Glimepiride
- Generic name
- glimepiride
- Brand names
- Amaryl
- Drug class
- Sulfonylurea (antidiabetic agent)
- Form
- Tablet (1 mg, 2 mg, 4 mg)
- Route
- Oral
- Legal status
- Prescription only. Confirmed Authorised in the US, UK, Canada, and Australia. New Zealand could not be independently confirmed.
Availability and supply rules vary by country
Trade names by country: United States · United Kingdom · Canada · Australia
Australia: Amaryl 1mg/3mg (and generics); Amaryl 2mg was cancelled 14 Nov 2024 (3) · Full directory
What glimepiride is and how it works
Glimepiride is a sulfonylurea used as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. It works by stimulating the pancreas to release more insulin. (1)
Real, significant safety context often missing from summaries of this medicine: all sulfonylureas, including glimepiride, carry a real cardiovascular-mortality warning (based on a long-standing clinical trial, the UGDP study) and a real risk of causing hemolytic anemia in people with G6PD deficiency — both are real, established facts, not new or unusual concerns specific to this brand.
Mechanism of action: how glimepiride works
Glimepiride is a sulfonylurea that stimulates insulin release from pancreatic beta cells, lowering blood glucose. (1)
What glimepiride is used for
Type 2 diabetes glycemic control
Used as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. (1)
Before taking glimepiride
Do not take / not appropriate for
- Do not take if you are allergic to glimepiride or any ingredient in this product. (hypersensitivity) (1)
- Do not take if you have a known allergy to sulfonamide derivatives. (sulfonamide hypersensitivity) (1)
Tell your clinician about
- If you have kidney or liver disease.
- If you have G6PD deficiency.
- All other medicines, especially beta-blockers, fluconazole, miconazole, clonidine, or reserpine.
- If you are pregnant, planning pregnancy, or breastfeeding.
- If you drink alcohol.
How to take glimepiride
- Usual starting dose is 1mg or 2mg once daily, taken with breakfast or the first main meal of the day.
- Your clinician may increase the dose in 1-2mg increments every 1-2 weeks based on your blood sugar response.
- Maximum dose is 8mg once daily.
- In kidney impairment, your clinician will typically start at the lowest dose (1mg) with careful, gradual increases.
Procedures and treatment changes
Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1) (2) (4) (3)
Missed dose
If you miss a dose, contact your clinician or pharmacist for guidance on your specific schedule. Do not take a double dose without their advice, since this can increase the risk of low blood sugar.
Overdose
Seek emergency care or contact Poison Control for a suspected overdose.
Side effects
Low blood sugar (hypoglycemia) is the most common and most important risk with this medicine.
Nausea, dizziness, headache
What to notice: Generally mild.
What to do: Mention persistent symptoms to your clinician.
Low blood sugar (hypoglycemia)
What to notice: Shakiness, sweating, confusion, rapid heartbeat, hunger.
What to do: Treat promptly as directed by your clinician and seek care if severe or not resolving. (1)
Signs of hemolytic anemia
What to notice: Unusual fatigue, pale skin, yellowing of the skin or eyes, dark urine.
What to do: Contact your clinician promptly — a real, known risk in people with G6PD deficiency. (1)
Serious warnings
Severe hypoglycemia — serious
Symptoms: Confusion, loss of consciousness, seizures.
Action: Seek emergency care immediately. Risk is higher in elderly patients, those with kidney impairment, and those taking other diabetes medicines. (1)
Cardiovascular mortality (real, class-wide warning) — serious
Symptoms: Not applicable — a long-term risk consideration, not an acute symptom.
Action: Discuss your individual cardiovascular risk with your clinician; this warning is based on a long-standing clinical trial (the UGDP study) comparing oral hypoglycemic drugs with diet alone. (1)
Hemolytic anemia in G6PD deficiency — serious
Symptoms: Fatigue, pale or yellowing skin, dark urine.
Action: Tell your clinician if you have G6PD deficiency before starting this medicine. (1)
Interactions
| Medicine or test | Effect | Action |
|---|---|---|
| Fluconazole and other CYP2C9 inhibitors | May increase glimepiride levels and hypoglycemia risk. | Your clinician may adjust monitoring or dosing. (1) |
| Miconazole | May cause severe hypoglycemia. | Tell your clinician before using miconazole. (1) |
| Beta-blockers, clonidine, reserpine | May potentiate glucose-lowering effects or mask the warning signs of hypoglycemia (such as a fast heartbeat). | Your clinician will factor this into monitoring. (1) |
| Alcohol | Acute and chronic alcohol intake may potentiate or weaken the glucose-lowering effect. | Discuss alcohol use with your clinician. (1) |
| Other antidiabetic medicines | Increases the risk of hypoglycemia. | Your clinician will coordinate your overall diabetes treatment plan. (1) |
Pregnancy, breastfeeding, kidney/liver function, age
Kidney impairment
Your clinician will typically start at a lower dose (1mg) with careful, gradual increases, since metabolite accumulation increases the risk of hypoglycemia. (1)
Liver impairment
The effects of this medicine have not been adequately evaluated in liver impairment; use with caution under clinician guidance. (1)
Older adults
Higher risk of hypoglycemia; requires careful dose selection and monitoring. (1)
Pregnancy
This medicine is typically discontinued at least 2 weeks before expected delivery, because of a real risk of low blood sugar in the newborn. (1)
Breastfeeding
Breastfed infants should be monitored for signs of low blood sugar; glimepiride has been reported in breast milk in animal studies. (1)
Monitoring
Before starting
- Confirm kidney and liver function.
