What is glimepiride?

Glimepiride is an oral diabetes medicine that is used together with diet and exercise to improve blood sugar control in adults with type 2 diabetes mellitus. glimepiride is not for treating type 1 diabetes.

Glimepiride may also be used for purposes not listed in this medication guide.

Glimepiride side effects

Get emergency medical help if you have signs of an allergic reaction (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling).

Glimepiride may cause serious side effects. Call your doctor at once if you have:

• pale or yellowed skin, dark colored urine;
• confusion, weakness; or
• fever.

Common side effects of glimepiride may include:

• headache;
• dizziness, weakness;
• nausea; or
• low blood sugar.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA .

Warnings

You should not use glimepiride if you have diabetic ketoacidosis, or if you are allergic to sulfa drugs.

Before taking this medicine

You should not use glimepiride if you are allergic to it, or if you have:

• an allergy to sulfa drugs; or
• diabetic ketoacidosis (call your doctor for treatment).

Tell your doctor if you have ever had:

• heart disease;
• liver or kidney disease; or
• an enzyme deficiency called glucose-6-phosphate dehydrogenase deficiency (G6PD).

Glimepiride may increase your risk of serious heart problems, but not treating your diabetes can also damage your heart and other organs. Talk to your doctor about the risks and benefits of glimepiride.

Follow your doctor’s instructions about using this medicine if you are pregnant or you become pregnant. Controlling diabetes is very important during pregnancy, and having high blood sugar may cause complications in both the mother and the baby. However, you may need to stop taking glimepiride for a short time just before your due date.

Medications similar to glimepiride have caused severe hypoglycemia in newborn babies whose mothers used the medicine near the time of delivery. If you take glimepiride during pregnancy, stop taking this medicine at least 2 weeks before your due date.

If you breastfeed while taking glimepiride, call your doctor if your baby shows signs of hypoglycemia (extreme drowsiness, feeding problems, mottled skin, blue lips, feeling cold or jittery, or having a seizure).

Glimepiride is not approved for use by anyone younger than 18 years old.

How should I take glimepiride?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

Glimepiride is usually taken once a day with breakfast or the first main meal of the day. Follow your doctor’s instructions. Take glimepiride with a full glass of water.

Your blood sugar will need to be checked often, and you may need other blood tests at your doctor’s office.

You may have low blood sugar (hypoglycemia) and feel very hungry, dizzy, irritable, confused, anxious, or shaky. To quickly treat hypoglycemia, eat or drink a fast-acting source of sugar (fruit juice, hard candy, crackers, raisins, or non-diet soda).

Your doctor may prescribe a glucagon injection kit in case you have severe hypoglycemia. Be sure your family or close friends know how to give you this injection in an emergency.

Blood sugar levels can be affected by stress, illness, surgery, exercise, alcohol use, or skipping meals. Ask your doctor before changing your dose or medication schedule.

Glimepiride is only part of a treatment program that may also include diet, exercise, weight control, blood sugar testing, and special medical care. Follow your doctor’s instructions very closely.

Store at room temperature away from moisture and heat.

Glimepiride dosing information

Usual Adult Dose for Diabetes Type 2:

Initial dose: 1 to 2 mg orally once a day
Maintenance dose: Increase in 1 or 2 mg increments no more frequently than every 1 to 2 weeks based on glycemic response
Maximum dose: 8 mg per day

Comments:
-Administer with breakfast or first main meal of the day.
-In patients who are at increased risk for hypoglycemia, start with 1 mg orally once a day and titrate slowly.
-When patients are being transferred to this drug from a longer half-life sulfonylurea, monitor 1 to 2 weeks for overlapping drug effect.

Use: As an adjunct to diet and exercise to improve glycemic control in patients with type 2 diabetes mellitus.

Usual Geriatric Dose for Diabetes Type 2:

Initial dose: 1 mg orally once a day; titrate slowly and monitor closely

Usual Pediatric Dose for Diabetes Type 2:

Not recommended because of adverse effects on body weight and hypoglycemia.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line . A glimepiride overdose can cause life-threatening hypoglycemia.

Symptoms of severe hypoglycemia include extreme weakness, confusion, tremors, sweating, fast heart rate, trouble speaking, nausea, vomiting, rapid breathing, fainting, and seizure (convulsions).

What should I avoid while taking glimepiride?

