Generic Name: Glimepiride
Class: Sulfonylureas
VA Class: HS502
Molecular Formula: C24H34N4O5S
CAS Number: 93479-97-1

Introduction

Antidiabetic agent; sulfonylurea.1 53

Uses for Amaryl

Diabetes Mellitus

Used alone or in combination with one or more other oral antidiabetic agents or insulin as an adjunct to diet and exercise to improve glycemic control in patients with type 2 diabetes mellitus.1 5 54 100 101 102 103 104 105 106 107 114 117

Slideshow: Prediabetes - Am I at Risk?

Used in fixed combination with rosiglitazone when treatment with both glimepiride and rosiglitazone is appropriate.114 Use of the glimepiride/rosiglitazone fixed-combination preparation (Avandaryl) is restricted to patients who are already being treated successfully with rosiglitazone and to those not already receiving rosiglitazone who are unable to achieve glycemic control with other antidiabetic agents and have decided (in consultation with their healthcare provider) not to take pioglitazone-containing preparations for medical reasons.114

Used in fixed combination with pioglitazone in patients with type 2 diabetes mellitus who are already receiving a thiazolidinedione and a sulfonylurea separately or who do not achieve adequate glycemic control with thiazolidinedione or sulfonylurea monotherapy.117

Many clinicians recommend metformin as the preferred initial oral antidiabetic agent for patients with type 2 diabetes mellitus.89 90 118 Sulfonylureas (e.g., glimepiride) are one of several second-line classes of agents used with other antidiabetic agents (e.g., metformin) in patients who are inadequately controlled on their current therapy.118

Oral antidiabetic agents not effective as sole therapy in patients with type 1 diabetes mellitus or diabetic acidosis, ketosis, or coma; insulin is necessary.1 14 28 29 42 45 114

Sulfonylurea antidiabetic agents not routinely recommended in hospitalized patients with diabetes mellitus.31 Long duration of action precludes rapid dosage adjustments.1 31 Increased risk of hypoglycemia in hospitalized diabetic patients with irregular eating patterns.31

Amaryl Dosage and Administration

General

  • Adjust dosage according to tolerance and fasting glucose determinations.1 114 Monitor regularly (e.g., fasting blood or plasma glucose determinations) to determine therapeutic response and minimum effective dosage.1 114 Undertake any change in therapy with care and monitor appropriately.114 Monitor HbA1c every 3–6 months to determine the patient’s continued response to therapy.1 114

  • Use lowest effective dosage (either as monotherapy or combined with metformin or insulin) to reduce both fasting glucose concentrations and HbA1c values to normal or near normal.1 17 18 24 31 28

  • If inadequate glycemic control and/or secondary failure occurs during monotherapy with glimepiride, may consider add-on therapy with metformin, insulin, or rosiglitazone (e.g., as the fixed combination of glimepiride and rosiglitazone).1 114 With concomitant glimepiride and metformin therapy, adjust dosage to the minimum effective level for each drug.1

  • Distribution of rosiglitazone and fixed-combination preparations containing rosiglitazone (e.g., Avandaryl) is restricted because of potential increased risk of MI associated with rosiglitazone; can only be obtained through the AVANDIA-Rosiglitazone Medicines Access Program.114 Contact 800-AVANDIA or visit www.avandia.com for specific information.114

Administration

Oral Administration

Administer glimepiride alone or in fixed combination with rosiglitazone or pioglitazone once daily with the first main meal.1 5 6 114 117

Dispensing errors have occurred involving Amaryl (the trade name for glimepiride) and Reminyl (the former US trade name for galantamine hydrobromide, an acetylcholinesterase inhibitor used for treatment of Alzheimer’s dementia).111 112 Serious adverse events (e.g., severe hypoglycemia, death) have occurred because glimepiride was used in patients for whom the drug was not prescribed.111 The manufacturer of Reminyl changed the US trade name for galantamine hydrobromide from Reminyl to Razadyne.113

