Glypam Tablets (Glimepiride)

Adult dose

Adjust individually for each patient. Swallow without chewing with more than 1/2 cup of water. This medication is taken once daily orally. It should be taken before breakfast or right before the first meal. It is very important not to skip meals after taking the medication. 1. Monotherapy 1) Initial dose and dosage determination For patients who have not previously received medication, treatment begins with 1 mg of glimepiride orally once daily. If necessary, the dosage may be increased by 1 mg at intervals of 1 to 2 weeks. Generally, when administering doses over 4 mg, additional effects are rarely observed, but some patients may show better metabolic control with an increase to 6 mg (or 8 mg). If 4 mg once daily fails, consider transitioning to insulin therapy; otherwise, consider combination with insulin or other oral antidiabetic medications. 2) Secondary dosage adjustment As treatment progresses, the required amount of this medication may decrease due to improvement in diabetes control. Therefore, dose reduction or discontinuation of this medication may be necessary to avoid hypoglycemia. Adjustments should also be considered when weight loss, lifestyle changes, or other factors that can increase the risk of hypoglycemia or hyperglycemia occur. 3) Transitioning from other oral antidiabetic medications to this medication There is no precise dosage correlation between this medication and other oral antidiabetic agents. When transitioning from another oral antidiabetic medication to this medication, it is advisable to follow the initial dosing method outlined previously. Specifically, start at 1 mg daily, adjusting the dose every 1 to 2 weeks as appropriate. Consider the effectiveness and duration of action of the previously used medication. 4) Medication adjustments During the use of this medication, regular checks of blood glucose and/or urine glucose levels are recommended, as well as regular measurements of glycosylated hemoglobin (HbA1c) levels. Generally, hypoglycemia is immediately managed by consuming glucose. Hypoglycemia may recur even after initially successful management with sulfonylureas; thus, careful monitoring of the patient is necessary. In cases of severe hypoglycemia, prompt medical intervention and follow-up may be required, and sometimes hospitalization is necessary. 2. Combination therapy 1) Combination therapy with insulin This medication in combination with insulin is used for patients with secondary failure, particularly when fasting blood glucose (FBG) exceeds 150 mg/dL. This medication is administered at 8 mg once daily with the first meal, while insulin starts at a low dose and is increased approximately weekly based on fasting blood glucose readings. Once stabilized, capillary blood glucose monitoring should be performed as frequently as possible. It is necessary to periodically adjust the insulin dosage while monitoring blood glucose and glycosylated hemoglobin. 2) Combination therapy with metformin If the patient does not respond adequately to the maximum dose of this medication, the addition of metformin may be considered. Clinical information exists for combination therapy with metformin and other sulfonylureas such as glibenclamide, glipizide, chlorpropamide, and tolbutamide. When this medication is used in conjunction with metformin, the dosages of each medication can be adjusted to achieve desired blood sugar levels. However, efforts should be made to determine the minimum effective doses for blood sugar control. There is a risk of hypoglycemia with the combination of this medication and metformin, and this risk may increase. Appropriate caution should be exercised.

This medication should not be used in patients with insulin-dependent diabetes, diabetic ketoacidosis, or coma. It is also not safe for patients with a history of allergic reactions to this medication or sulfonylureas, and those with severe liver or kidney dysfunction. Women who are pregnant or breastfeeding should not take this medication, and insulin therapy is recommended for patients with severe infections, before and after surgery, or with severe trauma. Patients with gastrointestinal disorders should be cautious as this medication may pose a risk of hypoglycemia. During the first week of starting this medication, the risk of hypoglycemia is high; therefore, blood sugar should be checked frequently. Elderly individuals, those with poor nutritional status or irregular eating habits, frequent alcohol consumers, and patients with compromised kidney or liver function should be particularly cautious. Additionally, those who have overdosed on this medication or have endocrine disorders are also at increased risk for hypoglycemia, so caution is necessary. If symptoms of hypoglycemia occur, immediate notification to a doctor or pharmacist is essential, and dosage adjustment may be required as necessary. This medication may cause hypoglycemia, and if severe, symptoms such as headaches, severe hunger, vomiting, confusion, drowsiness, and loss of consciousness may occur. Various side effects such as blurred vision, indigestion, liver dysfunction, blood abnormalities, and allergic reactions may appear, and if any abnormal symptoms occur, medical attention should be sought immediately. This medication should be taken regularly while maintaining a balanced diet and exercise, and it is important to be aware of hypoglycemia symptoms and management methods. In cases of hypoglycemia, consuming sugar or drinks containing sugar is essential to quickly raise blood sugar; artificial sweeteners will not be effective. This medication may interact with other drugs; thus, if there are other medications being taken, it is crucial to inform the healthcare provider, especially when used with medications that affect liver metabolism or blood sugar levels. Pregnant or breastfeeding women should not take this medication, and switching to insulin therapy if needed is considered safe. The safety and effectiveness of this medication have not been established in children under 18 years old; hence it is advisable not to use it in that age group. In the elderly, kidney function may decline; therefore, dosage adjustments and careful monitoring are required. In cases of overdose, induce vomiting and use adsorbents or laxatives to reduce drug absorption, and if severe hypoglycemia occurs, glucose injection should be administered immediately.

Serious side effects

• Hives
• severe swelling (edema)
• itching
• rash
• difficulty breathing
• hypotension
• shock
• anaphylaxis
• angioedema
• Stevens-Johnson syndrome

Mild side effects

• Headache
• severe hunger
• nausea
• vomiting
• fatigue
• sleep disturbances
• anxiety
• aggression
• decreased concentration
• reduction in agility or activity

This medication should be stored in a tightly sealed container to prevent exposure to air or moisture, and it should be kept at room temperature between 1 to 30 degrees Celsius.

Appearance

Dark green rectangular tablets

Package unit

30 tablets/bottle, 100 tablets/bottle