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Glimepiride side effects: what 38,726 FDA adverse event reports show

Glimepiride · 1,149 reaction terms · 131,203 drug–reaction co-reports · data 2026-09-14
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Drug class

Sulfonylurea

FDA label (Established Pharmacologic Class) · compare the class

Who reports

38,726 reports · 64% serious · 3,272 with death outcome · 49% female

openFDA FAERS counts, all years, deduplication not applied

Used for

Glimepiride tablets are indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus . Limitations of Use Glimepiride tablets should not be used for the treatment of type 1 diabetes mellitus or diabetic ketoacidosis, as it would not be effective in these settings.

FDA label, Indications and Usage

What it is

Glimepiride tablets USP, are an oral sulfonylurea that contains the active ingredient glimepiride USP.

FDA label, Description section

Boxed warning

None in the current label

How to read this page. FAERS is a spontaneous-reporting system: counts are not incidence rates and a signal is not proof of causation. Each reaction below is run through an automated screen — is the term in the FDA label (known), in the indications (the disease being treated), an administrative/coding term, or none of these (unlabeled)? That screen is mechanical text matching, not a causality assessment. The 30 hand-written Bradford Hill assessments are on the causality assessment page. Not medical advice.

Causality screen of the 40 strongest signals

Labeled adverse reaction 1Labeled (related wording) 5Likely indication confounding 4Reporting / coding artifact 1Lab value / disease marker 5Not in label — unassessed 24
What the badges mean

Strongest disproportionality signals

Flagged terms (PRR ≥ 2, χ² ≥ 4, n ≥ 10), ranked by PRR; infinite PRRs (no comparator reports) excluded. The EBGM column is a second, shrinkage-based estimate (MGPS) with its 5th percentile EB05 and the BCPNN IC025; a pair flagged by PRR alone is marked PRR-only and should be read as fragile. The strata column recomputes the PRR on serious reports only (and, for the 300 most-reported drugs, adjusted for age band), and flags pairs whose reports are unusually skewed by sex or come mostly from consumers. Each row also shows the PRR against the other drugs of the same FDA class, which removes most confounding by the condition being treated, and a calibrated p-value: on validation, known non-causes average an ROR of about 2, so significance is judged against that empirical null (✓ = p < 0.05 after calibration). 1,109 further terms are in the interactive explorer. Reaction links open the term's cross-drug page.