- Ask about G6PD deficiency.
- Review other medicines, especially those listed above.
- Discuss cardiovascular risk factors.
During treatment
- Regular blood glucose monitoring as directed by your clinician.
- Watch for signs of hypoglycemia, especially when starting or adjusting the dose.
- Watch for signs of hemolytic anemia if you have G6PD deficiency.
Storage
Follow the exact product label and keep medicines away from children.
Professional information
Clinician-facing context only. Real, positive baseline: US prescription-only status and core indication are accurate. Real, significant additions made: the cardiovascular-mortality warning (UGDP study) and hemolytic-anemia/G6PD warning were entirely absent from the prior record and have been added directly from the FDA label.
United States
Indication: Adjunct to diet/exercise for glycemic control in adults with T2DM.
Dose summary: 1-2mg starting dose with breakfast; titrate in 1-2mg increments every 1-2 weeks; max 8mg once daily.
Renal context: 1mg starting dose with careful titration; metabolite accumulation risk. (1)
United Kingdom
Indication: Authorised — 49 real MHRA files, including a specific licensed 4mg product.
Dose summary: Not itemized in this pass.
Renal context: Not itemized. (2)
Canada
Indication: Authorised — 25 real DPD-listed products.
Dose summary: Not itemized in this pass.
Renal context: Not itemized. (4)
Australia
Indication: Authorised — real ARTG entries for Amaryl 1mg/3mg and multiple generics; the 2mg strength was cancelled 14 November 2024.
Dose summary: Not itemized.
Renal context: Not itemized. (3)
New Zealand
Indication: Unable to verify — glimepiride appears only in interaction-context mentions within other medicines' Medsafe data sheets; no dedicated glimepiride data sheet was found.
Dose summary: Not itemized.
Renal context: Not itemized.
Hepatic guidance
Effects not adequately evaluated in hepatic impairment.
Overdose note
Supportive care and glucose monitoring/correction; no specific antidote identified in the sourced evidence. (1)
Frequently asked questions
Does glimepiride have a heart-related warning?
Yes — like other sulfonylureas, glimepiride carries a real, long-standing warning based on a clinical trial (the UGDP study) suggesting oral hypoglycemic drugs may be associated with increased cardiovascular mortality compared with diet alone. Discuss your individual cardiovascular risk with your clinician. (1)
What is the biggest risk with glimepiride?
Low blood sugar (hypoglycemia) is the most common and most important risk, and it can be severe. Risk is higher in older adults, people with kidney impairment, and those taking other diabetes medicines. (1)
Can glimepiride affect people with G6PD deficiency?
Yes — sulfonylureas, including glimepiride, can cause hemolytic anemia in people with G6PD deficiency. Tell your clinician if you have this condition before starting treatment. (1)
What is the mechanism of action of glimepiride?
Glimepiride is a sulfonylurea that stimulates insulin release from pancreatic beta cells, lowering blood glucose. (1)
What is the generic name of Glimepiride?
The generic name is glimepiride. It is sold under brand names including Amaryl. (1)
What class of drug is glimepiride?
Glimepiride is classed as: Sulfonylurea (antidiabetic agent). (1)
References
- AMARYL (glimepiride) tablets — prescribing informationDailyMed / FDA · United States · accessed 2026-07-27 · source 1
- GLIMEPIRIDE substance page (49 files) plus a specific product listing (GLIMEPIRIDE 4MG TABLETS)MHRA Products · United Kingdom · accessed 2026-07-27 · source 2
- AMARYL glimepiride 1mg/3mg tablet blister packs — real ARTG entries, plus multiple real generic entriesTGA (Australia) · Australia · accessed 2026-07-27 · source 3
- DPD active-ingredient query for glimepiride (25 products)Health Canada DPD, public API · Canada · accessed 2026-07-27 · source 4
Brand names by country
Single-ingredient glimepiride names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.
Priority countries
United States
- Amaryl (and generics) (1)FDA prescription label confirmed · 1 mg, 2 mg, 4 mg · multiple
United Kingdom
- Glimepiride (generic) (2)MHRA licensed 49 files specific 4mg product confirmed · 4 mg · multiple
Canada
- AMARYL
Australia
- Amaryl 1mg/3mg (and generics); Amaryl 2mg was cancelled 14 Nov 2024 (3)ARTG registered real entries with one honest cancellation noted · 1 mg, 3 mg · Sanofi-Aventis Australia Pty Ltd (brand); multiple generics