Glimepiride dosing

Hypoglycemia - If hypoglycemia occurs during up-titration of the dose or while maintained on therapy, a dosage reduction of the sulfonylurea component of rosiglitazone/glimepiride may be considered. 

Special populations - In elderly, debilitated, or malnourished patients, or patients with renal, hepatic, or adrenal insufficiency, the initial dosing, dose increments, and maintenance dosage of rosiglitazone/glimepiride should be conservative to avoid hypoglycemic reactions. 

Glimepiride (Amaryl) is metabolized to at least one active metabolite. It is quickly absorbed from the gastrointestinal tract within an hour of oral administration and excreted in the urine and feces. Its half-life varies from 5 to 9 hours depending on the frequency of multiple dosing. 

In healthy subjects, glimepiride 4 mg daily caused only minor, clinically unimportant changes in the prothrombin times (about 10% decrease in mean maximum prothrombin time) in response to single 25-mg doses of... 

Schaaf LJ, Sisson TA, Dietz AJ, Vivea A DM, Oliver LK, Knuth DW, Carel BJ. Influence of multiple dose glimepiride on the pharmacokinetics and pharmacodynamics of lacemic warfarin in healthy volunteers. PharmRes (1994) 11 (10 Suppl), S-359. 

A double-blind study in 12 healthy subjects found that fluconazole 400 mg on day one then 200 mg daily for a further 3 days increased the AUC and peak plasma level of a single 0.5-mg dose of glimepiride by about 2.5-fold and 1.5-fold, respectively. Fluconazole increased the mean elimination half-life of glimepiride from 2 to 3.3 hours. ... 

A placebo-controlled study in 10 healthy subjects found that rifampicin 600 mg daily for 5 days decreased the AUC of a single 1-mg dose of glimepiride given on day 6 by 34%. Rifampicin reduced the elimination half-life of glimepiride by 25%. However, no significant differences in blood glucose were found between the rifampicin and placebo regimens. ... 

---