Avoid drinking alcohol. It lowers blood sugar and may interfere with your diabetes treatment.

Avoid exposure to sunlight or tanning beds. Glimepiride can make you sunburn more easily. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.

What other drugs will affect glimepiride?

Glimepiride may not work as well when you use other medicines at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective.

If you also take colesevelam, take your glimepiride dose at least 4 hours before you take colesevelam.

Other drugs may affect glimepiride, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.

What is glipizide?

Glipizide is an oral diabetes medicine that helps control blood sugar levels by helping your pancreas produce insulin.

Glipizide is used together with diet and exercise to improve blood sugar control in adults with type 2 diabetes mellitus.

Glipizide is not for treating type 1 diabetes.

Warnings

You should not use glipizide if you have diabetic ketoacidosis (call your doctor for treatment).

Before taking this medicine

You should not use this medicine if you are allergic to glipizide, or if you have diabetic ketoacidosis (call your doctor for treatment).

Tell your doctor if you have ever had:

• liver or kidney disease;
• chronic diarrhea, or a blockage in your intestines; or
• an enzyme deficiency called glucose-6-phosphate dehydrogenase deficiency (G6PD).

Follow your doctor’s instructions about using glipizide if you are pregnant or you become pregnant. Controlling diabetes is very important during pregnancy, and having high blood sugar may cause complications in both the mother and the baby. You should not take glipizide during the last 2 weeks of pregnancy. Agents other than glipizide are currently recommended to treat diabetes in pregnant women.

It may not be safe to breastfeed while using this medicine. Ask your doctor about any risk.

How should I take glipizide?

Take glipizide exactly as prescribed by your doctor. Follow all directions on your prescription label. Your doctor may occasionally change your dose. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Take the regular tablet 30 minutes before your first meal of the day.

Take the glipizide extended-release tablet with your first meal of the day.

Swallow the tablet whole and do not crush, chew, or break it.

Your blood sugar may need to be checked often, and you may need other blood tests at your doctor’s office.

Low blood sugar (hypoglycemia) can happen to anyone who has diabetes. Symptoms include headache, hunger, sweating, irritability, dizziness, nausea, fast heart rate, and feeling anxious or shaky. To quickly treat low blood sugar, always keep a fast-acting source of sugar with you such as fruit juice, hard candy, crackers, raisins, or non-diet soda.

Your doctor can prescribe a glucagon emergency injection kit to use in case you have severe hypoglycemia and cannot eat or drink. Be sure your family and close friends know how to give you this injection in an emergency.

Also watch for signs of high blood sugar (hyperglycemia) such as increased thirst or urination, blurred vision, headache, and tiredness.

Blood sugar levels can be affected by stress, illness, surgery, exercise, alcohol use, or skipping meals. Ask your doctor before changing your dose or medication schedule.

Some forms of glipizide are made with a shell that is not absorbed or melted in the body. Part of the tablet shell may appear in your stool. This is a normal side effect and will not make the medication less effective.

Store at room temperature away from moisture, heat, and light.

What happens if I miss a dose?

Take your dose as soon as you can, but only if you are getting ready to eat a meal. If you skip a meal, skip the missed dose and wait until your next meal. Do not take two doses at one time.

Get your prescription refilled before you run out of medicine completely.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line . A glipizide overdose can cause life-threatening hypoglycemia.

Symptoms of severe hypoglycemia include extreme weakness, blurred vision, sweating, trouble speaking, tremors, stomach pain, confusion, and seizure (convulsions).

What to avoid

Avoid drinking alcohol. It lowers blood sugar and can cause side effects.

Avoid driving or operating machinery until you know how this medicine will affect you.

Glipizide side effects

Get emergency medical help if you have signs of an allergic reaction to glipizide: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have symptoms of low blood sugar:

• headache, irritability
• sweating, fast heart rate;
• dizziness, nausea; or
• hunger, feeling anxious or shaky.

Common glipizide side effects may include:

• diarrhea, constipation, gas;
• dizziness, drowsiness;
• tremors; or
• skin rash, redness, or itching.

What is Glucotrol?

Glucotrol is an oral diabetes medicine that helps control blood sugar levels by helping your pancreas produce insulin.

Glucotrol is used together with diet and exercise to improve blood sugar control in adults with type 2 diabetes mellitus.

Glucotrol is not for treating type 1 diabetes.

