Glimepiride in Pregnancy and Breastfeeding
Risk Factor: CM
Class: Hormones
/ Antidiabetic agents
Fetal Risk Summary
Glimepiride is a second generation sulfonylurea in the same class as glipizide and glyburide (see also Glipizide and Glyburide). It is used as an adjunct to diet and exercise, either alone or in combination with other oral agents, in the treatment of type II diabetes (non-insulin-dependent diabetes mellitus). It has also been used in combination with insulin when diet, exercise, and an oral hypoglycemic have not controlled hyperglycemia.
Reproduction studies in animals have been conducted with glimepiride (1). No teratogenic effects were observed in rats and rabbits given doses up to approximately 4,000 and 60 times, respectively, the maximum recommended human dose based on body surface area (MRHD). However, in some studies, rat pups, nursing from mothers given high doses of glimepiride during pregnancy and lactation, developed skeletal deformities consisting of shortening, thickening, and bending of the humerus during the postnatal period (1). Moreover, fetotoxicity (intrauterine death) occurred in both rats and rabbits at 50 and 0.1 times, respectively, the MRHD. The fetotoxicity, that had also been observed with other sulfonylureas, occurred only at doses that produced maternal hypoglycemia and was thought to be due to that affect (1). No effect on the fertility of male and female rats was noted at doses up to 4,000 times the MRHD (1).
It is not known if glimepiride crosses the placenta, but the molecular weight (about 491) is low enough that transfer to the fetus should be expected. Hypoglycemia in the newborn may occur if glimepiride is taken close to delivery.
No reports describing the use of glimepiride during human pregnancy have been located. Insulin is the treatment of choice for pregnant diabetic patients because, in general, other hypoglycemic agents do not provide adequate glycemic control. Moreover, insulin, unlike most oral agents, does not cross the placenta to the fetus, thus eliminating the additional concern that the drug therapy itself will adversely effect the fetus. Carefully prescribed insulin therapy provides better control of the mother's glucose, thereby preventing the fetal and neonatal complications that occur with this disease. High maternal glucose levels, as may occur in diabetes mellitus, are closely associated with a number of maternal and fetal adverse effects, including fetal structural anomalies if the hyperglycemia occurs early in gestation. To prevent this toxicity, most experts, including the American College of Obstetricians and Gynecologists, recommend that insulin be used for types I and II diabetes occurring during pregnancy and, if diet therapy alone is not successful, for gestational diabetes (2,3).
Breast Feeding Summary
No reports describing the use of glimepiride during human lactation have been located. Consistent with its relatively low molecular weight (about 491), significant concentrations of glimepiride have been found in rat milk and in the serum of rat pups (1). Skeletal deformities have been observed in nursing rats whose mothers were being given high doses of glimepiride (see above). Because neonatal hypoglycemia is a potential effect, women taking glimepiride should consider changing to insulin therapy during the nursing period (1).
References
- Product information. Amaryl. Hoechst Marion Roussel, 2000.
- American College of Obstetricians and Gynecologists. Diabetes and pregnancy. Technical Bulletin. No. 200, December 1994.
-
Coustan DR. Management of gestational diabetes, Clin Obstet Gynecol 1991;34:55864.
Questions and Answers
Is it okay to take Levaquin with Glimepiride?, I am a type 2 diabetic and take a combination of Glimepiride and Metformin. I currently have a head and chest cold and went to a local clinic for treatment as I have a severe cough and sinus infection and my doctor is out of town until next week. The clinic doctor prescribed Levaquin which seems to be an antibiotic. I checked the Internet for information and the Levaquin website says not to take in conjunction with Glipizide or other types of these kinds of medicines. I'm not sure what to do.
Yes, Levaquin is an antibiotic. Is the prescribing doctor aware that you are on these other drugs ? If not, it's best to call him/her and ask if it's safe. If they do know about it and prescribed it anyway, it's very possible that the interactions between the two are only under certain conditions (i.e. renal failure) and therefore it's safe to use together if you don't meet certain criteria.
I checked them against each other in my interaction guide and it showed no interactions. But, always follow your doctors directions .
Here's an on-line interaction checker if you're interested....
http://www.drugdigest.org/DD/Interaction...
Have a blessed day :-)
Glimepiride made my vision blurry. How long til it clears?, My doctor prescribed 8mg a day of Glimepiride and my vision immediately blurred - I am seeing double. How long until I adjust to this medicine? It's been a week. My bg is totally normal, so it's good in that respect. Thanks
It may be an effect of a hypoglycemic response,or possible a neurological or retinovascular problem. .At least let the doc know soon, and take no more glimepiride till you do.(or cut it in half).
Is almost constant heartburn a side effect of taking glimepiride?, Since I've been taking it, I've had heartburn nearly every day. I have an appointment with my doctor in two weeks but am uncertain if I should see someone earlier.
