Glimepiride Dosage (Kitni leni hai)
Careful dose titration is essential with Glimepiride. Because it is a sulfonylurea, the risk of hypoglycaemia is directly tied to dosing. Always start at 1mg and increase slowly — the goal is the lowest effective dose.
Standard Adult Titration Schedule
| Phase | Dose | Timing |
|---|---|---|
| Starting dose | 1mg once daily | Before breakfast |
| After 1–2 weeks | 2mg once daily | If blood sugar target not met |
| After further 1–2 weeks | 3mg once daily | Based on response |
| Usual maintenance | 1–4mg once daily | Before breakfast |
| Maximum dose | 8mg once daily | Single morning dose |
Key rule: Only increase the dose under your doctor's guidance — check fasting blood glucose before each increase.
When to Take (Timing)
- 15–30 minutes before breakfast — ideal
- With breakfast — acceptable
- Never skip the meal after taking Glimepiride — this is the most common cause of hypoglycaemia
Combination Dosing with Metformin
When used alongside Metformin:
| Medicine | Dose | Timing |
|---|---|---|
| Glimepiride | 1–2mg once daily | Before breakfast |
| Metformin | 500–1000mg twice daily | With breakfast and dinner |
A lower Glimepiride dose is often sufficient in combination — which reduces hypoglycaemia risk.
Special Populations (Khaas Mareezon ke Liye)
Elderly Patients (60+ Years)
- Start at 1mg — no exceptions
- Titrate very slowly with close blood sugar monitoring
- Consider a relaxed HbA1c target (7.5–8%) — stricter targets increase hypoglycaemia risk in the elderly
- Hypoglycaemia symptoms in older patients can sometimes be atypical
Kidney Disease (Gurdey ki Bimari)
| eGFR (mL/min/1.73m²) | Recommendation |
|---|---|
| ≥ 60 | Normal dosing (start 1mg, titrate) |
| 30–59 | Start at 1mg only — very cautious titration |
| < 30 | Avoid — severe hypoglycaemia risk |
Liver Disease
- Mild: Use with caution — impaired drug metabolism
- Severe: Avoid — unpredictable drug levels and hypoglycaemia risk
Missed Dose (Dose Bhool Jayein)
- Take as soon as remembered — only if you are eating or have just eaten
- Never take on an empty stomach — direct hypoglycaemia risk
- If your next dose is nearly due, skip the missed one
- Never take a double dose
Overdose and Severe Hypoglycaemia
Glimepiride overdose or skipping meals can cause severe hypoglycaemia:
| Severity | Symptoms | Action |
|---|---|---|
| Mild | Sweating, hunger, shaking, headache | 15g fast carbs: juice, glucose tablets |
| Moderate | Confusion, weakness, difficulty concentrating | Same — monitor closely |
| Severe | Loss of consciousness, seizures | Emergency — IV glucose or glucagon needed |
The 15-15 Rule (Mild/Moderate): 1. Take 15g fast-acting carbohydrates (150ml juice, 3 glucose tablets, or 3 teaspoons of sugar in water) 2. Wait 15 minutes 3. Check blood sugar — if still low, repeat 4. Once improved, eat a proper meal or snack
The information in this guide is for educational purposes only. Always confirm dosing with your doctor or pharmacist.