Maximum Dose of Amaryl (Glimepiride)
The maximum recommended dose of Amaryl (glimepiride) is 8 mg once daily, as stated in the FDA drug label. 1
Dosing Information
Glimepiride is a second-generation sulfonylurea used in the management of type 2 diabetes mellitus. The dosing recommendations are as follows:
Starting dose:
- Standard: 1-2 mg once daily
- For patients at increased risk of hypoglycemia (elderly, renal impairment): 1 mg once daily 1
Dose titration:
- Increments of 1-2 mg
- Titration should not occur more frequently than every 1-2 weeks
- Conservative titration for high-risk patients 1
Usual effective dosage range: 1-4 mg daily 2, 3
- Clinical studies show little additional benefit between 4 mg and 8 mg daily doses 2
Administration Guidelines
- Should be administered with breakfast or the first main meal of the day 1
- When coadministered with colesevelam, glimepiride should be taken at least 4 hours prior to colesevelam 1
Special Populations
Renal Impairment
- Start with lower doses (1 mg) in patients with renal impairment 1
- Use with caution in patients with advanced kidney disease 4
Elderly
Hepatic Impairment
- Use with caution in patients with hepatic impairment 3
Monitoring Considerations
- Monitor for hypoglycemia, which occurred in 10-20% of patients treated for ≤1 year 2
- Risk of hypoglycemia may be lower with glimepiride compared to other sulfonylureas, particularly in the first month of treatment 2
- If maximum dose fails to achieve adequate glycemic control, consider adding metformin or insulin 5
Clinical Efficacy
Glimepiride has been shown to be effective in:
- Reducing fasting plasma glucose
- Reducing postprandial glucose
- Lowering HbA1c levels 3
The medication has a rapid onset of action and long duration of effect, allowing for once-daily dosing, which improves patient compliance 6.