SIDE EFFECTS: Nausea or upset stomach may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly. Tell your doctor immediately if any of these highly unlikely but very serious side effects occur: yellowing eyes or skin, stomach/abdominal pain, dark urine, unusual tiredness or weakness, easy bleeding or bruising, signs of infection (e.g., fever, persistent sore throat), mental/mood changes, unusual or sudden weight gain, seizures. This medication can cause low blood sugar (hypoglycemia). This effect may occur if you do not consume enough calories (from food, juices, fruit, etc.). The symptoms include chills, cold sweat, blurred vision, dizziness, drowsiness, shaking, rapid heart rate, weakness, headache, fainting, tingling of the hands or feet, or hunger. It is a good habit to carry glucose tablets or gel to treat low blood sugar. If you are in a situation where you don't have these reliable forms of glucose, eat a quick source of sugar such as table sugar, honey, or candy, or drink a glass of orange juice or non-diet soda to quickly raise your blood sugar level. Tell your doctor immediately about the reaction. To help prevent hypoglycemia, eat meals on a regular schedule and do not skip meals. Symptoms of high blood sugar (hyperglycemia) include thirst, increased urination, confusion, drowsiness, flushing, rapid breathing, or fruity breath odor. If these symptoms occur, tell your doctor immediately. Your medication dosage may need to be increased. A serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction include: rash, itching, swelling, dizziness, trouble breathing. If you notice other effects not listed above, contact your doctor or pharmacist.
Hope this helps.
How long should it take someone before eating after taking amaryl (Glimepiride) tabs and what kind of meal?,
Usually 30-60 minutes before you eat a main meal. Especially where you will be eating carbohydrates.
Information on the pills IC Glimepiride 4mg and IC Metformin HCL 500 MG.I prefer info from ppl takin the pills, Sorry for the short typing in the subject.
I this question is for people who have taken/is taking/ knows someone who has taken the pills mentioned above.
What was their sugar level before and after starting the pills and what where their side effects?
My husbad just started the pills tonight.
His sugar level is normally around 350 or so.
Thanks.
Metformin is a pretty neat drug, but don't expect it and that other one to take the place of diet and exercise.
Metformin helps his insulin work better to overcome the resistance of the cell walls allowing insulin to get the blood glucose into the cell more efficiently. It also helps slow the conversion of glycogen into glucose. Third, it slows the absorption of glucose in the intestine during digestion.
[edit] Oh yeah, I forgot to tell you about Metformin side affects... occasional nausea or diarrhea (particularly in the beginning). Remote possibility of lactic acidosis... possibility increases with alcohol consumption.
I'll get back to you in a minute.
Okay, I thought so. Glimepiride is a sulfonylurea. That's a drug whose job is to force the pancreas to produce more insulin.... bad idea. Best idea is to naturally coax the body's cells to become less resistant to insulin. That way, his pancreas won't "wear out" forcing him to take insulin shots. Get that weight down, exercise, and improve the diet and avoid sulfonylureas if at all possible... yes, they're effective at lowering blood glucose, but how they do it is hardly the best way to get the job done.
If you want to help him, I strongly urge both of you to learn as much about taking care of diabetes through healthy diet and daily exercise as you can. Begin here:
http://www.geocities.com/seabulls69/Type...
http://www.drfuhrman.com
http://www.drmcdougall.com
http://www.diabetesimprovement.com/
Does the medicine tablet Glimepiride cause irritation to the throat and nausea as a side affect?,
Yes it can cause stomach upset and nausea. It also can cause weight gain, fatigue and diarrhea. But remember it is very important to treat diabetes so ask your doctor for an alternative medicine. There are many of them.
is it dangerous to take glimepiride, nexium, cymbalta, metaformin and lipitor all at the same time?, and if not, then is it dangerous to take hydroxyzine, oxycodone and codeine at the same time? ....or any combination of any of those pills?
...honest opinions please...thnx in advance =]
All the drugs you mentioned are CNS/respiratory-depressants. Taken together, they act additively with each other.
Patients taking these drugs altogether should be monitored for potentially excessive or prolonged CNS and respiratory depression. It is advised to avoid hazardous activities requiring complete mental alertness and motor coordination & notify your prescribing doctor should excessive or prolonged CNS effects interfere with your normal activities.
Can it take several days or weeks for glimepiride to work?, I was on Januvia for 30 days with no change to my numbers. Now I'm on glepiride for 5 days with no change to my numbers. I'm confused medications have no effect.
I was in the same boat. Simply taking oral meds is not the solution to controlling type two diabetes. The solution revolves around a comprehensive approach that includes a very healthy natural foods based diet and plenty of moderate daily exercise. Since adopting this basic philosophy, my weight has gone down, my blood sugar has gone down, I quit taking Metformin eight months ago, my energy is up, and I feel great.
I am a diabetes patient.Gemer-2 tablet ( glimepiride 2mg and metformin 500mcg ) will reduce my body weight?, I am 37 years old, type 2 diabetes patient for past two years. My sugar level has been controlled by the medicine Gemer-2 ( glimepiride 2mg and metformin 500mg ). I weigh 63 kg and I am 5 feet and 5 inches tall ( 165cm ). Now my weight has gone down. Between two year I lost 6 kg. Two years ago it was 69 kg. Since two years I have been using this medicine. Please explain why this happens?. ( My sugar level fasting 90 mg only).
Losing weight is more a matter of calories ingested verses calories burned. The medication's job is merely to insure that those calories become available to the cells to be burned instead of building up in the blood. Your diet and activity level have more to do with it than the medication. The notion that a pill, all by itself, is going to lower your weight is nonsense.
Can I drink Fresca when I am on GLIMEPIRIDE.?, New to the type 2, always loved my fresca.
Now the Glimepiride bottle says to avoid grapefruit.
Is there enough grapefruit juice in Fresca to matter, It's third on the label after water and citric acid.
Thanks
Avoid it like the plague unless you really want a migraine so bad you need to go to the hospital.
