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Compare Glimepiride vs Metformin

Side-by-side medication summaries to compare pros and cons, side effects, interactions, and more.

Glimepiride

Metformin

Summary

Glimepiride is an oral medication used to control blood sugar levels in people with type 2 diabetes. It belongs to the sulfonylurea class of drugs, which functions by stimulating the pancreas to release insulin, lowering blood sugar levels. Typically taken once daily with breakfast or the first main meal, glimepiride is often part of a broader diabetes management plan that includes diet and exercise. Common side effects include low blood sugar, dizziness, and weight gain​.

Metformin is an oral medication commonly prescribed to manage blood sugar levels in individuals with type 2 diabetes. It works by decreasing glucose production in the liver, improving the body's sensitivity to insulin, and reducing the amount of sugar absorbed by the intestines. Metformin is often used as a first-line treatment due to its efficacy, safety profile, and additional benefits, such as weight stabilization and low risk of low blood sugar. Common side effects include gastrointestinal issues like nausea, diarrhea, and abdominal discomfort.

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Prescription

Prescription

Drug Category

Sulfonylurea

Biguinide

Approved Uses*

Glimepiride tablets are indicated:

  • As an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus

Metformin hydrochloride tablets are indicated:

  • As an adjunct to diet and exercise to improve glycemic control in adults and pediatric patients 10 years of age and older with type 2 diabetes mellitus

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Dosage*

  • Typically taken orally once daily

  • Comes in 1 mg, 2 mg, and 4 mg tablets

  • Typically taken orally once, twice, or three times daily

  • Comes in 500 mg, 850 mg, and 1,000 mg tablets

Known Common Side Effects*

Common adverse reactions in clinical trials (≥5% and more common than with placebo) include:

  • Low blood sugar

  • Headache

  • Nausea

  • Dizziness

For metformin hydrochloride, the most common adverse reactions (>5%) are:

  • Diarrhea

  • Nausea/vomiting

  • Flatulence

  • Weakness

  • Indigestion

  • Abdominal discomfort

  • Headache

Interactions & Contraindications*

  • Hypersensitivity to glimepiride or any of the product’s ingredients

  • Hypersensitivity to sulfonamide derivatives

  • Drug interactions: Certain medications may affect glucose metabolism, miconazole, cytochrome P450 2C9 interactions, colesevelam

  • Severe renal impairment (eGFR below 30 mL/min/1.73 m2)

  • Hypersensitivity to metformin

  • Acute or chronic metabolic acidosis, including diabetic ketoacidosis, with or without coma

  • Drug interactions: Carbonic anhydrase inhibitors, drugs that reduce metformin clearance (such as ranolazine, vandetanib, dolutegravir, and cimetidine), alcohol

Warnings & Precautions*

  • Low blood sugar: May be severe

  • Hypersensitivity reactions: Postmarketing reports include anaphylaxis, angioedema, and Stevens-Johnson syndrome

  • Hemolytic anemia: Can occur if glucose 6-phosphate dehydrogenase (G6PD) deficient

  • Potential increased risk of cardiovascular mortality with sulfonylureas

  • Macrovascular outcomes: No clinical studies establishing conclusive evidence of macrovascular risk reduction with glimepiride

  • Lactic acidosis: See Boxed Warning

  • Vitamin B12 deficiency: Metformin may lower vitamin B12 levels

  • Low blood sugar with concomitant use with insulin and insulin secretagogues

  • Females and males of reproductive potential: Potential for an unintended pregnancy

Boxed Warning*

WARNING: LACTIC ACIDOSIS

Postmarketing cases of metformin-associated lactic acidosis have resulted in death, hypothermia, hypotension, and resistant bradyarrhythmias. Symptoms included malaise, myalgias, respiratory distress, somnolence, and abdominal pain. Laboratory abnormalities included elevated blood lactate levels, anion gap acidosis, increased lactate/pyruvate ratio; and metformin plasma levels generally >5 mcg/mL.

Risk factors include renal impairment, concomitant use of certain drugs, age >65 years old, radiological studies with contrast, surgery and other procedures, hypoxic states, excessive alcohol intake, and hepatic impairment. Steps to reduce the risk of and manage metformin-associated lactic acidosis in these high risk groups are provided in the Full Prescribing Information.

If lactic acidosis is suspected, discontinue metformin hydrochloride tablets and institute general supportive measures in a hospital setting. Prompt hemodialysis is recommended.




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Reference

*This information is from the glimepiride label used by Dr. Reddy's Laboratories Limited. See the Full Prescribing Information for more complete information. This information may not be accurate for all medications that include the active ingredient glimepiride.

*This information is from the metformin hydrochloride label used by Epic Pharma, LLC. See the Full Prescribing Information for more complete information. Metformin is also the active ingredient in brand-name medications, including Glucophage® and Glumetza®, and this information may not be accurate for all medications that include the active ingredient metformin.

The information provided here is NOT MEDICAL ADVICE and is for informational and educational purposes only. The drug comparison tool does not determine eligibility for medications or treatments provided via the Hims/Hers platform. Consultation with a healthcare provider is required to assess suitability for any medical treatment based on individual health and medical history. All product names and associated trademarks are the property of their respective owners.


This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

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