Show:
ReactionReportsPRR 95% CI · ROR · χ²/pEBGM EB05 · IC025Label screenSerious-only & strataTrial cross-check
Blood lactic acid2098.7
61.3–159.1ROR 98.8 · calibrated p 5e-7 ✓
77.5 EB05 53.0 · IC025 +4.0
3/3 methods agree
vs other Sulfonylureas: only this drug
Not in label — unassessedserious n=20not reported in cached trials
Hypoglycaemic encephalopathy5385.1
63.7–113.7ROR 85.2 · calibrated p 6e-7 ✓
71.7 EB05 56.9 · IC025 +5.0
3/3 methods agree
vs other Sulfonylureas: only this drug
Not in label — unassessedserious n=53 · ♀ 73% (drug 49%) · 100% cliniciannot reported in cached trials
Hypoglycaemic coma21844.1
38.4–50.6ROR 44.3 · calibrated p 3e-5 ✓
40.7 EB05 36.3 · IC025 +5.0
3/3 methods agree
vs other Sulfonylureas: PRR 1.9 (1.5–2.3)
Not in label — unassessedserious n=218 · 95% cliniciannot reported in cached trials
Diabetic metabolic decompensation7430.5
24.1–38.6ROR 30.6 · calibrated p 3e-4 ✓
28.7 EB05 23.6 · IC025 +4.2
3/3 methods agree
vs other Sulfonylureas: only this drug
Likely indication confounding
shares a disease stem with the indications wording
serious n=74NCT01243424: 2/3,010 (0.1%) on Glimepiride (serious AE)
Necrotising oesophagitis2326.5
17.5–40.3ROR 26.6 · calibrated p 8e-4 ✓
24.9 EB05 17.4 · IC025 +3.4
3/3 methods agree
vs other Sulfonylureas: only this drug
Not in label — unassessedserious n=23 · ♀ 0% (drug 49%) · 100% cliniciannot reported in cached trials
Nephrogenic anaemia19823.9
20.7–27.6ROR 24.0 · calibrated p 9e-4 ✓
22.9 EB05 20.3 · IC025 +4.2
3/3 methods agree
vs other Sulfonylureas: PRR 0.4 (0.4–0.5)
Not in label — unassessedserious n=198not reported in cached trials
Chronic kidney disease-mineral and bone disorder4423.0
17.0–31.2ROR 23.1 · calibrated p 0.001 ✓
21.9 EB05 17.0 · IC025 +3.7
3/3 methods agree
vs other Sulfonylureas: PRR 0.4 (0.3–0.5)
Not in label — unassessedserious n=44not reported in cached trials
Hyperparathyroidism secondary9420.8
17.0–25.6ROR 20.9 · calibrated p 0.002 ✓
20.0 EB05 16.8 · IC025 +3.8
3/3 methods agree
vs other Sulfonylureas: PRR 0.4 (0.3–0.5)
Not in label — unassessedserious n=94NCT01243424: 1/3,010 (0.0%) on Glimepiride (serious AE)
Eosinophilic myocarditis2720.7
14.1–30.5ROR 20.8 · calibrated p 0.002 ✓
19.7 EB05 14.2 · IC025 +3.3
3/3 methods agree
vs other Sulfonylureas: only this drug
Not in label — unassessedserious n=27 · ♀ 100% (drug 49%) · 100% cliniciannot reported in cached trials
Hypoglycaemia (low blood sugar)1,67919.4
18.5–20.3ROR 20.2 · calibrated p 0.002 ✓
18.7 EB05 18.0 · IC025 +4.1
3/3 methods agree
vs other Sulfonylureas: PRR 0.7 (0.6–0.7)
Labeled adverse reaction
exact term
serious PRR 17.9NCT01794143: 28/1,254 (2.2%) on Glimepiride (serious AE)
Brash syndrome4317.7
13.1–24.0ROR 17.7 · calibrated p 0.004 ✓
17.0 EB05 13.1 · IC025 +3.3
3/3 methods agree
vs other Sulfonylureas: only this drug
Not in label — unassessedserious n=43 · ♀ 0% (drug 49%) · 100% cliniciannot reported in cached trials
Gastrointestinal hypomotility6516.2
12.7–20.8ROR 16.2 · calibrated p 0.006 ✓