Warnings

You should not use Glucotrol if you have diabetic ketoacidosis (call your doctor for treatment).

Before taking Glucotrol, tell your doctor if you have kidney or liver disease, chronic diarrhea or a blockage in your intestines, glucose-6-phosphate dehydrogenase deficiency (G6PD), a disorder of your pituitary or adrenal glands, a history of heart disease, or if you are malnourished.

Before taking this medicine

You should not use Glucotrol if you are allergic to glipizide, or if you have diabetic ketoacidosis (call your doctor for treatment).

Tell your doctor if you have ever had:

• liver or kidney disease;
• chronic diarrhea, or a blockage in your intestines; or
• an enzyme deficiency called glucose-6-phosphate dehydrogenase deficiency (G6PD).

Follow your doctor’s instructions about using Glucotrol if you are pregnant or you become pregnant. Controlling diabetes is very important during pregnancy, and having high blood sugar may cause complications in both the mother and the baby. However, you may need to stop taking Glucotrol for a short time just before your due date.

It may not be safe to breastfeed while using this medicine. Ask your doctor about any risk.

How should I take Glucotrol?

Take Glucotrol exactly as prescribed by your doctor. Follow all directions on your prescription label. Your doctor may occasionally change your dose. Do not take this medicine in larger or smaller amounts or for longer than recommended.

Take the regular tablet 30 minutes before your first meal of the day.

Take the Glucotrol XL extended-release tablet with your first meal of the day. Swallow the tablet whole and do not crush, chew, or break it.

Your blood sugar will need to be checked often, and you may need other blood tests at your doctor’s office.

Low blood sugar (hypoglycemia) can happen to everyone who has diabetes. Symptoms include headache, hunger, sweating, irritability, dizziness, nausea, fast heart rate, and feeling anxious or shaky. To quickly treat low blood sugar, always keep a fast-acting source of sugar with you such as fruit juice, hard candy, crackers, raisins, or non-diet soda.

Your doctor can prescribe a glucagon emergency injection kit to use in case you have severe hypoglycemia and cannot eat or drink. Be sure your family and close friends know how to give you this injection in an emergency.

Also watch for signs of high blood sugar (hyperglycemia) such as increased thirst or urination, blurred vision, headache, and tiredness.

Blood sugar levels can be affected by stress, illness, surgery, exercise, alcohol use, or skipping meals. Ask your doctor before changing your dose or medication schedule.

When you take Glucotrol XL you may see something in your stool that looks like a tablet. This is the empty shell from the tablet. It is normal for the empty shell to pass with your bowel movement after medicine has been absorbed by your body.

Store at room temperature away from moisture, heat, and light.

Dosing information

Usual Adult Dose of Glucotrol for Diabetes Type 2:

Immediate release:
Initial dose: 5 mg orally once a day, 30 minutes before breakfast
Maintenance dose: Up to 40 mg in divided doses 30 minutes before a meal of adequate caloric content. Doses may be increased in intervals of 2.5 to 5 mg a day according to blood glucose response.
Maximum single dose: 15 mg
Maximum daily dose: 40 mg
Comments:
-At least several days should elapse between titration steps.
-If response to a single dose is not satisfactory, dividing that dose may prove effective.

Extended Release:
Initial dose: 5 mg orally once a day, 30 minutes before breakfast
Maintenance dose: 5 to 10 mg orally once a day
Maximum daily dose: 20 mg
Patients receiving immediate release may be switched safely to extended release tablets once-a-day at the nearest equivalent total daily dose, or titrate to the appropriate extended release dose starting with 5 mg once daily.
Combination use:
-When adding other blood-glucose-lowering agents to the extended release tablets, the agent should be initiated at the lowest recommended dose. Observe for hypoglycemia.
-When adding extended release tablets to other blood-glucose-lowering agents, Glucotrol XL extended release can be initiated at 5 mg. Start at a lower dose in patients that are more sensitive to hypoglycemia.

When transferring patients from insulin to glipizide, the following general guidelines should be considered:
-For patients with daily insulin doses of 20 units or less: Discontinue insulin and begin glipizide at usual dosages.
-For patients with daily insulin doses greater than 20 units: Insulin dose should be reduced by 50% and glipizide therapy may begin at usual dosages.
Comments:
-Several days should elapse between titration steps.
-Subsequent reductions in insulin dosage should depend on individual patient response.
-During the insulin withdrawal period, the patient should test urine samples for sugar and ketone bodies at least three times daily.
-Some patients receiving greater than 40 units of insulin daily may need to consider hospitalization during the transition period.