Dosage

With the fixed combination of glimepiride and rosiglitazone maleate, dosage of rosiglitazone component expressed in terms of rosiglitazone.114

Adults

Diabetes Mellitus
Glimepiride Monotherapy
Oral

Initially, 1–2 mg once daily for previously untreated patients or patients transferred from other antidiabetic agents.1 In patients receiving 1 mg daily, increase dosage to 2 mg daily after 1–2 weeks if adequate glycemic control has not been achieved.53 Increase dosage in increments of no more than 2 mg daily at 1- to 2-week intervals up to a maximum of 8 mg once daily.1 Usual maintenance dosage is 1–4 mg once daily.1 53

Maximum initial dosage should not exceed 2 mg once daily.1

Glimepiride/Rosiglitazone Fixed-combination Therapy (Avandaryl)
Oral

Initially, 1 mg of glimepiride and 4 mg of rosiglitazone once daily.114 May consider initial dosage of 2 mg of glimepiride and 4 mg of rosiglitazone once daily in patients already receiving a sulfonylurea or rosiglitazone.114

Initiate rosiglitazone component at the lowest recommended dosage.114

In patients previously receiving rosiglitazone monotherapy, allow approximately 1–2 weeks to assess therapeutic response to newly initiated glimepiride component before adjusting dosage.114 If additional glycemic control is needed after 1–2 weeks, increase dosage of the glimepiride component in increments of ≤2 mg.114 Assess response to increase in glimepiride component after 1–2 weeks to determine need for further dosage adjustment.114

In patients previously receiving sulfonylurea monotherapy, allow 2 weeks to observe reduction in blood glucose concentrations and 2–3 months to observe full therapeutic response to newly initiated rosiglitazone component.114 If additional glycemic control is needed after 8–12 weeks, increase dosage of the rosiglitazone component.114 If additional glycemic control is needed 2–3 months after an increase in rosiglitazone component, further titrate dosage.114

Patients switching from combined therapy with separate glimepiride and rosiglitazone preparations: Usual initial dosage of the fixed-combination is the same as the patient's existing dosage of the individual drugs.114

If hypoglycemia occurs, consider a reduced dosage of the glimepiride component.114

Glimepiride/Pioglitazone Fixed-combination Therapy (Duetact)
Oral

Select initial dosage based on patient’s current dosage of glimepiride (or another sulfonylurea agent) and/or pioglitazone.117

Patients currently receiving glimepiride monotherapy: Usual initial dosage is 2 or 4 mg of glimepiride and 30 mg of pioglitazone once daily.117

Patients transferring from monotherapy with other sulfonylureas: Initially, 2 mg of glimepiride and 30 mg of pioglitazone once daily.117 If patient is being transferred from a sulfonylurea with a long half-life (e.g., chlorpropamide), monitor closely for hypoglycemia during initial 1–2 weeks of the transition period.117

Patients currently receiving pioglitazone monotherapy: Usual initial dosage is 2 mg of glimepiride and 30 mg of pioglitazone once daily.117

Patients switching from combined therapy with separate glimepiride and pioglitazone preparations: Initiate fixed combination with 2 or 4 mg of glimepiride and 30 mg of pioglitazone once daily based on patient’s current dosage of glimepiride and pioglitazone.117 Carefully monitor patients whose hyperglycemia was not previously controlled with 15 mg of pioglitazone in combination with glimepiride during transfer.117

Gradually titrate dosage as needed based on therapeutic response.117 Allow sufficient time (e.g., 8–12 weeks) to assess response.117 If additional glycemic control is needed, may increase dosage until maximum daily dosage of 8 mg of glimepiride and 45 mg of pioglitazone is reached.117

Patients with type 2 diabetes mellitus and systolic dysfunction: Initiate glimepiride/pioglitazone fixed-combination at the lowest recommended dosage; use fixed combination preparation only after patient has previously received pioglitazone 15 mg once daily as monotherapy and has safely tolerated dosage titration to 30 mg once daily.117 Closely monitor for weight gain, edema, or other manifestations of CHF exacerbation if subsequent dosage adjustment required.117