15.7 EB05 12.7 · IC025 +3.4
3/3 methods agree
vs other Sulfonylureas: PRR 0.6 (0.5–0.9)
Not in label — unassessedserious n=64 · 100% consumernot reported in cached trials
Glycosylated haemoglobin increased65114.3
13.3–15.5ROR 14.6 · calibrated p 0.008 ✓
14.0 EB05 13.1 · IC025 +3.7
3/3 methods agree
vs other Sulfonylureas: PRR 0.5 (0.5–0.6)
Lab value / disease markerserious PRR 13.1not reported in cached trials
Rebound acid hypersecretion7713.9
11.1–17.4ROR 13.9 · calibrated p 0.010 ✓
13.5 EB05 11.1 · IC025 +3.3
3/3 methods agree
vs other Sulfonylureas: PRR 0.5 (0.4–0.6)
Not in label — unassessedserious n=77not reported in cached trials
Glycosylated haemoglobin decreased3913.6
9.9–18.6ROR 13.6 · calibrated p 0.012 ✓
13.0 EB05 9.7 · IC025 +3.0
3/3 methods agree
vs other Sulfonylureas: PRR 0.8 (0.5–1.3)
Lab value / disease markerserious n=22not reported in cached trials
Hyperglycaemic hyperosmolar nonketotic syndrome2713.5
9.2–19.8ROR 13.5 · calibrated p 0.014 ✓
12.7 EB05 8.9 · IC025 +2.8
3/3 methods agree
vs other Sulfonylureas: only this drug
Not in label — unassessedserious n=23 · 100% clinicianNCT01243424: 1/3,010 (0.0%) on Glimepiride (serious AE)
Euglycaemic diabetic ketoacidosis9012.5
10.1–15.4ROR 12.5 · calibrated p 0.015 ✓
12.1 EB05 10.1 · IC025 +3.2
3/3 methods agree
vs other Sulfonylureas: PRR 1.4 (1.0–1.9)
Likely indication confounding
shares a disease stem with the indications wording
serious n=90 · 100% cliniciannot reported in cached trials
Lactic acidosis64911.2
10.3–12.0ROR 11.3 · calibrated p 0.021 ✓
10.9 EB05 10.2 · IC025 +3.3
3/3 methods agree
vs other Sulfonylureas: PRR 1.3 (1.1–1.4)
Not in label — unassessedserious PRR 9.8 · 93% clinicianNCT01794143: 5/1,254 (0.4%) on Glimepiride (serious AE)
Adenocarcinoma pancreas2510.7
7.2–15.9ROR 10.7 · calibrated p 0.031 ✓
9.7 EB05 6.7 · IC025 +2.5
3/3 methods agree
vs other Sulfonylureas: PRR 0.7 (0.4–1.2)
Not in label — unassessedserious n=25NCT01243424: 1/3,010 (0.0%) on Glimepiride (serious AE)
Early satiety3710.7
7.7–14.8ROR 10.7 · calibrated p 0.029 ✓
10.0 EB05 7.4 · IC025 +2.7
3/3 methods agree
vs other Sulfonylureas: PRR 0.3 (0.2–0.4)
Not in label — unassessedserious n=17 · 100% consumernot reported in cached trials
Impaired gastric emptying23610.2
9.0–11.6ROR 10.2 · calibrated p 0.030 ✓
9.9 EB05 8.9 · IC025 +3.1
3/3 methods agree
vs other Sulfonylureas: PRR 0.6 (0.5–0.6)
Not in label — unassessedserious PRR 9.6 · 93% consumerNCT01243424: 1/3,010 (0.0%) on Glimepiride (serious AE)
Blood glucose fluctuation1979.9
8.6–11.3ROR 9.9 · calibrated p 0.034 ✓
9.6 EB05 8.5 · IC025 +3.0
3/3 methods agree
vs other Sulfonylureas: PRR 0.3 (0.3–0.4)
Lab value / disease markerserious n=100 · 75% consumernot reported in cached trials
Pancreatic carcinoma metastatic519.8
7.4–13.0ROR 9.8 · calibrated p 0.038 ✓
9.3 EB05 7.2 · IC025 +2.7
3/3 methods agree
vs other Sulfonylureas: PRR 0.5 (0.3–0.6)
Not in label — unassessedserious n=51NCT01243424: 3/3,010 (0.1%) on Glimepiride (serious AE)