Patients Receiving Other Oral Hypoglycemic Agents:
-When transferring from longer half-life sulfonylureas: Observe for 1 to 2 weeks for hypoglycemia.
-Glucotrol XL extended release coadministered with colesevelam: Glipizide should be administered at least 4 hours prior to colesevelam.

Use: Adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.

Usual Geriatric Dose of Glucotrol for Diabetes Type 2:

Initial dose: 2.5 mg orally once a day 30 minutes before breakfast

Comments:
-Maintenance dosing should be conservative to avoid hypoglycemic reactions.
-Doses can be adjusted with caution taking into account the degree of hepatic, renal, or cardiac function, and the concomitant disease or other drug therapy.

Use: Adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.

What happens if I miss a dose?

Take your dose as soon as you can, but only if you are getting ready to eat a meal. If you skip a meal, skip the missed dose and wait until your next meal. Do not take two doses at one time.

Get your prescription refilled before you run out of medicine completely.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line . A glipizide overdose can cause life-threatening hypoglycemia.

Symptoms of severe hypoglycemia include extreme weakness, blurred vision, sweating, trouble speaking, tremors, stomach pain, confusion, and seizure (convulsions).

What to avoid

Avoid drinking alcohol. It lowers blood sugar and can cause side effects.

Avoid driving or operating machinery until you know how glipizide will affect you.

Glucotrol side effects

Get emergency medical help if you have signs of an allergic reaction to Glucotrol: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have symptoms of low blood sugar:

• headache, irritability
• sweating, fast heart rate;
• dizziness, nausea; or
• hunger, feeling anxious or shaky.

Common Glucotrol side effects may include:

• diarrhea, constipation, gas;
• dizziness, drowsiness;
• tremors; or
• skin rash, redness, or itching.

What is glyburide?

Glyburide is an oral diabetes medicine that helps control blood sugar levels.

Glyburide is used together with diet and exercise to improve blood sugar control in adults with type 2 diabetes mellitus.

Glyburide is not for treating type 1 diabetes.

Warnings

You should not use glyburide if you are being treated with bosentan (Tracleer), or if you have diabetic ketoacidosis (call your doctor for treatment). Glyburide is not for treating type 1 diabetes.

Before taking glyburide, tell your doctor if you are allergic to sulfa drugs, if you have been using insulin or chlorpropamide (Diabinese), or if you have hemolytic anemia (a lack of red blood cells), an enzyme deficiency (G6PD), a nerve disorder, liver disease, or kidney disease.

Take care not to let your blood sugar get too low. Low blood sugar (hypoglycemia) can occur if you skip a meal, exercise too long, drink alcohol, or are under stress. Symptoms include headache, hunger, weakness, sweating, tremor, irritability, or trouble concentrating. Carry hard candy or glucose tablets with you in case you have low blood sugar. Other sugar sources include orange juice and milk. Be sure your family and close friends know how to help you in an emergency.

Before taking this medicine

You should not use glyburide if you are allergic to it, or if:

• you are being treated with bosentan (Tracleer);
• you have type 1 diabetes; or
• you have diabetic ketoacidosis (call your doctor for treatment).

Tell your doctor if you have ever had:

• hemolytic anemia (a lack of red blood cells);
• an enzyme deficiency called glucose-6-phosphate dehydrogenase deficiency (G6PD);
• a nerve disorder affecting bodily functions;
• liver or kidney disease; or
• an allergy to sulfa drugs.

Before taking glyburide, tell your doctor if you have taken another oral diabetes medicine or used insulin during the past 2 weeks.

Glyburide may increase your risk of serious heart problems, but not treating your diabetes can also damage your heart and other organs. Talk to your doctor about the risks and benefits of this medicine.

Tell your doctor if you are pregnant or breastfeeding.

Follow your doctor’s instructions about using glyburide if you are pregnant or you become pregnant. Controlling diabetes is very important during pregnancy, and having high blood sugar may cause complications in both the mother and the baby.

How should I take glyburide?

Glyburide is usually taken with breakfast or the first main meal of the day.

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

Your blood sugar may need to be checked often, and you may need other blood tests at your doctor’s office.

