Sulphonylurea

Glimepiride

Brand names: Amaryl

Glimepiride is a once-daily sulfonylurea used in type 2 diabetes to stimulate insulin secretion.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

US labelling (FDA)

Reference — US labelling, may differ from UK

Recommended starting dose is 1 or 2 mg once daily. Increase in 1 or 2 mg increments no more frequently than every 1 to 2 weeks based on glycemic response. Maximum recommended dose is 8 mg once daily ( 2.1 ). Administer with breakfast or first meal of the day ( 2.1 ). Use 1 mg starting dose and titrate slowly in patients at increased risk for hypoglycemia (e.g., elderly, patients with renal impairment) ( 2.1 ). 2.1 Recommended Dosing Glimepiride tablets should be administered with breakfast or the first main meal of the day. The recommended starting dose of glimepiride tablets are 1 mg or 2 mg once daily. Patients at increased risk for hypoglycemia (e.g., the elderly or patients with renal …

Source: US FDA prescribing information (openFDA / DailyMed), label dated 2024-11-13. Accessed 2026-06-12. US dosing and indications can differ from UK practice — use UK sources for prescribing decisions.

Clinical monograph

How it works

It closes ATP-sensitive potassium channels on pancreatic beta cells, triggering insulin release — so it requires residual beta-cell function.

Prescribing in practice

Hypoglycaemia is the main risk and can be prolonged — greater in older people, renal impairment, missed meals and with alcohol.
It tends to cause weight gain.
Use caution and lower doses in renal or hepatic impairment.

Monitoring

Monitor glucose/HbA1c, hypoglycaemia awareness and weight.

Counselling the patient

Learn to recognise and treat hypos — carry a fast-acting sugar.
Don't skip meals; be careful with alcohol.
Hypoglycaemia can affect driving — follow DVLA advice.

Evidence & guidelines

An option when metformin is insufficient or unsuitable (NICE NG28), balancing efficacy against hypoglycaemia and weight gain.

Reference: NICE NG28 (Type 2 DM); Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Pathways