Index of drugs

Treatment of type 2 diabetes where diet, exercise and weight loss are not effective enough.

1 tabl contains 1 mg, 2 mg, 3 mg or 4 mg of glimepiride.

Oral hypoglycemic drug from the sulfonylurea group. The effect of Glimepiride is mainly to stimulate insulin secretion by pancreatic beta cells. In addition, it increases the sensitivity of peripheral tissues to insulin and reduces the uptake of insulin by the liver. The bioavailability of glimepiride administered orally is complete. The maximum concentration of the drug in the blood occurs approximately 2.5 hours after administration. The degree of binding to plasma proteins is> 99%. The average half-life in the blood is 5-8 h. At high doses, a slight increase in half-life was observed. The drug is excreted in 58% with urine and in 35% with faeces. Two metabolites, probably due to metabolism in the liver, have been detected in the urine and faeces: a hydroxyl and carboxylic derivative. The terminal half-life of these metabolites was 3-6 h and 5-6 h, respectively.

Hypersensitivity to Glimepiride, other sulphonylureas or sulfonamides or to the other ingredients of the preparation. Insulin dependent diabetes. Diabetic coma. Ketoacidosis. Severe kidney or liver problems. Pregnancy and breastfeeding.

There is no experience regarding the use of glimepiride in patients with severe hepatic impairment and dialysis patients. In patients with severe renal or hepatic impairment a switch to insulin therapy is indicated. The product contains lactose - should not be used in patients with rare hereditary galactose intolerance, Lapp lactase deficiency or malabsorption of glucose-galactose. There is no experience regarding the use of the drug in children.

The drug is contraindicated during pregnancy and breastfeeding. Insulin should be used during pregnancy.

Uncommon (0.1-1%): Transient visual disturbances (especially at the beginning of treatment). Rare (0.01-0.1%): thrombocytopenia, leukopenia, anemia, granulocytopenia, agranulocytosis, haemolytic anemia, pancytopenia - usually reversible after discontinuation of the drug; hypoglycemia; pruritus, rash, urticaria, hypersensitivity to light; increase in liver enzymes. Very rare (<0.01%): allergic vasculitis; hyponatremia; shock; dyspnoea; nausea, vomiting, diarrhea, feeling compressed or full of stomach, abdominal pain; hepatic impairment (eg cholestasis, jaundice), hepatitis, hepatic failure; hypersensitivity (decrease in blood pressure up to shock), cross-sensitivity to sulfonylureas, sulfonamides and related substances.

The dose is determined based on the results of the blood Glucose and urine tests. The initial dose of glimepiride is 1 mg / day. If this dose provides good control, it should be used as a maintenance dose. In the absence of satisfactory control, the dose should be gradually increased, based on the results of glycemic control, at intervals of 1-2 weeks, to a dose of 2 mg glimepiride, 3 mg or 4 mg daily. Only in exceptional cases, a dose of glimepiride greater than 4 mg daily gives better treatment results. The maximum recommended daily dose is 6 mg.
In patients who have not been adequately controlled with the maximum daily dose of glimepiride, the concomitant use of insulin may be initiated as necessary. It is necessary, when maintaining the dose of glimepiride, to start with low-dose insulin, which should then be increased depending on the desired level of metabolic control. Combination therapy should be started under close medical supervision.
If other oral antidiabetic agents are changed to glimepiride, the dose and half-life of the previous medicine should be taken into account. The recommended starting dose of glimepiride is 1 mg a day.Depending on the response to treatment, the dose may be increased gradually in accordance with the recommendations given above.
Glimepiride is usually sufficient once a day. It is recommended to take the medicine shortly before or during breakfast, or - in patients who do not eat breakfast - shortly before or during the first main meal. The tablets should be swallowed whole with liquid.
During treatment, when the sensitivity of tissues to insulin increases as a result of improved diabetes control, the need for glimepiride may be reduced. Therefore, to reduce the occurrence of hypoglycaemia, a dose reduction or termination of treatment should be considered over time. A change in dosage may also be necessary if you change your weight or your lifestyle or other factors that increase the risk of hypo- or hyperglycaemia.