【藥品性質提示】 根據 2019 AGS Beers Criteria，本藥品為【潛在不適當用藥 (PIM)】，不建議用於老年人。 #高警訊藥品

糖尿病 (Sulfonylurea) Type 2 diabetes mellitus

Sulfonylurea Antidiabetic Agent
Stimulates insulin release from the pancreatic beta cells; reduces glucose output from the liver; insulin sensitivity is increased at peripheral target sites

Glimepiride is completely and rapidly absorbed after oral doses. Metabolism occurs in the liver.

1. Hypersensitivity to glimepiride, any component of the formulation, or sulfonamides
2. Pregnancy; breastfeeding
3. Type 1 diabetes; diabetic ketoacidosis (with or without coma)
4. Severe renal or hepatic impairment

Contraindicated; Agents other than glimepiride are currently recommended to treat diabetes mellitus in pregnancy

Common:
Hypoglycemia, dizziness, headache, nausea, increased serum ALT, flu-like symptoms, accidental injury
Postmarketing:
Agranulocytosis, alopecia, anaphylaxis, angioedema, aplastic anemia, cholestatic jaundice, diarrhea, disulfiram-like reaction, dyspnea, erythema, gastrointestinal pain, hemolytic anemia, hepatic failure, hepatitis, hypersensitivity, hyponatremia, hypotension, immune thrombocytopenia, leukopenia, morbilliform rash, pancytopenia, porphyria cutanea tarda, pruritus, shock, SIADH, skin photosensitivity, SJS, thrombocytopenia, urticaria, vomiting, weight gain

1. Initial: 1 to 2 mg once daily with the first main meal; May increase dose in 1 to 2 mg increments every 1 to 4 weeks if needed
2. Usual maintenance dose: 2 to 4 mg/day (maximum: 8 mg/day)

1. eGFR >60 mL/minute/1.73 m2: No dosage adjustment necessary
2. eGFR 15-60 mL/minute/1.73 m2: Consider initiating at a low dose (eg, 1 mg daily) and titrating cautiously
3. eGFR <15 mL/minute/1.73 m2: Avoid use due to risk of hypoglycemia
4. Intermittent hemodialysis, Peritoneal dialysis: Unlikely to be significantly dialyzable (highly protein bound); agents other than sulfonylureas are preferred due to risk of hypoglycemia
5. CRRT, PIRRT: Avoid use

There are no dosage adjustments provided in the manufacturer's labeling (has not been studied).