Glimepiride

Medically Reviewed by Dr. Harshi Dhingra, M.D.

Last Reviewed: Jul 10, 2023

Warnings

Glimepiride (Amaryl) Risks, Warnings, and Complications

Glimepiride can cause or worsen health problems in some people. Talk to your doctor or pharmacist about other treatments for type 2 diabetes mellitus if you are at an increased risk of adverse reactions or complications from this medication. Some of the risks of taking glimepiride include:

HYPOGLYCEMIA: Glimepiride and other drugs in its class (sulfonylureas) can cause severe hypoglycemia (very low blood sugar levels). This can impair your ability to react and concentrate and thereby put you at risk of accidents, for example, while driving a motor vehicle or operating machinery. Severe hypoglycemia can also lead to loss of consciousness, convulsions, temporary or permanent brain damage, and even death.
Elderly patients, those with impaired kidney function, and people taking other anti-diabetic drugs are at a particularly high risk of developing low blood sugar. In addition, malnourished and debilitated people and those with adrenal, pituitary, or hepatic impairment are also more susceptible to this complication. Prolonged exercise, insufficient caloric intake, and alcohol ingestion are additional risk factors for hypoglycemia while on Amaryl tablets or other sulfonylureas.
Ask your doctor how to recognize hypoglycemia and manage it. Your doctor may tell you to take glucose tablets, eat hard candy, or drink fruit juice or regular (non-diet) soda if your blood sugar level falls below a particular level (usually between 50-70 mg/dL).
ALLERGIC REACTIONS: Glimepiride has been reported to cause hypersensitivity (allergic) reactions in a small number of people, including serious reactions such as anaphylaxis (throat closing), angioedema (swelling), and severe skin reactions. Stop taking glimepiride and seek emergency medical attention if you develop a skin rash, hives, itching, swelling of the face or throat, or difficulty breathing or swallowing.
HEMOLYTIC ANEMIA: In people with a medical condition called glucose 6-phosphate dehydrogenase (G6PD) deficiency, glimepiride can cause hemolytic anemia (anemia due to the abnormally fast breakdown of red blood cells). This complication can occur even in patients who do not have G6PD deficiency. Tell your doctor without delay if you develop tiredness, weakness, dizziness, yellowing of the skin or eyes, stomach pains, light-colored stool, or dark-colored urine after starting glimepiride.
INCREASED RISK OF DEATH DUE TO HEART PROBLEMS: Oral anti-diabetes drugs from the same class as glimepiride have been linked to an up to 2.5 times increased risk of death due to cardiovascular causes compared to other diabetes treatments such as diet alone or diet and insulin. Talk to your doctor about the risks versus benefits of taking glimepiride and alternative diabetes treatment if this is a concern for you.

Precautions Before Starting Glimepiride (Amaryl)

Tell your doctor if you have ever had an allergic reaction to glimepiride, any of the active or inactive ingredients in glimepiride tablets, or any other medications. Your pharmacy can give you a list of ingredients.

Give your doctor and pharmacist a complete list of your medications, including prescription medications, over-the-counter medicines, vitamins, supplements, and herbal products. This can help avoid possible drug interactions between your medications.

Give your doctor a complete medical history. Glimepiride may not be right for people with certain medical conditions, such as G6PD deficiency (a hereditary condition that causes hemolytic anemia), kidney disease, liver disease, heart disease, or endocrine disorders involving the pituitary gland, adrenal glands, or thyroid gland.

If you are 65 years of age or older, talk to your doctor about the potential risks of taking glimepiride. There may be other safer diabetes medications available.

Tell your health care professional if you are pregnant, could be pregnant, plan to get pregnant, or are nursing an infant with breast milk.

Precautions During Use of Glimepiride (Amaryl)

Keep all your healthcare appointments during glimepiride treatment. Your doctor may want to adjust your dose based on glycemic control and your response to the medicine.

Glimepiride can increase the sensitivity of your skin to sunlight. Avoid unnecessary sun exposure and the use of tanning beds. Wear protective clothing and sunscreen to protect your skin.

Avoid drinking alcohol while on glimepiride. Alcohol can make the side effects of this medication worse and cause symptoms such as flushing, headache, nausea, vomiting, weakness, confusion, blurred vision, chest pain, sweating, anxiety, choking, and breathing difficulties.

Talk to your doctor about what to do if you are stressed, sick with an infection, or injured, as these conditions can affect your blood glucose levels.

Tell your doctor if you become pregnant while taking glimepiride.

Tell all your healthcare providers you are on glimepiride, especially before any surgery, including dental procedures.

Glimepiride (Amaryl) Drug Interactions

Concomitant administration of other drugs can affect how glimepiride works. Possible interactions with other medicines and or an overlapping drug effect can increase the risk of severe adverse reactions.

The following medications may have interactions with glimepiride:

Anticoagulants or blood thinners such as warfarin (Coumadin)
Nonsteroidal anti-inflammatory medications (NSAIDs) such as aspirin, ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn)
Antibiotics such as chloramphenicol and clarithromycin (Biaxin)
Quinolone and fluoroquinolone antibiotics such as ciprofloxacin (Cipro), levofloxacin (Levaquin), moxifloxacin (Avelox), ofloxacin (Floxin), norfloxacin (Noroxin), cinoxacin (Cinobac), gatifloxacin (Tequin), sparfloxacin (Zagam), enoxacin (Penetrex), lomefloxacin (Maxaquin), nalidixic acid (NegGram), and a combination of trovafloxacin and alatrofloxacin (Trovan)
Sulfa antibiotics such as co-trimoxazole (Bactrim, Septra) and sulfasalazine (Azulfidine)
Anti-tuberculosis medications such as isoniazid (INH) and rifampin (Rifadin)
Diuretics or water pills
Blood pressure medications (beta blockers) such as propranolol (Inderal), metoprolol (Lopressor, Toprol XL), labetalol (Normodyne), atenolol (Tenormin), and nadolol (Corgard)
Medications prescribed for heart rhythm abnormalities such as disopyramide (Norpace)
Antifungal drugs such as fluconazole (Diflucan) and miconazole (Monistat)
Antidepressants such as fluoxetine (Prozac, Sarafem)
Hormone replacement therapy and oral contraceptives (birth control pills, rings, patches, implants, and injections)
Other medications used to treat high blood sugar, including insulin
MAO inhibitors such as selegiline (Eldepryl, Emsam, Zelapar), isocarboxazid (Marplan), tranylcypromine (Parnate), and phenelzine (Nardil)
Asthma medications
Medications used to treat colds
Drugs prescribed for mental illnesses
Anti-nausea medications
Niacin (B vitamin)
Oral steroids such as prednisone (Deltasone), methylprednisolone (Medrol), and dexamethasone (Decadron, Dexone)
Anabolic steroids and androgens
Anticonvulsants such as phenytoin (Dilantin)
Anti-gout medications such as probenecid (Benemid)
Salicylate pain medications such as magnesium salicylate (Doan's), choline salicylate (Arthropan), choline magnesium trisalicylate, diflunisal (Dolobid), and salsalate (Argesic, Disalcid)
Thyroid medications
Protease inhibitors (HIV medications)

Give your doctor or pharmacist a complete list of your medications, including prescription drugs, nonprescription drugs, dietary supplements, and herbal remedies. Also, tell your healthcare professional if you smoke, drink alcohol, or use recreational drugs because some of these substances can cause serious health complications when used with prescription medications.

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