[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Sulfonylureas](https://durgical.com/en/pharmacology/classes/sulfonylureas/) › Glimepiride

[Pharmacology](https://durgical.com/en/pharmacology/) · [Sulfonylureas](https://durgical.com/en/pharmacology/classes/sulfonylureas/)

# Glimepiride

A once-daily sulfonylurea for type 2 diabetes: it increases insulin release and can cause hypoglycemia and weight gain.

Updated 2026-11-01

- Class: [Sulfonylureas](https://durgical.com/en/pharmacology/classes/sulfonylureas/)
- Ion channel: Sulfonylurea receptor 1 (SUR1) of the KATP channel
- ATC code: A10BB12

## ⚠ High-alert medication

An error with this medicine can cause serious harm: double checks and protocols are used.

⇅**Sulfonylurea receptor 1 (SUR1) of the KATP channel**Glimepiride

ⓘ No structure with this drug is available; the figure shows glibenclamide, another sulfonylurea that binds the same SUR1 pocket of the KATP channel (hamster SUR1, rat Kir6.2).

**Target in 3D:** Sulfonylurea receptor 1 (SUR1) of the KATP channel. PDB structure 6BAA (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/6BAA) · Drag to rotate · pinch to zoom

## Mechanism of action

Glimepiride binds SUR1 and closes the beta-cell KATP channel; depolarization opens calcium channels and insulin is released, regardless of the glucose level. Its long action allows once-daily use.

- Binds SUR1 on the beta-cell KATP channel
- The channel closes and the membrane depolarizes
- Calcium channels open and insulin granules are released
- Glucose falls, even when it is already low

## Pharmacokinetics

**Absorption**
Oral, well absorbed.

**Metabolism**
In the liver by CYP2C9.

**Elimination**
Urine and feces as metabolites; kidney impairment raises hypoglycemia risk.

## Indications

- Type 2 diabetes, with diet and exercise, alone or combined [Type 2 diabetes mellitus →](https://durgical.com/en/conditions/type-2-diabetes-mellitus/)

## Adverse effects

### Common

- Hypoglycemia
- Weight gain
- Dizziness, nausea, headache

### Serious (rare, important)

- Severe hypoglycemia
- Hemolytic anemia in G6PD deficiency (sulfonylurea class)
- Serious allergic reactions: anaphylaxis, angioedema, Stevens–Johnson syndrome

## Contraindications

- Hypersensitivity to glimepiride
- Hypersensitivity to sulfonamide derivatives
- Type 1 diabetes and ketoacidosis (not effective)

## Key interactions

**Insulin and other glucose-lowering drugs**
Add to hypoglycemia.

**Beta-blockers**
Can increase the effect and blunt the warning signs of hypoglycemia.

**NSAIDs and salicylates, sulfonamides, fluoroquinolones, oral azole antifungals (miconazole)**
Can increase the glucose-lowering effect and cause severe hypoglycemia.

**Alcohol**
Raises the risk of hypoglycemia.

**Colesevelam**
Reduces glimepiride absorption, so they are given hours apart.

## What is monitored

- Capillary glucose
- HbA1c
- Kidney function

## Administration and safety

- Oral tablet, given with a meal (usually breakfast); a skipped meal raises hypoglycemia risk.
- Look-alike names: glipizide, glyburide (glibenclamide) and glimepiride are easily confused.
- Often held while the patient is fasting (nil by mouth) in hospital.

## Nursing care

- Before: capillary glucose, kidney and liver function, meal intake, age.
- During: signs of hypoglycemia (sweating, tremor, confusion); beta-blockers can mask them.
- After a hypoglycemia episode: glucose is rechecked for many hours, because it can come back.
- Teach: carry fast sugar, avoid skipping meals, limit alcohol.

## Pregnancy and breastfeeding

Insulin is the usual choice. A sulfonylurea taken near delivery can cause prolonged hypoglycemia in the newborn.

## Memory aid

Glimepiride: 'glim-once' a day. Same SUR1 switch as every sulfonylurea; a sulfa allergy is a reason to avoid it.

## Test yourself

Think of the answer, then tap the question to see it.

## Which drug allergy is a contraindication to glimepiride?

Hypersensitivity to sulfonamide derivatives.

## Which enzyme metabolizes glimepiride?

CYP2C9 in the liver; its inhibitors can raise levels and hypoglycemia risk.

## Why are colesevelam and glimepiride given hours apart?

Colesevelam binds glimepiride in the gut and reduces its absorption.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/glimepiride/)

## Related drugs

- [Glibenclamide](https://durgical.com/en/pharmacology/glibenclamide/)
- [Gliclazide](https://durgical.com/en/pharmacology/gliclazide/)
- [Glipizide](https://durgical.com/en/pharmacology/glipizide/)

## Related conditions

- [Type 2 diabetes mellitus](https://durgical.com/en/conditions/type-2-diabetes-mellitus/)

[← Back to the class: Sulfonylureas](https://durgical.com/en/pharmacology/classes/sulfonylureas/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [Glimepiride: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a696016.html) (MedlinePlus (U.S. National Library of Medicine), 2026); [DailyMed - GLIMEPIRIDE- glimepiride tablet](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=61be3059-6400-4fe4-b4ac-b07344f1362f) (DailyMed (U.S. National Library of Medicine), 2026); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=A10BB12) (WHO Collaborating Centre for Drug Statistics Methodology, 2026).

## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake

Representative model, for educational purposes only.

---
Source: https://durgical.com/en/pharmacology/glimepiride/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/glimepiride/