Concomitant Glimepiride and Insulin Therapy
Oral

Initially, 8 mg once daily and a low insulin dosage in patients whose fasting plasma or serum glucose concentration exceeds 150 mg/dL despite appropriate oral antidiabetic monotherapy, diet, and exercise.1 31

Adjust insulin dosage upward at approximately weekly intervals until adequate glycemic control is achieved.1 31 53 Periodic adjustments in insulin dosage may be necessary during continued combination therapy.1

Initial Dosage in Patients Transferred from Other Sulfonylurea Agents
Oral

Initially, 1–2 mg once daily.1 1 2 May discontinue other sulfonylurea agents immediately.1 2 3 96 During transfer from chlorpropamide (a sulfonylurea with a long elimination half-life), monitor closely for hypoglycemia during the initial 1–2 weeks of the transition period.1

The initial dosage of glimepiride during transfer from other therapy should not exceed 2 mg daily.1

Prescribing Limits

Adults

Diabetes Mellitus
Oral

Glimepiride monotherapy: Maximum 8 mg daily.1

Fixed combination with rosiglitazone: Maximum 4 mg of glimepiride and 8 mg of rosiglitazone daily.114

Fixed combination with pioglitazone: Maximum 8 mg of glimepiride and 45 mg of pioglitazone daily.117

Special Populations

Hepatic Impairment

Glimepiride monotherapy: Initially, 1 mg once daily.1 Conservative initial and maintenance dosages recommended.1

Fixed-combination preparation with rosiglitazone: Initially, 1 mg of glimepiride and 4 mg of rosiglitazone daily.114 Conservative initial and maintenance dosages recommended in patients with mild hepatic impairment; these individuals may be particularly sensitive to the hypoglycemic effects of glimepiride.114 Do not initiate therapy with fixed combination of glimepiride and rosiglitazone in patients with clinical evidence of active liver disease or elevated serum aminotransferase concentrations (ALT >2.5 times ULN).114

Renal Impairment

Glimepiride monotherapy: Initially, 1 mg once daily.1 Titrate dosage upward based on fasting glucose concentrations.1 Dosages >1 mg daily may not be required if Clcr <22 mL/minute.1 8

Fixed-combination preparation with rosiglitazone: Initially, 1 mg of glimepiride and 4 mg of rosiglitazone daily.114 Conservative initial and maintenance dosages recommended; individuals with renal impairment may be particularly sensitive to the hypoglycemic effects of glimepiride.114

Geriatric Patients

Geriatric individuals may be particularly sensitive to the hypoglycemic effects of glimepiride.1 114

Glimepiride monotherapy: Initially, 1 mg once daily.1 Titrate dosage upward with care.1 114 Conservative initial and maintenance dosages recommended.1 53 114

Fixed-combination preparation with rosiglitazone: Initially, 1 mg of glimepiride and 4 mg of rosiglitazone daily.114 Conservative initial and maintenance dosages recommended.114

Adrenal Insufficiency

Fixed-combination preparation with rosiglitazone: Initially, 1 mg of glimepiride and 4 mg of rosiglitazone daily.114 Conservative initial and maintenance dosages recommended; these individuals may be particularly sensitive to the hypoglycemic effects of glimepiride.114

Debilitated or Malnourished Patients

These individuals may be particularly sensitive to the hypoglycemic effects of glimepiride.1 114

Glimepiride monotherapy: Initially, 1 mg once daily.1 Conservative initial and maintenance dosages recommended.1

Fixed-combination preparation with rosiglitazone: Initially, 1 mg of glimepiride and 4 mg of rosiglitazone daily.114 Conservative initial and maintenance dosages recommended.114

Cautions for Amaryl

Contraindications

  • Known hypersensitivity to glimepiride or any ingredient in formulation.1

  • Diabetic ketoacidosis, with or without coma.1 114

Warnings/Precautions

Warnings

Cardiovascular Effects

Increased cardiovascular mortality reported with certain other antidiabetic agents (i.e., tolbutamide, phenformin).1 99 114 However, the American Diabetes Association (ADA) considers the benefits of intensive glycemic control with insulin or sulfonylureas to outweigh the risks overall.31 58 64 99