Glycosylated haemoglobin abnormal209.3
6.0–14.5ROR 9.3 · calibrated p 0.051
8.1 EB05 5.3 · IC025 +2.2
3/3 methods agree
vs other Sulfonylureas: PRR 0.4 (0.3–0.7)
Lab value / disease marker–not reported in cached trials
End stage renal disease2998.9
8.0–10.0ROR 9.0 · calibrated p 0.047 ✓
8.7 EB05 7.9 · IC025 +2.9
3/3 methods agree
vs other Sulfonylureas: PRR 0.4 (0.3–0.4)
Not in label — unassessedserious PRR 7.8NCT01243424: 3/3,010 (0.1%) on Glimepiride (serious AE)
Injection site nodule1778.8
7.6–10.3ROR 8.9 · calibrated p 0.049 ✓
8.6 EB05 7.6 · IC025 +2.8
3/3 methods agree
vs other Sulfonylureas: PRR 0.6 (0.5–0.7)
Not in label — unassessedserious n=29 · 84% consumernot reported in cached trials
Diabetic retinopathy548.7
6.7–11.4ROR 8.7 · calibrated p 0.055
8.2 EB05 6.5 · IC025 +2.6
3/3 methods agree
vs other Sulfonylureas: PRR 0.4 (0.3–0.5)
Likely indication confounding
shares a disease stem with the indications wording
serious n=52NCT01243424: 2/3,010 (0.1%) on Glimepiride (serious AE)
Diabetic nephropathy348.4
6.0–11.8ROR 8.4 · calibrated p 0.063
7.7 EB05 5.7 · IC025 +2.3
3/3 methods agree
vs other Sulfonylureas: PRR 0.4 (0.3–0.6)
Likely indication confounding
shares a disease stem with the indications wording
serious n=34 · 100% clinicianNCT01243424: 1/3,010 (0.0%) on Glimepiride (serious AE)
Blood glucose abnormal2738.1
7.2–9.1ROR 8.1 · calibrated p 0.064
7.9 EB05 7.1 · IC025 +2.8
3/3 methods agree
vs other Sulfonylureas: PRR 0.4 (0.4–0.5)
Lab value / disease markerserious PRR 6.9 · 74% consumernot reported in cached trials
Pancreatitis necrotising327.7
5.4–10.9ROR 7.7 · calibrated p 0.083
7.0 EB05 5.1 · IC025 +2.2
3/3 methods agree
vs other Sulfonylureas: only this drug
Not in label — unassessedserious n=32 · 100% clinicianNCT01243424: 1/3,023 (0.0%) on Glimepiride (serious AE)
Bladder transitional cell carcinoma207.6
4.9–11.9ROR 7.6 · calibrated p 0.090
6.6 EB05 4.5 · IC025 +2.0
3/3 methods agree
vs other Sulfonylureas: PRR 0.2 (0.1–0.3)
Not in label — unassessedserious n=19NCT01243424: 8/3,010 (0.3%) on Glimepiride (serious AE)
Venous occlusion257.5
5.0–11.1ROR 7.5 · calibrated p 0.093
6.7 EB05 4.7 · IC025 +2.0
3/3 methods agree
vs other Sulfonylureas: only this drug
Not in label — unassessedserious n=24 · 100% consumernot reported in cached trials
Metabolic alkalosis217.2
4.7–11.1ROR 7.2 · calibrated p 0.105
6.3 EB05 4.3 · IC025 +1.9
3/3 methods agree
vs other Sulfonylureas: only this drug
Not in label — unassessedserious n=21not reported in cached trials
Chronic kidney disease9076.5
6.1–6.9ROR 6.6 · calibrated p 0.116
6.4 EB05 6.0 · IC025 +2.6
3/3 methods agree
vs other Sulfonylureas: PRR 0.4 (0.4–0.5)
Not in label — unassessedserious PRR 5.8NCT01243424: 1/3,023 (0.0%) on Glimepiride (serious AE)
Intentional device misuse526.4
4.8–8.4ROR 6.4 · calibrated p 0.134
6.0 EB05 4.7 · IC025 +2.1
3/3 methods agree
vs other Sulfonylureas: PRR 1.2 (0.8–1.9)
Reporting / coding artifact100% consumernot reported in cached trials

