Generic Name Glimepiride

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Brand Name Amaryl

Classification Oral Hypoglycemic Agent, Sulfonylureas
Mode of Action Stimulates the beta cells of the pancreas to increase release of
insulin. It also increases sensitivity of peripheral insulin
receptors, which increase insulin binding in the peripheral
tissues
Ordered Dosage
Adult [PO]
 Initial: 1 mg daily
 May increase in increments of 1 mg at intervals of 1-2
weeks according to response.
 Maintenance: 4mg/day
 Max: 6mg/day

Elderly
 Initial: 1mg once daily

Indications Type 2 Diabetes mellitus

Contraindications Renal Impairment
Hepatic Impairment
Hypersensitivity
Type 1 diabetes or Insulin-dependent diabetes
Diabetic ketoacidosis (with or without coma)
Side Effects  nausea,
 upset stomach,
 stomach pain,
 vomiting,
 diarrhea,
 dizziness,
 headache,
 tiredness,
 increased skin sensitivity to sunlight,
 itching, or
 skin rash.
Adverse Effects  Significant:
o Hypoglycaemia, haemolytic anaemia (in G6PD
 deficiency), hypersensitivity reaction (e.g.
anaphylaxis, angioedema, Stevens-Johnson
syndrome), weight gain.
 Blood and lymphatic system disorders:
o Leukopenia, agranulocytosis, aplastic anaemia,
pancytopenia, thrombocytopenia.
 Endocrine disorders: Inappropriate antidiuretic hormone
secretion (SIADH).
 Eye disorders: Visual disturbances.
 Gastrointestinal disorders: Abdominal pain, diarrhoea,
nausea, vomiting, dysgeusia.
 General disorders and administration site conditions:
Asthenia
 Hepatobiliary disorders: Cholestasis, jaundice, hepatitis,
liver failure, hepatic porphyria.
 Metabolism and nutrition disorders: Disulfiram-like
reactions, hyponatraemia.
 Nervous system disorders: Headache, dizziness.
 Skin and subcutaneous tissue disorders: Photosensitivity,
alopecia.
Drug Interactions Increased hypoglycaemic effect with:
 NSAIDs (e.g. phenylbutazone),
 insulin, oral antidiabetics (e.g. metformin),
 salicylates, fluoxetine, anabolic steroids and androgens,
antibiotics (e.g. chloramphenicol, sulphonamides,
tetracyclines, quinolones, clarithromycin)
 coumarin anticoagulants, disopyramide, fibrates, ACE
inhibitors, MAOIs, allopurinol, probenecid,
sulfinpyrazone, cyclophosphamide, fluconazole and
pentoxifylline.

Decreased hypoglycaemic effect with:

 oestrogens, oral contraceptives
 thiazide diuretics
 glucocorticoids
 phenothiazine derivatives (e.g. chlorpromazine)
 sympathomimetics (e.g. epinephrine, albuterol,
terbutaline)
 nicotinic acid (high doses) and nicotinic acid derivatives,
laxative (long term use),
 phenytoin, diazoxide, glucagon, barbiturates, rifampicin
and isoniazid.

Signs of hypoglycaemia may be reduced or absent in

patients taking sympatholytic drugs (e.g. ß-blockers,
clonidine, guanethidine, reserpine).

May cause severe hypoglycaemia with miconazole.

Nursing Responsibilities 1. Instruct client to take the drug 15 to 30 minutes before
 meals, do not take medication and skip meals
2. Monitor blood glucose levels daily
3. Teach client to maintain weight and dietary restrictions
along with medication.
4. Call the doctor for signs of hypoglycemia (fatigue,
hunger, cool moist skin, increase anxiety, dizziness, and
palpitations.)
5. Monitor urine or serum glucose levels frequently to
determine effectiveness of drug and dosage being used.
6. WARNING: Transfer to insulin therapy during periods of
high stress (eg, infections, surgery, trauma).
7. Use IV glucose if severe hypoglycemia occurs as a
result of overdose.
8. Arrange for consultation with dietitian to establish weight-
loss program and dietary control.
9. Arrange for thorough diabetic teaching program,
including disease, dietary control, exercise, signs and
symptoms of hypoglycemia and hyperglycemia,
avoidance of infection, hygiene
10. Avoid alcohol while using this drug.

Reference Cunha, J.P. (2018). Amaryl side effects center. RxList.

Retrieved from www.rxlist.com/amaryl-side-effects-drug-
center on September 21, 2020

RNpedia. Glimepiride nursing considerations & management.

Retrieved from
www.rnpedia.com/nursing-notes/pharmacology-drug-
study-notes/glimepiride/ from September 21, 2020

MIMS Philippines. (2020). Glimepiride. Retrieved from

www.mimsonline.com.ph on September 21, 2020