The following undesirable effects are based on experience with glimepiride and other sulfonylureas.
Blood and Lympathic System Disorders: Rare: Thrombocytopenia, leukopenia, granulocytopenia, agranulocytosis, erythropenia, haemolytic anaemia and pancytopenia, which are in general reversible upon discontinuation of medication.
Immune System Disorders: Very rare: Leukocytoclastic vasculitis, mild hypersensitivity reactions that may develop into serious reactions with dyspnoea, fall in blood pressure and sometime shock. Cross-allergenicity with sulfonylureas, sulfonamides or related substances is possible.
Metabolism and Nutrition Disorders: Rare: Hypoglycaemia.
These hypoglycaemic reactions mostly occur immediately, maybe severe and are not always easy to correct. The occurrence of such reactions depends, as with other hypoglycaemic therapies, on individual factors such as dietary habits and dosage.
Eye Disorders: Visual disturbances, transient, may occur especially on initiation of treatment, due to changes in blood glucose levels.
Gastrointestinal Disorders: Very rare: nausea, vomiting, diarrhoea, abdominal distension, abdominal discomfort and abdominal pain, which seldom lead to discontinuation of therapy.
Hepato-Biliary Disorders: Hepatic enzymes increased. Very rare: Hepatic function abnormal (e.g. with cholestasis and jaundice), hepatitis and hepatic failure.
Skin and Subcutaneous Tissue Disorders: Hypersensitivity reactions of the skin may occur as pruritus, rash, urticaria and photosensitivity.
Investigations: Very rare: blood sodium decrease.