General Precautions

Hypoglycemia

Possible severe hypoglycemia, especially in geriatric, debilitated, or malnourished patients and those with adrenal, pituitary, hepatic, or renal insufficiency.1 114 Increased risk of hypoglycemia with strenuous exercise, alcohol ingestion, insufficient caloric intake, or use in combination with other oral antidiabetic agents (e.g., rosiglitazone, metformin).1 114

Hypoglycemia may be difficult to recognize in geriatric patients and in those receiving β-adrenergic blocking agents.1 114

Appropriate patient selection and careful dosing are important to avoid glimepiride-induced hypoglycemia.1 114

Loss of Glycemic Control

Possible loss of glycemic control during periods of stress (e.g., fever, trauma, infection, surgery); administration of insulin may be required.1 114 May reinstitute oral antidiabetic therapy after an acute episode has resolved.114

Efficacy of therapy may decrease over time (secondary failure).1 Addition of metformin or insulin to therapy may be required.1 54 (See Diabetes Mellitus under Uses.)

Use of Fixed Combinations

When used in fixed combination with rosiglitazone or pioglitazone, consider the cautions, precautions, and contraindications associated with rosiglitazone or pioglitazone.114 117

Specific Populations

Pregnancy

Category C.1 114

Many experts recommend use of insulin during pregnancy to maintain optimum control of blood glucose concentrations.1 114

Lactation

Distributed into milk in rats; other sulfonylureas distributed into human milk.1 Use not recommended.1 114 If oral antidiabetic therapy discontinued and diet alone is inadequate for optimal glycemic control, consider institution of insulin.1 114

Pediatric Use

Glimepiride: Safety and efficacy not established in children <16 years of age.1 53

Fixed combination with rosiglitazone: Safety and efficacy not established in children <18 years of age.114

Fixed combination with pioglitazone: Safety and efficacy not established in pediatric patients.117

ADA states that use of oral antidiabetic agents may be considered in children with type 2 diabetes mellitus because of the greater compliance and convenience and lack of evidence demonstrating better efficacy of insulin for type 2 diabetes mellitus.93

Geriatric Use

No substantial differences in safety, efficacy, or pharmacokinetics relative to younger adults, but increased sensitivity cannot be ruled out.1

Possible increased risk of adverse effects due to age-related decreases in renal function.1 Renal function monitoring recommended, and care should be taken in dosage selection.1 (See Geriatric Patients under Dosage and Administration.)

Increased risk of hypoglycemia; may be difficult to recognize in geriatric patients.1

Hepatic Impairment

Increased risk of hypoglycemia; conservative dosing recommended.1 (See Hepatic Impairment under Dosage and Administration.)

Renal Impairment

Decreased clearance.1

Increased risk of hypoglycemia; conservative dosing recommended.1 (See Renal Impairment under Dosage and Administration.)

Common Adverse Effects

Dizziness, asthenia, headache, nausea.1

Interactions for Amaryl

Metabolized by CYP2C9.1 114

Drugs Affecting Hepatic Microsomal Enzymes

Pharmacokinetic interactions likely with drugs that are inhibitors and inducers of CYP2C9; possible alteration in metabolism of glimepiride.1 114

Protein-bound Drugs

Potential pharmacokinetic interaction (increased hypoglycemic effect).1 114 (See Specific Drugs under Interactions.)