Low blood sugar (hypoglycemia) can happen to anyone who has diabetes. Symptoms include headache, hunger, sweating, irritability, dizziness, nausea, fast heart rate, and feeling anxious or shaky. To quickly treat low blood sugar, always keep a fast-acting source of sugar with you such as fruit juice, hard candy, crackers, raisins, or non-diet soda.

Your doctor can prescribe a glucagon emergency injection kit to use in case you have severe hypoglycemia and cannot eat or drink. Be sure your family and close friends know how to give you this injection in an emergency.

Also watch for signs of high blood sugar (hyperglycemia) such as increased thirst or urination.

Blood sugar levels can be affected by stress, illness, surgery, exercise, alcohol use, or skipping meals. Ask your doctor before changing your dose or medication schedule.

If your doctor changes your brand, strength, or type of glyburide, your dosage needs may change. Ask your pharmacist if you have any questions about the new kind of glyburide you receive at the pharmacy.

Store at room temperature away from moisture and heat. Keep the bottle tightly closed when not in use.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line . A glyburide overdose can cause life-threatening hypoglycemia.

Symptoms of severe hypoglycemia include extreme weakness, nausea, tremors, sweating, confusion, trouble speaking, fast heartbeats, or seizure.

What to avoid

Avoid drinking alcohol. It lowers blood sugar and may interfere with your diabetes treatment.

Glyburide could make you sunburn more easily. Avoid sunlight or tanning beds. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.

Glyburide side effects

Get emergency medical help if you have signs of an allergic reaction to glyburide (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning in your eyes, skin pain, red or purple skin rash that spreads and causes blistering and peeling).

Call your doctor at once if you have:

• dark urine, jaundice (yellowing of the skin or eyes);
• severe skin rash, redness, or itching;
• pale skin, easy bruising or bleeding;
• fever, chills, sore throat, mouth sores; or
• low levels of sodium in the bodyheadache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady.

Older adults may be more likely to have low blood sugar while taking glyburide.

Common glyburide side effects may include:

• low blood sugar;
• nausea, heartburn, feeling full;
• muscle or joint pain;
• blurred vision; or
• mild rash or skin redness.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA .

Dosing information

Usual Adult Dose for Diabetes Type 2:

Standard glyburide:
-Initial dose: 2.5 mg to 5 mg orally once a day
-Dose titration: Increase in increments of no more than 2.5 mg at weekly intervals based upon blood glucose response
-Maintenance dose: 1.25 to 20 mg orally as a single dose or in divided doses
-Maximum dose: 20 mg/day

Micronized glyburide:
-Initial dose: 1.5 mg to 3 mg orally once a day
-Dose titration: Increase in increments of no more than 1.5 mg at weekly intervals based upon blood glucose response
-Maintenance dose: 0.75 to 12 mg orally as a single dose or in divided doses
-Maximum dose: 12 mg/day

Comments:
-Administer with breakfast or the first main meal of the day
-Lower initial doses may be used in patients who are sensitive to hypoglycemic drugs
-Once a day therapy is generally satisfactory, however, some patients may have a more satisfactory response with twice-a-day dosing, especially those receiving higher doses.

TRANSFER FROM OTHER HYPOGLYCEMIC THERAPY:
-Oral Antidiabetic Therapy: No exact dosage relationships exists between standard glyburide, micronized glyburide, or other oral hypoglycemic agents; when transferring patients from other oral hypoglycemic therapy, the maximum starting doses should be observed.
-Insulin:
–If the insulin dose is less than 20 units per day substitute 2.5 to 5 mg (standard) OR 1.5 to 3 mg (micronized) orally once a day.
–If the insulin dose is between 20 and 40 units per day, substitute 5 mg (standard) OR 3 mg (micronized) orally once a day.
–If the insulin dose is more than 40 units per day; transition the patient by concomitantly decreasing insulin by 50% and starting glyburide at 5 mg (standard) OR 3 mg (micronized) orally once a day; as insulin is progressively withdrawn, titrate in increments of 1.25 to 2.5 mg (standard) OR 0.75 to 1.5 mg (micronized) orally once a day every 2 to 10 days.

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

Usual Geriatric Dose for Diabetes Type 2:

Initial dose: 1.25 to 2.5 mg (standard) orally or 0.75 to 1.5 mg (micronized) orally once a day.