How glimepiride works
Glimepiride is an active ingredient from the group of so-called sulfonylureas. It stimulates the body to release more insulin in order to lower blood glucose levels. This may be necessary for people with type 2 diabetes. However, they are only prescribed blood glucose-lowering drugs such as glimepiride if other measures (dietary changes, more exercise, etc.) have not been able to lower blood glucose levels sufficiently.
Every cell in the body constantly needs energy to function properly. The most important source of energy is carbohydrates, which are supplied through food. In the digestive tract, they are broken down into their smallest building blocks (simple sugars), since only these can be absorbed into the blood through the intestinal wall.
The hormone insulin is needed for the sugar to be able to pass from the blood into the body’s cells. It “helps” the sugar to get inside cells. In people with type 2 diabetes, too few insulin receptors on the cell surface or, in the later stages, generally too little insulin, cause the sugar to remain in the blood.
Absorption, degradation and excretion
After absorption by mouth (per oral), glimepiride is completely absorbed from the intestine into the blood and distributed throughout the body. Eventually, the drug is broken down in the liver and excreted in the urine and stool. After an average of five to eight hours, half of glimepiride has been broken down.
When is glimepiride used?
The area of use (indication) for glimepiride is:
- Treatment of type 2 diabetes when weight reduction, exercise, and dietary changes have not sufficiently lowered elevated blood glucose levels
Since type 2 diabetes is a chronic disease, treatment is permanent.
How glimepiride is used
Glimepiride is used in the form of tablets. As a rule, patients start with a dose of one milligram per day. Depending on the individual metabolic situation, the doctor may increase the dose to a maximum of six milligrams per day.
The tablets are usually taken once a day. They should be taken before or with the first main meal of the day.
The full effect of glimepiride use is achieved after about one to two weeks.
What are the side effects of glimepiride?
Rarely, i.e. in less than one percent of those treated, glimepiride causes side effects in the form of allergic reactions, hypoglycemia, gastrointestinal complaints and changes in the blood count.
During glimepiride therapy, diabetics should always have fast-acting carbohydrates (glucose syrup, fruit juices, sweetened drinks, etc.) on hand – in case of hypoglycemia. Signs include dizziness, shaky hands and headaches after waking up. If you experience such symptoms, also talk to your doctor about adjusting your glimepiride dosage if necessary.
Taking agents that increase insulin release may result in an increased feeling of hunger and associated weight gain. Therefore, it is especially important to pay attention to a healthy diet.
What should be considered when taking glimepiride?
Contraindications
Glimepiride must not be taken by:
- hypersensitivity to the active substance, other sulfonylurea derivatives, or any of the other ingredients of the drug
- type 1 diabetes
- ketoacidosis (severe metabolic derangement with low blood pH due to ketone bodies)
- severe kidney and liver dysfunction
Drug interactions
- Phenylbutazone (drug for rheumatic diseases)
- Chloramphenicol (antibiotic)
- Fibrates (agents to lower elevated blood lipid levels such as cholesterol)
- ACE inhibitors (drugs for high blood pressure)
In addition, there are medicines that may weaken the blood sugar-lowering effect of glimepiride. These include:
- Preparations with female hormones (estrogens)
- cortisone (anti-inflammatory agents)
- certain diuretics (thiazide diuretics)
- epinephrine
Unpredictable interactions may also occur with alcohol. Experts therefore advise against simultaneous alcohol consumption.
Caution is also advised if coumarin-type anticoagulants (warfarin, phenprocoumon) are taken in addition to glimepiride.
Trafficability and operation of machines
Unexpected attacks of hypoglycemia may occur, especially at the beginning of treatment, which may lead to dizziness and fainting. Therefore, it is essential to pay attention to individual tolerance. It is best to discuss with a doctor whether you are allowed to actively participate in road traffic and operate heavy machinery despite glimepiride use.
Age restrictions
Pregnancy and lactation
Oral anti-diabetic agents (such as glimepiride) are not used in gestational diabetes. Instead, insulins that are injected are the first choice. If women with type 2 diabetes want to become pregnant, a switch to insulin is made in advance.
It is not known whether glimepiride passes into breast milk. However, due to the high protein binding, transfer is unlikely. Administration of the drug therefore seems acceptable as long as the infant is well monitored. To be on the safe side, however, insulin is also the drug of first choice during the breastfeeding period if drug-induced blood glucose lowering is necessary.
How to obtain medication with glimepiride
Medicines containing glimepiride require a prescription in Germany, Austria and Switzerland. You can therefore only obtain them from a pharmacy with a prescription from your doctor.
How long has glimepiride been known?
Sulfonylureas have been used for some time as blood sugar-lowering agents in diabetes. Further development of older representatives of this class of active ingredients led to the introduction of glimepiride in 1996.