Trial evidence (ClinicalTrials.gov)

✓ Trial adverse-event data found on ClinicalTrials.gov

Largest completed trials with posted results that list Glimepiride as a study intervention. The right-hand column of the signal table shows whether each FAERS term was also recorded in these trials, with a real denominator (16 of 40 signal terms matched).

Caveats: trial populations, doses and follow-up differ from the reporting population; AE terms are sponsor-coded and matched here by wording; absence from a trial list means the term was not reported above the sponsor's frequency threshold, not that it cannot occur.

Most frequently reported reactions

By raw co-report count, regardless of disproportionality. Common terms here are often the illness itself or generic outcomes.

ReactionReportsPRR 95% CI · ROR · χ²/pEBGM EB05 · IC025Label screenSerious-only & strataTrial cross-check
Nausea2,3391.6
1.5–1.7ROR 1.6 · calibrated p 0.735
1.6 EB05 1.6 · IC025 +0.6
vs other Sulfonylureas: PRR 0.4 (0.3–0.4)
Labeled adverse reaction
exact term
serious PRR 1.5NCT01243424: 5/3,010 (0.2%) on Glimepiride (serious AE)
Diarrhoea (diarrhea)2,2611.9
1.8–2.0ROR 2.0 · calibrated p 0.923
1.9 EB05 1.8 · IC025 +0.9
vs other Sulfonylureas: PRR 0.5 (0.5–0.5)
Not in label — unassessedserious PRR 1.7NCT01243424: 5/3,010 (0.2%) on Glimepiride (serious AE)
Drug ineffective (drug did not work)1,9450.8
0.8–0.8ROR 0.8 · calibrated p 0.177
0.8 EB05 0.8 · IC025 -0.4
PRR-only: not supported by EBGM or IC
vs other Sulfonylureas: PRR 0.4 (0.4–0.4)
Reporting / coding artifactserious PRR 0.8not reported in cached trials
Hypoglycaemia (low blood sugar)1,67919.4
18.5–20.3ROR 20.2 · calibrated p 0.002 ✓
18.7 EB05 18.0 · IC025 +4.1
3/3 methods agree
vs other Sulfonylureas: PRR 0.7 (0.6–0.7)
Labeled adverse reaction
exact term
serious PRR 17.9NCT01794143: 28/1,254 (2.2%) on Glimepiride (serious AE)
Dizziness1,3961.5
1.4–1.6ROR 1.5 · calibrated p 0.667
1.5 EB05 1.5 · IC025 +0.5
vs other Sulfonylureas: PRR 0.4 (0.4–0.4)
Labeled adverse reaction
exact term
serious PRR 1.4NCT01243424: 7/3,010 (0.2%) on Glimepiride (serious AE)
Vomiting1,3531.6
1.5–1.6ROR 1.6 · calibrated p 0.696
1.6 EB05 1.5 · IC025 +0.6
vs other Sulfonylureas: PRR 0.4 (0.4–0.4)
Not in label — unassessedserious PRR 1.5NCT01243424: 4/3,010 (0.1%) on Glimepiride (serious AE)
Dyspnoea (shortness of breath)1,3471.3
1.2–1.4ROR 1.3 · calibrated p 0.508
1.3 EB05 1.2 · IC025 +0.3
vs other Sulfonylureas: PRR 0.4 (0.4–0.4)
Labeled adverse reaction
exact term
serious PRR 1.2NCT01243424: 22/3,010 (0.7%) on Glimepiride (serious AE)
Asthenia (weakness)1,2181.8
1.7–1.9ROR 1.8 · calibrated p 0.818
1.8 EB05 1.7 · IC025 +0.7
vs other Sulfonylureas: PRR 0.4 (0.4–0.4)
Labeled adverse reaction
exact term
serious PRR 1.6NCT01243424: 7/3,010 (0.2%) on Glimepiride (serious AE)
Decreased appetite (loss of appetite)1,1692.7
2.6–2.9ROR 2.8 · calibrated p 0.697
2.7 EB05 2.6 · IC025 +1.4
3/3 methods agree
vs other Sulfonylureas: PRR 0.4 (0.4–0.4)
Not in label — unassessedserious PRR 2.3NCT01243424: 2/3,023 (0.1%) on Glimepiride (serious AE)
Off label use (used outside approved label)1,1180.7
0.7–0.7ROR 0.7 · calibrated p 0.125
0.7 EB05 0.7 · IC025 -0.6
PRR-only: not supported by EBGM or IC
vs other Sulfonylureas: PRR 0.5 (0.5–0.6)
Reporting / coding artifactserious PRR 0.7not reported in cached trials
Fall1,0991.8
1.7–1.9ROR 1.8 · calibrated p 0.839
1.8 EB05 1.7 · IC025 +0.7
vs other Sulfonylureas: PRR 0.5 (0.4–0.5)
Not in label — unassessedserious PRR 1.6NCT01243424: 44/3,010 (1.5%) on Glimepiride (serious AE)

Unlabeled candidate signals

These flagged terms were not found in the FDA label text and do not match an artifact pattern. They are the pairs that would merit a structured assessment (temporality, dose-response, biological plausibility, consistency across databases, trial or cohort evidence). The screen has not done that; string-matching misses label wording, and a strong PRR can still be stimulated reporting, co-medication, or the disease itself.

Want to assess one of these properly? The runbook describes the Bradford Hill / trial-evidence workflow used on the assessment page, and handoff_top1000_signals.csv lists the strongest unassessed pairs across all drugs.

Common questions

What are the most reported side effects of Glimepiride?

In FDA FAERS, the most frequently co-reported reaction terms for Glimepiride are blood glucose increased, nausea, diarrhoea, fatigue, hypoglycaemia, weight decreased. These are report counts, not rates: FAERS has no denominator, reporting is voluntary and uneven, and a term can be reported because of the illness being treated rather than the drug.

Does Glimepiride have an FDA boxed warning?

No. The FDA label retrieved for Glimepiride has no boxed warning; see the label's Warnings and Precautions for the recognised risks.

Do FAERS signals prove that Glimepiride causes these side effects?

No. A disproportionality signal (PRR, ROR) means a reaction is reported more often with this drug than with others in the database. That can reflect a real effect, but also the disease being treated, stimulated reporting after news or litigation, co-medications, or how reports are coded. Causality needs temporality, dose-response, biological plausibility, consistency across data sources and, ideally, trial or cohort evidence. This page screens each term against the FDA label and ClinicalTrials.gov results; it does not establish causation.

Sources & methods

Page generated 2026-10-14. Label and PubChem text are retrieved automatically and may lag the current label; always check the current prescribing information. OpenPV is a beta research tool of the Open Source Medicine Foundation.