Glimepiride is a medicine used to treat type 2 diabetes.

Type 2 diabetes is a condition where the body doesn't make enough insulin, or the insulin that it makes doesn't work properly. This can cause high blood sugar levels (hyperglycaemia).

Glimepiride lowers your blood sugar by increasing the amount of insulin your body produces.

Glimepiride is only available on prescription. It comes as tablets.

• It's usual to take glimepiride once a day in the morning.
• The most common side effects are feeling sick, indigestion and diarrhoea.
• Glimepiride can sometimes give you low blood sugar (hypoglycaemia). Carry some sweets or fruit juice with you to help when this happens.
• Some people find they put on weight with glimepiride.
• Glimepiride is also known by the brand name Amaryl.

Glimepiride can be taken by adults (aged 18 years and older).

A diabetes specialist may sometimes prescribe glimepiride for children and young people less than 18 years of age.

Glimepiride isn't suitable for some people. To make sure it's safe for you, tell your doctor if you:

• have had an allergic reaction to glimepiride or any other medicines in the past
• have severe kidney or liver disease
• have G6PD-deficiency (an inherited condition affecting red blood cells)
• are due to have surgery
• are pregnant, trying to get pregnant or breastfeeding

This medicine isn't used to treat type 1 diabetes (when your body does not produce insulin).

Doses of glimepiride can vary. Follow your doctor's instructions when taking this medicine.

You'll usually take glimepiride once a day. Take this medicine with food.

Most people take it in the morning with their breakfast. If you don't eat breakfast, make sure you take it with your first meal of the day. Try to take it at the same time every day.

Swallow the tablets whole, with a glass or water. Do not chew them.

If you find it difficult to swallow tablets, use the score line in the middle of the tablet to break it in 2, then take both halves.

How much will I take?

Glimepiride comes as 1mg, 2mg, 3mg and 4mg tablets.

Your doctor will tell you how many tablets to take. You may need to take 1 or 2 tablets to make up your daily dose.

The usual starting dose for adults is 1mg, taken once a day. Your doctor may increase your dose gradually over a few weeks or months, up to a regular dose of 4mg once a day.

The maximum daily dose is 6mg.

Will my dose go up or down?

Your doctor will check your blood sugar levels regularly. They may change your dose of glimepiride to keep your blood sugar under control.

What if I take too much?

The amount of glimepiride that can lead to an overdose varies from person to person.

If you think you have low blood sugar, have some food or drink that quickly gets sugar into your bloodstream such as sugar cubes or fruit juice.

This type of sugar won't last long in your blood. You may also need to eat a starchy carbohydrate, like a sandwich or a couple of biscuits.

What if I forget to take it?

If you forget to take your daily glimepiride, skip the missed dose and take your next dose at the usual time.

Do not take a double dose to make up for a forgotten one.

If you forget doses often, it may help to set an alarm to remind you. You could ask your pharmacist for advice on other ways to remember your medicines.

Like all medicines, glimepiride can cause side effects although not everyone gets them.

Common side effects

These common side effects happen in more than 1 in 100 people. Talk to your doctor or pharmacist if these side effects bother you or don't go away:

• feeling sick (nausea) or indigestion
• diarrhoea

Your eyesight may also be affected for a short time. This often happens when you start your treatment because of changes in your blood sugar levels.

Serious side effects

It happens rarely, but some people may have serious side effects after taking glimepiride.

Call your doctor straight away if:

• your skin or the whites of your eyes turn yellow - these can be signs of a liver problem
• you have a sore throat and high temperature, your skin is unusually pale, you are bleeding for longer than usual or get unexpected bruises - these can be signs of a blood disorder

Low blood sugar

Glimepiride can sometimes cause low blood sugar (known as "hypos" or hypoglycaemia).

Early warning signs of low blood sugar include:

• feeling hungry
• trembling or shaking
• sweating
• confusion
• difficulty concentrating

It's also possible for your blood sugar to go too low while you're asleep. If this happens, it can make you feel sweaty, tired and confused when you wake up.

Low blood sugar may happen if you:

• take too much of some types of diabetes medicines
• eat meals irregularly or skip meals
• are fasting
• don't eat a healthy diet and aren't getting enough nutrients
• change what you eat
• increase your physical activity without eating more to compensate
• drink alcohol, especially after skipping a meal
• take some other medicines or herbal medicines at the same time
• have a hormone disorder such as hypothyroidism
• have kidney or liver problems

To prevent hypos, it's important to have regular meals, including breakfast. Never miss or delay a meal.

If you're planning to exercise more than usual, make sure you eat carbohydrates (bread, pasta, cereals) before, during or afterwards.

Always carry a fast-acting carbohydrate with you, like sugar cubes, fruit juice or some sweets, in case your blood sugar level gets low. Artificial sweeteners won't help. You may also need to eat a starchy carbohydrate, like a sandwich or a biscuit, to maintain your blood sugar for longer.

If taking in sugar does not help or if the hypo symptoms come back, contact your doctor or the nearest hospital.

Make sure your friends and family know about your diabetes and the symptoms of low blood sugar levels so they can recognise a hypo if it happens.

Serious allergic reaction

It is possible to have a serious allergic reaction (anaphylaxis) to glimepiride.

These are not all the side effects of glimepiride. For a full list see the leaflet inside your medicines packet.

What to do about:

• feeling sick (nausea) or indigestion - make sure you take your tablets with a meal. Stick to simple meals and avoid rich or spicy food.
• diarrhoea - drink lots of fluids, such as water or squash, to avoid dehydration. Signs of dehydration include peeing less than usual or having dark strong-smelling pee. Do not take any other medicines to treat diarrhoea without speaking to a pharmacist or doctor.

Glimepiride is not generally recommended in pregnancy or while breastfeeding. It's not clear whether glimepiride can harm your unborn baby.

For safety, your doctor will probably change your medicine to insulin if you're trying for a baby or as soon as you find out you're pregnant.

Glimepiride and breastfeeding

Glimepiride isn't usually recommended while breastfeeding as there's a risk your baby may get low blood sugar.

Talk to your doctor if you want to breastfeed. They will be able to recommend the best treatment for you and your baby.

Some medicines interfere with the way glimepiride works. Your doctor may need to adjust your dose of glimepiride. They may also recommend checking your blood sugar levels more often.

Tell your doctor if you're taking any of these medicines before starting on glimepiride:

• steroid tablets such as prednisolone
• some medicines used to treat heart problems, high blood pressure and high cholesterol
• medicines to treat bacterial or fungal infections such as clarithromycin, co-trimoxazole, miconazole or fluconazole
• rifampicin, a medicine used to treat tuberculosis
• other diabetes medicines

Some women may need to adjust their dose of glimepiride after starting contraceptive pills. In rare cases contraceptive pills can increase blood sugar levels.

Taking glimepiride with painkillers

It's safe to take paracetamol with glimepiride.

However, check with your doctor or pharmacist before taking non-steroidal anti-inflammatories (NSAIDs) with glimepiride. NSAIDs such as ibuprofen or high-dose aspirin can sometimes lower your blood sugar level.

Mixing glimepiride with herbal remedies and supplements

There's very little information about taking herbal remedies or supplements with glimepiride.