Glimepiride

Also indexed as: Amaryl®

Glimepiride is used to treat type 2, or non-insulin dependent, diabetes when diet and exercise alone have been ineffective. It is a type of drug called a sulfonylurea.

Summary of Interactions with Vitamins, Herbs, and Foods
(for details about the summarized interactions, read the full article)

Beneficial May be Beneficial: Supportive interaction—Taking these supplements may support or otherwise help your medication work better.

Lithium*

Magnesium*
Avoid Avoid: Adverse interaction—Avoid these supplements when taking this medication because taking them together may cause undesirable or dangerous results.

Ginkgo biloba

Vitamin B3* (Niacin)
Depletion or interference

None known
Side effect reduction/prevention

None known
Reduced drug absorption/bioavailability

None known

An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.

Interactions with Dietary Supplements

Vitamin B3 (Niacin)
Vitamin B3 can raise blood sugar levels, which makes diabetes difficult to control.1 Use of niacin along with glimepiride may increase requirements for the drug. On the other hand, individuals who stop taking niacin while on glimepiride should monitor their blood for lower-than-usual glucose levels.

Magnesium
Supplementing magnesium may enhance the blood-sugar-lowering effects of sulfonylurea drugs.2 Though no current studies have investigated whether glimepiride increases the risk of developing hypoglycemia, individuals should closely monitor their blood glucose while taking glimepiride together with magnesium supplements.

Lithium
Lithium is a mineral that may be present in some supplements and is also used in large amounts to treat mood disorders such as manic-depression. Taking lithium and sulfonylurea drugs together may increase the risk of developing hypoglycemia.3 Consequently, people taking glimepiride and lithium together should frequently monitor themselves for low blood glucose.

Ginkgo biloba
In a preliminary trial, administration of Ginkgo biloba extract (120 mg per day) for three months to patients with type 2 diabetes who were taking oral anti-diabetes medication resulted in a significant worsening of glucose tolerance. Ginkgo did not impair glucose tolerance in individuals whose diabetes was controlled by diet.4 Individuals taking oral anti-diabetes medication should consult a doctor before taking Ginkgo biloba.

Interactions with Food and Other Compounds

Food
The ingestion of food with glimepiride can lower the overall blood levels of the drug by nearly 10%.5 Though this is a minor reduction, maximum effectiveness would be achieved if glimepiride were taken on an empty stomach.

References

1. Sifton DW, ed. Physicians Desk Reference. Montvale, NJ: Medical Economics Company, Inc., 2000, 1346–9.

2. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, Inc., 1997, 213.

3. Werbach MR. Foundations of Nutritional Medicine. Tarzana, CA: Third Line Press, Inc., 1997, 212.

4. Kudolo GB. The effect of 3-month ingestion of Ginkgo biloba extract (EGb 761) on pancreatic beta-cell function in response to glucose loading in individuals with non-insulin-dependent diabetes mellitus. J Clin Pharmacol2001;41:600–11.

5. Sifton DW, ed. Physicians Desk Reference. Montvale, NJ: Medical Economics Company, Inc., 2000, 1346–9.