Can glimepiride be taken with glipizide (Glibenclamide)?

From the Guidelines

No, glimepiride and glipizide should not be taken together. These medications are both sulfonylureas that work in the same way to lower blood sugar by stimulating insulin release from the pancreas. Taking them together would essentially be doubling up on the same type of medication, which increases the risk of hypoglycemia (dangerously low blood sugar) without providing additional therapeutic benefit.

Key Considerations

• The risk of hypoglycemia is a significant concern when using sulfonylureas, and combining two sulfonylureas would further increase this risk 1.
• If your current diabetes medication isn't adequately controlling your blood sugar, your healthcare provider might consider either adjusting the dose of your current sulfonylurea or switching to a different medication class that works through a different mechanism.
• The most recent guidelines on pharmacologic approaches to glycemic treatment emphasize the importance of considering the individual patient's characteristics, such as kidney function and risk of hypoglycemia, when selecting a medication regimen 1.

Recommendations

• If you're currently prescribed both glimepiride and glipizide, contact your healthcare provider immediately for guidance.
• Symptoms of hypoglycemia include shakiness, dizziness, sweating, confusion, and in severe cases, loss of consciousness.
• Always carry fast-acting glucose with you if you take any diabetes medication that can cause hypoglycemia.

Additional Guidance

• Patient education and use of low or variable dosing with later generation sulfonylureas may be used to mitigate the risk of hypoglycemia, particularly in individuals at high risk such as older patients and those with chronic kidney disease (CKD) 1.
• The selection of optimal pharmacotherapy for diabetes in patients with CKD requires careful consideration of the potential risks and benefits of each medication, including the risk of hypoglycemia and the potential for adverse cardiovascular outcomes 1.

From the FDA Drug Label

1. 1 Drugs Affecting Glucose Metabolism A number of medications affect glucose metabolism and may require glimepiride dose adjustment and particularly close monitoring for hypoglycemia or worsening glycemic control The following are examples of medications that may increase the glucose-lowering effect of sulfonylureas including glimepiride, increasing the susceptibility to and/or intensity of hypoglycemia: oral anti-diabetic medications,

The answer is: No, glimepiride should not be taken with glipezide, as both are oral anti-diabetic medications and may increase the risk of hypoglycemia 2.

From the Research

Glimepiride and Glipezide Interaction

• There is no direct evidence in the provided studies that compares the interaction between glimepiride and glipezide.
• However, the studies suggest that glimepiride can be used in combination with other oral antidiabetic drugs, including metformin and insulin, in patients with type 2 diabetes mellitus 3, 4.
• Glimepiride has been compared to other sulfonylureas, such as glibenclamide and glipizide, and has been shown to have similar efficacy and a lower risk of hypoglycemia 3, 5.
• The studies do not provide information on the specific interaction between glimepiride and glipezide, but they suggest that glimepiride can be used safely and effectively in patients with type 2 diabetes mellitus when used as monotherapy or in combination with other antidiabetic agents 3, 4, 5, 6.

Safety and Efficacy of Glimepiride

• Glimepiride has been shown to be effective in reducing fasting plasma glucose, post-prandial glucose, and glycosylated hemoglobin levels in patients with type 2 diabetes mellitus 3, 4, 5.
• The drug has a low risk of hypoglycemia, particularly when compared to other sulfonylureas, such as glibenclamide 3, 5, 6.
• Glimepiride can be used safely in patients with renal or hepatic disease, but the dosage should be adjusted accordingly 3, 4.
• The studies suggest that glimepiride is a useful and cost-effective treatment option for managing type 2 diabetes mellitus, particularly when used in combination with metformin 4, 5.