Close observation recommended when initiating or discontinuing concomitant therapy with a highly protein-bound drug.1

Drugs with Hyperglycemic Effects

Potential pharmacologic interaction (loss of glycemic control).1 114

Close observation recommended when initiating or discontinuing concomitant therapy.1 114

Specific Drugs

Drug

Interaction

Comments

ACE inhibitors (e.g., ramipril)

No evidence of clinically important adverse interactions in clinical studies1 114

Antifungals, oral (i.e., miconazole)

Increased hypoglycemic effect; severe hypoglycemia reported1 114

Not known whether interaction occurs with IV, topical, or vaginal antifungal dosage forms1 114

β-Adrenergic blocking agents (e.g., propranolol)

Highly protein-bound drugs may displace glimepiride from plasma proteins and potentiate hypoglycemic effect1 114

Increased peak plasma concentrations and half-life and decreased clearance of glimepiride with concomitant propranolol1 114

Observe carefully for hypoglycemic effects when initiating concomitant therapy or loss of glycemic control when discontinuing such therapy1 114

Exercise caution with concomitant therapy114

No evidence of clinically important adverse interactions in clinical studies1 114

Calcium-channel blockers

No evidence of clinically important adverse interactions in clinical studies1

Chloramphenicol

Highly protein-bound drugs may displace glimepiride from plasma proteins and potentiate hypoglycemic effect1 114

Observe carefully for hypoglycemic effects when initiating concomitant therapy or loss of glycemic control when discontinuing such therapy1 114

Corticosteroids

Potential for decreased hypoglycemic effect1 114

Observe carefully for loss of glycemic control when initiating concomitant therapy or hypoglycemic effects when discontinuing such therapy1 114

Coumarin anticoagulants (e.g., warfarin)

Highly protein-bound drugs may displace glimepiride from plasma proteins and potentiate hypoglycemic effect1 114

No change in warfarin protein binding with concomitant administration but slight decrease in pharmacodynamic response1 114

Observe carefully for hypoglycemic effects when initiating concomitant therapy or loss of glycemic control when discontinuing such therapy1 114

No clinically important pharmacokinetic interaction with warfarin reported1

Diuretics (e.g., thiazides)

Potential for decreased hypoglycemic effect1 114

Observe carefully for loss of glycemic control when initiating concomitant therapy or hypoglycemic effects when discontinuing such therapy1 114

Estrogens

Potential for decreased hypoglycemic effect1 114

Observe carefully for loss of glycemic control when initiating concomitant therapy or hypoglycemic effects when discontinuing such therapy1 114

No evidence of clinically important adverse interactions in clinical studies1

Fluconazole

Increased AUC and half-life of glimepiride143

Concomitant use may increase the risk of hypoglycemia143

H2-receptor antagonists (e.g., cimetidine, ranitidine)

No clinically important pharmacokinetic interactions observed.1 114

HMG-CoA reductase inhibitors (statins)

No evidence of clinically important adverse interactions in clinical studies1

Hormonal contraceptives

Potential for decreased hypoglycemic effect1 114

Observe carefully for loss of glycemic control when initiating concomitant therapy or hypoglycemic effects when discontinuing such therapy1 114

Isoniazid

Potential for decreased hypoglycemic effect1 114

Observe carefully for loss of glycemic control when initiating concomitant therapy or hypoglycemic effects when discontinuing such therapy1 114

MAO inhibitors

Highly protein-bound drugs may displace glimepiride from plasma proteins and potentiate hypoglycemic effect114

Observe carefully for hypoglycemic effects when initiating concomitant therapy or loss of glycemic control when discontinuing such therapy1 114

Niacin

Potential for decreased hypoglycemic effect1 114

Observe carefully for loss of glycemic control when initiating concomitant therapy or hypoglycemic effects when discontinuing such therapy1 114

NSAIAs

Potential for increased hypoglycemic effect1 114

No evidence of clinically important adverse interactions in clinical studies1

Observe carefully for hypoglycemic effects when initiating concomitant therapy or loss of glycemic control when discontinuing such therapy1 114

Phenothiazines

Potential for decreased hypoglycemic effect1 114

Observe carefully for loss of glycemic control when initiating concomitant therapy or hypoglycemic effects when discontinuing such therapy1

Phenytoin

Potential for decreased hypoglycemic effect1 114

Observe carefully for loss of glycemic control when initiating concomitant therapy or hypoglycemic effects when discontinuing such therapy1 114

