Glimepiride

Glimepiride is a sulfonylurea — oral antidiabetic for type 2 diabetes medicine available in Bangladesh under many brand names. Below are its uses, side effects and precautions — and every brand with its current price.

Glimepiride is prescribed for:

• Type 2 diabetes mellitus — when blood sugar is not controlled by diet, weight control and exercise alone.
• Combination therapy — alongside metformin, DPP-4 inhibitors, SGLT2 inhibitors or insulin when one medicine is not enough, as decided by the doctor.

It is not suitable for type 1 diabetes or for diabetic ketoacidosis, because in those situations the pancreas cannot supply insulin and injection insulin is essential. The doctor chooses glimepiride considering your age, kidney and liver function, eating pattern and risk of low blood sugar.

Possible side effects of Glimepiride include:

• Hypoglycaemia (low blood sugar) — the most important one: sweating, trembling, sudden hunger, palpitations, dizziness, blurred vision, confusion; severe cases can cause fainting or fits. Treat immediately with sugar, glucose or sweets, then eat a meal.
• Weight gain — modest, due to increased insulin.
• Stomach upset — nausea, fullness or mild abdominal pain, usually temporary.
• Skin reactions — rash or itching in some people.
• Rarely, blood-cell changes or liver enzyme rise — your doctor may order occasional blood tests.

Report repeated hypoglycaemia episodes to your doctor; the dose may need lowering.

While on Glimepiride:

• Eat meals on time and never skip them; carry glucose, sugar or sweets with you, especially when travelling or fasting is likely.
• Learn the warning signs of low blood sugar and teach family members what to do.
• Be extra careful with driving or operating machinery until you know how the medicine affects you — hypoglycaemia impairs concentration.
• Elderly patients and those with kidney or liver disease are more prone to prolonged hypoglycaemia; doses are kept lower.
• Alcohol can both mask and worsen low blood sugar — best avoided.
• During Ramadan or any fasting, consult your doctor beforehand; the dose timing usually needs changing.
• Continue regular blood sugar and HbA1c checks.

Many medicines interact with Glimepiride; always show your doctor your full medicine list:

• Drugs that increase hypoglycaemia risk — other antidiabetics, insulin, aspirin and NSAIDs, some antibiotics (e.g. fluoroquinolones, sulfonamides/co-trimoxazole), fluconazole and certain antidepressants.
• Drugs that raise blood sugar and weaken control — steroids, thiazide diuretics, some hormone preparations.
• Beta-blockers — can hide the warning signs of low blood sugar (tremor, palpitations).
• Warfarin — effects of either drug may change; monitoring is needed.
• Alcohol — unpredictable rise or fall of sugar; avoid.

Do not take Glimepiride if you have:

• Type 1 diabetes or diabetic ketoacidosis (with or without coma) — insulin is mandatory in these conditions.
• Severe kidney or liver failure — risk of prolonged, dangerous hypoglycaemia; insulin is usually preferred.
• Allergy to glimepiride, other sulfonylureas or sulfonamide drugs.
• Pregnancy and breastfeeding — glimepiride is generally avoided; insulin is the standard alternative.

Pregnancy: Glimepiride is not recommended during pregnancy. If you are planning pregnancy or discover you are pregnant, contact your doctor promptly — treatment is usually switched to insulin, which controls sugar safely for the baby. Uncontrolled diabetes in pregnancy harms both mother and child, so never simply stop the medicine without arranging a replacement plan with your doctor.

Breastfeeding: Sulfonylureas may pass into breast milk and could lower the baby's blood sugar, so glimepiride is generally avoided while breastfeeding. Your doctor will advise insulin or another suitable option during this period.

Keep Glimepiride below 30°C in a dry place, protected from light and moisture. Leave the tablets in their original blister strip until use, and keep all medicines locked away from children. Do not use beyond the expiry date on the pack, and dispose of expired tablets through a pharmacy instead of household rubbish.