Glimepiride
- Class: Sulfonylurea
- Used for: type 2 diabetes
- Say it: glye-MEP-ih-ride
- Forms: tablet
Mnemonic: Glimepiride: the sulfonylurea taken once a day
Same mechanism as glyburide — closing the beta cell potassium channel — but a cleaner pharmacokinetic profile and once-daily dosing, with somewhat less hypoglycaemia in older patients.
Same mechanism as glyburide — closing the beta cell potassium channel — but a cleaner pharmacokinetic profile and once-daily dosing, with somewhat less hypoglycaemia in older patients.
Suffix GLI- / GLY-: A GLI- or GLY- name SQUEEZES insulin out — hungry or not.
These close the beta cell's potassium channel directly, releasing insulin whatever the blood sugar is doing. Glucose-independent is the phrase to hold on to: it is exactly why this class causes hypoglycaemia and weight gain, and why metformin does not. All drug suffixes ›
These close the beta cell's potassium channel directly, releasing insulin whatever the blood sugar is doing. Glucose-independent is the phrase to hold on to: it is exactly why this class causes hypoglycaemia and weight gain, and why metformin does not. All drug suffixes ›
Side effects
Common: hypoglycemia, weight gain, dizziness
Serious: severe hypoglycemia
Typical dose
1–4 mg once daily with breakfast
Start at 1 mg. Warn about recognising and treating a hypo before driving.
Check yourself
Which two side effects characterise the sulfonylureas?
- Hypoglycaemia and weight gain
- Weight loss and dehydration
- Lactic acidosis and diarrhoea
- Genital infections and dehydration
Show answer
A. Hypoglycaemia and weight gain
Driving insulin release raises the risk of hypoglycaemia and promotes storage, so weight rises. Option three describes metformin and option four the SGLT2 inhibitors — a useful contrast when choosing a second agent.
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