Probenecid

Highly protein-bound drugs may displace glimepiride from plasma proteins and potentiate hypoglycemic effect1 114

Observe carefully for hypoglycemic effects when initiating concomitant therapy or loss of glycemic control when discontinuing such therapy1 114

Rifampin

Decreased AUC and half-life of glimepiride144

No clinically important pharmacodynamic interactions reported144

Salicylates (e.g., aspirin)

Highly protein-bound drugs may displace glimepiride from plasma proteins and potentiate hypoglycemic effect1 114

Increased glimepiride clearance with concomitant aspirin (1 g 3 times daily); no change in blood glucose concentrations or evidence of hypoglycemia1 114

Observe carefully for hypoglycemic effects when initiating concomitant therapy or loss of glycemic control when discontinuing such therapy1 114

No evidence of clinically important adverse interactions in clinical studies1

Sulfonamides

Highly protein-bound drugs may displace glimepiride from plasma proteins and potentiate hypoglycemic effect1 114

No evidence of clinically important adverse interactions in clinical studies1

Observe carefully for hypoglycemic effects when initiating concomitant therapy or loss of glycemic control when discontinuing such therapy1 114

Sympathomimetic agents

Potential for decreased hypoglycemic effect1 114

Observe carefully for loss of glycemic control when initiating concomitant therapy or hypoglycemic effects when discontinuing such therapy1

Thyroid hormones

Potential for decreased hypoglycemic effect1 114

No evidence of clinically important adverse interactions in clinical studies1

Observe carefully for loss of glycemic control when initiating concomitant therapy or hypoglycemic effects when discontinuing such therapy1 114

Amaryl Pharmacokinetics

Absorption

Bioavailability

Completely absorbed; oral bioavailability of 100%.1 114 Peak blood concentrations attained within 2–3 hours.1 114

Fixed-combination preparation containing 4 mg of glimepiride and 4 mg of rosiglitazone is bioequivalent to the individual components administered separately at the same dosages in fasted state.114

Onset

Time to maximum effect about 2–3 hours.1

Duration

Glucose-lowering effect persists for 24 hours.1

Food

Food increases the time to peak blood concentrations by about 12%.1 The mean peak blood concentration and AUC are decreased by 8 and 9%, respectively.1

Special Populations

Pediatric patients: Peak serum concentrations and AUC attained in children and adolescents 10–17 years of age were comparable to values in adults.114

Distribution

Extent

Volume of distribution: 8.8 L (113 mL/kg).1

Not known if glimepiride is distributed into human milk.1

Plasma Protein Binding

>99.5%.1 114

Elimination

Metabolism

Metabolized by CYP2C9 and by cytosolic enzymes to active and inactive metabolites.1 114

Elimination Route

Excreted in urine (60%) and feces (40%) predominantly as metabolites.1 114

Half-life

Averages 5.3 hours after a single dose in healthy individuals.1 Averages 9.2 hours in patients with type 2 diabetes mellitus at steady state.1

Special Populations

Renal impairment: Decreased serum drug concentrations and increased concentrations and half-lives of the metabolites.1

Geriatric patients: At steady state, lower mean AUC (13%) and increased clearance (11%) compared with younger patients.114

Stability

Storage

Oral

Tablets

Glimepiride: Well-closed containers at 15–30°C.1

Fixed combination of glimepiride and rosiglitazone: Tight, light-resistant containers at 25°C (may be exposed to 15–30°C).114

Actions

  • Reduces both fasting and postprandial blood glucose concentrations and HbA1c in a dose-dependent manner.1 5 6 20

  • Lowers blood glucose concentration principally by stimulating postprandial secretion of endogenous insulin from the beta cells of the pancreas.1 9 10 11 28 54 114 Also enhances peripheral sensitivity to insulin.1 2 3 5 6 49 50 114

  • Provides overall glycemic control without appreciably increasing fasting insulin secretion.1 2 3 5 6 49 50

  • Ineffective in the absence of functioning beta cells.1

Advice to Patients

  • Inform patients of the potential risks and advantages of glimepiride therapy and of alternative forms of treatment.1 114

