Side effects:Â Hypoglycemia: The incidence of hypoglycemia with glimepiride is documented. Others: In patients treated with glimepiride, adverse events, other than hypogiycemia, considered to be possibly or probably related to study drug that occurred in more than 1 % of patients included dizziness (1 .7%), asthenia (1 .6%), headache (1 .5%), and nausea ( 1 . 1 %); Allergic skin reactions, e.g., pruritus, erythema, urticaria, and morbilliform or maculopapular eruptions, occur in less than I % of treated patients, (these may be transient and may disappear despite ,ontinued use of glimepiride).
Precautions and warnings:Â In the initial weeks of treatment, the risk of hypoglycemia may be increased and careful monitoring is essential. If such risk is present it may be necessary to adjust the dosage of glimepiride. Hypoglycemia can almost always be promptly controlled by immediate intake of carbohydrates (glucose or sugar e.g, in the form of sugar lumps, sugar-sweetened fruit juice or sugar-sweetened tea). Caution in renal insufficiency and obese patients.
Pregnancy category:Sulphonylureas are contra-indicated during pregnancy & breastfeeding, so, a suitable treatment schedule should be prescribed with insulin.
Child:Â Not categorized yet
Therapeutic class:Â Glimepiride
Dosage and administrations: The dosage of glimepiride must be the lowest one, which is sufficient to achieve the desired melabolic control. The usual initial dose is Img once daily. If necessary, the daily dose can be increased. Any increase should be based on reqular blood sugar monitoring, and gradual, i.e at intervals of one to two weeks, and carried out stepwise as follows- 1mg-2mg-3mg-4mg-6mg. In patients with well controlled diabetes, the usual dose range is 1 to 4mg daily. Normally, a single daily dose is sufficient. This should be taken Immediately before a subslantial breakfast or- if none is laken- immediately before the first main meal, with sufficient amounts of liquid (approximately half glass). It is very imporlant not to skip meals after laking the drug. Secondary dosage adjustment- as the contr 01 of diabetes improves, sensitivity to insulin increases; therefore, glimepiride requirement may fall as treatment proceeds. To avoid hypoglycemia, timely dose reduction or cessation of glimepiride therapy must be considered. A dose adjustment must also be considered whenever the·patient’s weight or life-style changes, or other factors arise which cause an increased susceptibility to hypo- or hyperglycemia. When substituting glimepiride for other oral diabetic agents, the initial daily dose is Img, this applies even in changeover from the maximum dose of the drug.
Indication:Â Glimepiride is used alone in type 2 diabetes patients with diet & exercise after an adequate trial of dietary therapy and exercise that have been proved unsatisfactory. It can also be used in combination with other oral insulin sensitizing drugs like metformin, acarbose & piogliazone, and with insulin when diet, exercise and the above oral hypoglycemic agents do not result in adequate glycemic control.
Composition action:Â Known hypersensitivity to glimepiride or any of the ingredients of the product. Diabetic ketoacidosis, with or without coma, this condition should be treated with insulin.
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