. doi:10.4158/EP09102.RA [PubMed 19454396]
  31. Neumiller JJ, Alicic RZ, Tuttle KR. Therapeutic considerations for antihyperglycemic agents in diabetic kidney disease. J Am Soc Nephrol. 2017;28(8):2263-2274. doi:10.1681/ASN.2016121372 [PubMed 28465376]
  32. Niemi M, Cascorbi I, Timm R, et al, "Glyburide and glimepiride pharmacokinetics in subjects with different CYP2C9 genotypes," Clin Pharmacol Ther, 2002, 72(3):326-32. [PubMed 12235454]
  33. Peterli R, Steinert RE, Woelnerhanssen B, et al. Metabolic and hormonal changes after laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy: a randomized, prospective trial. Obes Surg. 2012;22(5):740-748. doi: 10.1007/s11695-012-0622-3. [PubMed 22354457]
  34. Refer to manufacturer's labeling.
  35. Riddle MC. Oral pharmacologic management of type 2 diabetes. Am Fam Physician. 1999;60(9):2613-2620. [PubMed 10605995]
  36. Rosenkranz B, Profozic V, Metelko Z, Mrzljak V, Lange C, Malerczyk V. Pharmacokinetics and safety of glimepiride at clinically effective doses in diabetic patients with renal impairment. Diabetologia. 1996;39(12):1617-1624. doi:10.1007/s001250050624 [PubMed 8960852]
  37. Rosenstock J, Kahn SE, Johansen OE, et al; CAROLINA Investigators. Effect of linagliptin vs glimepiride on major adverse cardiovascular outcomes in patients with type 2 diabetes: the CAROLINA randomized clinical trial. JAMA. 2019;322(12):1155-1166. doi: 10.1001/jama.2019.13772. [PubMed 31536101]
  38. Rosenstock J, Samols E, Muchmore DB, Schneider J. Glimepiride, a new once-daily sulfonylurea. A double-blind placebo-controlled study of NIDDM patients. Glimepiride Study Group. Diabetes Care. 1996;19(11):1194-1199. doi:10.2337/diacare.19.11.1194 [PubMed 8908379]
  39. Samson SL, Vellanki P, Blonde L, et al. American Association of Clinical Endocrinology consensus statement: comprehensive type 2 diabetes management algorithm - 2023 update. Endocr Pract. 2023;29(5):305-340. doi:10.1016/j.eprac.2023.02.001 [PubMed 37150579]
  40. Slatore CG, Tilles SA. Sulfonamide hypersensitivity. Immunol Allergy Clin North Am. 2004;24(3):477-490. [PubMed 15242722]
  41. Tandra S, Chalasani N, Jones DR, Mattar S, Hall SD, Vuppalanchi R. Pharmacokinetic and pharmacodynamic alterations in the Roux-en-Y gastric bypass recipients. Ann Surg. 2013;258(2):262-269. doi: 10.1097/SLA.0b013e31827a0e82 [PubMed 23222033]
  42. Tornero P, De Barrio M, Baeza ML, Herrero T. Cross-reactivity among p-amino group compounds in sulfonamide fixed drug eruption: diagnostic value of patch testing. Contact Dermatitis. 2004;51(2):57-62. [PubMed 15373844]
  43. UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33) [published correction appears in: Lancet. 1999;354(9178):602]. Lancet. 1998;352(9131):837-853. [PubMed 9742976]
  44. Wexler DJ. Initial management of hyperglycemia in adults with type 2 diabetes mellitus. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed October 13, 2021a.
  45. Wexler DJ. Management of persistent hyperglycemia in type 2 diabetes mellitus. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed September 18, 2020.
  46. Wexler DJ. Sulfonylureas and meglitinides in the treatment of type 2 diabetes mellitus. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed October 13, 2021b.
Topic 8491 Version 460.0

آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