Glimepiride is contraindicated in patients with known hypersensitivity to the drug.
All sulfonylureas are capable of producing severe and prolonged hypoglycemia. Hypoglycemia should be avoided with proper patient selection, dosage, and instructions concerning diet, exercise, laboratory tests and follow-up procedures. Patients with impaired renal function may be more sensitive to the glucose-lowering effect of glimepiride.
Secondary failure, or a loss of blood sugar control, may occur when a patient stabilized on any diabetic regimen is exposed to stress such as fever, trauma, infection, or surgery. At such times, it may be necessary to add insulin in combination with glimepiride, or even use insulin monotherapy.
Glimepiride should not be used in the treatment of insulin-dependent (type 1) diabetes mellitus. Use in type 2 diabetes mellitus is contraindicated in patients with ketoacidosis (with or without coma) and in those with severe infections, trauma or other severe conditions where glimepiride is unlikely to control the hyperglycemia. Insulin should be used in such situations.