Glimepiride
1-[[p-[2-(3-ethyl-4-methyl-2-oxo-3-pyrroline-1-carboxamido)ethyl]phenyl]sulfonyl]-3-(trans-4-methylcyclohexyl)urea
Also known as: Amarel · Amarylle · Euglim · Glimepil · Solosa · Roname · HOE-490
Reviewed by the VetSheet Veterinary TeamUpdated Apr 5, 2026Evidence-based veterinary reference
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Dosing by species
🌎 NA — North America🌍 EU — Europe
Cats
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Treatment of NIDDM | 2 mg (total dose) per cat | PO | once daily | — | 🌎 NA |
| Treatment of NIDDM | 1-2 mg (total dose per cat) | PO | once daily | — | 🌎 NA |
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Overview
Glimepiride is an oral, once-daily anti-hyperglycemic agent belonging to the sulfonylurea class.
Clinical Pearl: While dogs almost exclusively develop insulin-dependent diabetes mellitus (IDDM) requiring exogenous insulin, cats frequently develop non-insulin dependent diabetes mellitus (NIDDM), similar to human Type 2 diabetes. This makes oral hypoglycemic agents like glimepiride potentially useful in feline patients whose pancreas still retains some beta-cell function.
- Advantages: Its longer duration of action allows for convenient once-daily dosing in cats, and it may present fewer side effects compared to older generation sulfonylureas like glipizide.
- Limitations: Clinical experience in veterinary medicine remains very limited, and it is considered an investigational or adjunctive therapy.
Mechanism of action
Glimepiride is a medium- to long-acting secretagogue sulfonylurea.
Primary Mechanism:
- Binds to the SUR1 receptor on the membrane of functioning pancreatic beta cells.
- Closes ATP-sensitive potassium (K+) channels → cell depolarization.
- Opens voltage-gated calcium (Ca2+) channels → calcium influx.
- Triggers the exocytosis and release of insulin granules into the bloodstream.
Secondary Mechanism:
- With continued use, it may also increase peripheral tissue sensitivity to insulin, reducing insulin resistance.
Safety & warnings
Contraindications
- Hypersensitivity to glimepiride or other sulfonylureas
- Diabetic ketoacidosis (DKA)
Adverse effects
- Hypoglycemia
- Dizziness
- Asthenia
- Liver function impairment (rare)
- Allergic respiratory reactions (rare)
- Dermatologic reactions (rare)
- Hematologic reactions (rare)
Precautions
Warning: Do not confuse glimepiride with other sulfonylureas such as glipizide or glyburide.
- Pregnancy: FDA Category C. Animal studies show intrauterine deaths secondary to maternal hypoglycemia. Avoid use during pregnancy.
- Nursing: Excreted in maternal milk; manufacturer recommends discontinuing in nursing mothers.
- Hepatic/Renal Impairment: Use with caution as metabolism and excretion may be delayed, increasing the risk of hypoglycemia.
Drug interactions
May increase plasma levels of glimepiride
May potentiate hypoglycemic effect
May displace glimepiride from plasma proteins
May reduce efficacy
May reduce hypoglycemic efficacy
May reduce hypoglycemic efficacy
May reduce hypoglycemic efficacy
May reduce hypoglycemic efficacy
May reduce hypoglycemic efficacy
May displace glimepiride from plasma proteins
May reduce hypoglycemic efficacy
May displace glimepiride from plasma proteins
Monitoring
- Fasting blood glucose
- Appetite and attitude
- Body condition
- PU/PD resolution
- Serum fructosamine
- Glycosylated hemoglobin levels
- Signs of hypoglycemia
Pharmacokinetics
Absorption
In humans, completely absorbed from the GI tract. Peak levels occur in 2-3 hours; food delays the peak somewhat and lowers AUC by about 9%.
Distribution
Volume of distribution is 0.11 L/kg; the drug is greater than 99% bound to plasma proteins (in humans).
Metabolism
Hepatically metabolized to at least two major metabolites. One of these, M1, has activity at about 1/3 that of the parent compound.
Elimination
Clearance is 48 mL/min. Approximately 60% of the drug (as metabolites) is excreted into the urine and the remainder in the feces. Has a 24-hour duration of activity in humans.
Overdose
Overdoses can lead to hypoglycemia, ranging from mild to severe and life-threatening.
Treatment:
- Immediate glucose administration (oral if conscious, IV dextrose if severe/unconscious).
- Intensive monitoring is critical.
- Due to the drug's long duration of activity, patients may require continuous glucose support (e.g., IV dextrose CRI) for at least 48 hours post-ingestion, even after apparent clinical recovery.
Available products
Formulations
- Oral Tablets
Human-labeled
- Glimepiride Oral Tablets: 1 mg, 2 mg, & 4 mg; Amaryl, generic; (Rx)
Regulatory status
No regulatory data for: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Storage & stability
Glimepiride tablets should be stored between 15-30°C (59-86°F) in well-closed containers.
Client information
Glimepiride is used to help manage diabetes in cats.
Important: The use of this medication in cats is considered investigational or 'off-label'.
- Administration: Give exactly as prescribed by your veterinarian, typically once daily.
- Hypoglycemia Risk: Because this drug lowers blood sugar, there is a risk it could drop too low. Watch closely for signs of low blood sugar (hypoglycemia), which include:
- Extreme lethargy or weakness
- Wobbly gait or incoordination
- Muscle twitching or tremors
- Seizures or collapse
- Emergency Action: If you notice these signs, rub a small amount of corn syrup (like Karo syrup) or honey on your cat's gums and contact your veterinarian immediately.
- Monitoring: Keep all follow-up appointments for blood and urine tests to ensure the medication is working safely.
VetSheet drug reference is intended for licensed veterinary professionals as a clinical decision-support aid, not a substitute for professional judgement or the manufacturer’s current label.