Hypoglycemic (blood sugar lowering medication)
Glimepiride is a prescription oral medication used to help control blood sugar levels in adults with type 2 diabetes. It works by helping your pancreas release more insulin. It should be taken with your first meal of the day. Because it can cause low blood sugar (hypoglycemia), it is important to use it as directed and be aware of the signs of low blood sugar.
How it worksGlimepiride works by binding to specific receptors in the pancreas, which triggers the release of insulin into your bloodstream to lower your blood sugar.
Brand names:AVANDARYL, DUETACT, AMARYL
How to take
The starting dose is usually 1 mg or 2 mg once daily, taken with breakfast or your first main meal. Your doctor may increase the dose slowly, but the maximum daily dose is 8 mg.
Take this medication with your first meal of the day. If you are elderly or have kidney issues, your doctor may start you on a lower 1 mg dose.
Key warnings
- ·Severe hypoglycemia: Glimepiride can cause dangerously low blood sugar, which may lead to seizures, brain damage, or death.
- ·Allergic reactions: Stop use and seek help if you experience signs of an allergic reaction.
- ·Blood disorders: People with G6PD deficiency may be at risk for hemolytic anemia.
- ·Heart health: There is a potential increased risk of cardiovascular mortality with sulfonylureas.
Do not use if
- ·History of hypersensitivity to glimepiride or its ingredients
- ·History of allergic reactions to sulfonamide derivatives
Side effects
Common
Serious
- ·Severe low blood sugar (hypoglycemia) which can lead to unconsciousness or seizures
- ·Allergic reactions (anaphylaxis, swelling, or skin rashes like Stevens-Johnson syndrome)
- ·Hemolytic anemia (a type of red blood cell breakdown, especially in people with G6PD deficiency)
- ·Cholecystitis (gallbladder inflammation)
Seek help if
- ·Severe low blood sugar
- ·Allergic reactions
- ·Signs of hemolytic anemia
Interactions
- ·Oral miconazole (can cause severe low blood sugar)
- ·Colesevelam (may reduce how much glimepiride your body absorbs; take glimepiride at least 4 hours before)
- ·Medications that affect cytochrome P450 2C9
- ·Other diabetes medications like insulin or pramlintide acetate
- ·ACE inhibitors, H2 blockers, and certain antibiotics
Special populations
PregnancyWhile studies haven't shown major birth defect risks, glimepiride can pass to the baby and cause low blood sugar in newborns. It is generally recommended to stop taking glimepiride at least two weeks before your expected delivery date.
PediatricGlimepiride is not recommended for children because it can cause low blood sugar and weight gain.
GeriatricGlimepiride can be used in older adults, but they may be more sensitive to the drug. Because the kidneys clear this drug, older adults with kidney issues should be monitored closely.
Talk to your doctor
Monitor
- ·Blood glucose levels
- ·Signs of hypoglycemia
- ·Allergic reaction symptoms
- ·Weight changes
Questions to ask
- ·Am I at high risk for hypoglycemia?
- ·How will my kidney function affect my dose?
- ·Should I adjust my dose if I am taking other medications?
- ·What should I do if I experience a sudden drop in blood sugar?
Pharmacokinetics
Practical
OverdoseAn overdose can cause severe low blood sugar. Mild cases can be treated with sugar, but severe cases (like seizures or loss of consciousness) are medical emergencies requiring immediate treatment with glucagon or IV glucose.
Ingredients
Allergens
Inactive
Educational summary derived from FDA labeling, AI-assisted. Not medical advice — consult a healthcare professional. Updated 2026-04-25.