  • Importance of taking the medication each morning with breakfast or with the first main meal.1 114

  • Importance of adhering to diet and exercise regimen.1 13 15 16 114

  • Importance of hygiene and avoidance of infection.31

  • Advise patients about the nature of diabetes mellitus, prevention and detection of complications, and importance of glycemic control.18 31 22

  • Importance of appropriate management of hypoglycemia and hyperglycemia.1 Risks of hypoglycemia.1 114 Importance of patients and responsible family members understanding symptoms and treatment of hypoglycemic reactions and identifying conditions that predispose to the development of such reactions.1 114

  • Importance of regular monitoring of blood glucose (preferably self-monitoring) and of HbA1c.1 114

  • Discuss potential for alterations in dosage requirements in special situations (e.g., illness, fever, trauma, infection, surgery); importance of informing clinician promptly if such situations occur.114

  • Importance of understanding primary and secondary failure to therapy.1

  • Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.1 114

  • Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs and dietary or herbal supplements,1 as well as any concomitant illnesses (e.g., type 1 diabetes mellitus, kidney or liver disease).114

  • Advise patients receiving β-adrenergic blocking agents about potential risk for hypoglycemia.114

  • Importance of informing patients of other important precautionary information.1 (See Cautions.)

Preparations

Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.

* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name

Glimepiride

Routes

Dosage Forms

Strengths

Brand Names

Manufacturer

Oral

Tablets

1 mg*

Amaryl (scored)

Sanofi-Aventis

2 mg*

Amaryl (scored)

Sanofi-Aventis

4 mg*

Amaryl (scored)

Sanofi-Aventis

Glimepiride Combinations

Routes

Dosage Forms

Strengths

Brand Names

Manufacturer

Oral

Tablets

2 mg with Rosiglitazone Maleate 4 mg (of rosiglitazone)

Avandaryl

GlaxoSmithKline

2 mg with Rosiglitazone Maleate 8 mg (of rosiglitazone)

Avandaryl

GlaxoSmithKline

4 mg with Rosiglitazone Maleate 4 mg (of rosiglitazone)

Avandaryl

GlaxoSmithKline

4 mg with Rosiglitazone Maleate 8 mg (of rosiglitazone)

Avandaryl

GlaxoSmithKline

Comparative Pricing

This pricing information is subject to change at the sole discretion of DS Pharmacy. This pricing information was updated 02/2014. Actual costs to patients will vary depending on the use of specific retail or mail-order locations and health insurance copays.

Amaryl 1MG Tablets (SANOFI-AVENTIS U.S.): 30/$28.99 or 90/$65.97

Amaryl 2MG Tablets (SANOFI-AVENTIS U.S.): 30/$39.99 or 90/$99.97

Amaryl 4MG Tablets (SANOFI-AVENTIS U.S.): 30/$66.99 or 90/$179.98

Avandaryl 4-1MG Tablets (GLAXO SMITH KLINE): 30/$155.31 or 90/$434.86

Avandaryl 4-2MG Tablets (GLAXO SMITH KLINE): 30/$156.00 or 90/$447.65

Avandaryl 4-4MG Tablets (GLAXO SMITH KLINE): 30/$155.31 or 90/$434.86

Duetact 30-2MG Tablets (TAKEDA PHARMACEUTICALS): 30/$294.86 or 90/$856.64

Duetact 30-4MG Tablets (TAKEDA PHARMACEUTICALS): 30/$289.98 or 90/$849.98

Glimepiride 1MG Tablets (PERRIGO PHARMACEUTICALS): 30/$12.99 or 60/$19.98

Glimepiride 2MG Tablets (DR.REDDY'S LABORATORIES): 90/$18.99 or 180/$37.98

Glimepiride 4MG Tablets (DR.REDDY'S LABORATORIES): 30/$14.99 or 90/$41.99

AHFS DI Essentials. © Copyright, 2004-2014, Selected Revisions February 15, 2013. American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland 20814.

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