Drug General Information (ID: DDIZY9TX7R)
Drug Name			Glimepiride		Drug Info		Nalmefene		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antidiabetic Agents				Antidotes
Structure

Mechanism of Glimepiride-Nalmefene Interaction (Severity Level: Moderate)
Competitive binding of plasma proteins Click to Show/Hide Mechanism Graph
Drug Name		Glimepiride				Nalmefene
Mechanism		Competition for plasma protein binding sites				Competition for plasma protein binding sites
Key Mechanism Factor 1
		Factor Name		Plasma protein binding
		Factor Description		Plasma protein binding refers to the degree of binding of a drug to proteins in the blood, and the lower the degree of binding, the more efficiently the drug can cross cell membranes or diffuse. Plasma protein binding alters the distribution and therapeutic characteristics of the drugs.
Mechanism Description		Increased plasma concentration of Nalmefene and Glimepiride due to competitive binding of plasma proteins

Recommended Action
Management		Patients should be monitored closely for hypoglycemia during concomitant therapy, particularly following addition of a highly protein-bound drug to a stabilized glimepiride regimen. Patients should be advised to regularly monitor their blood sugar, counseled on how to recognize and treat hypoglycemia (e.g., headache, dizziness, drowsiness, nausea, tremor, hunger, weakness, or palpitations) and to notify their physician if it occurs. Likewise, such patients should be observed for loss of glycemic control when the highly protein-bound drug is withdrawn.

References
1	Product Information. Amaryl (glimepiride). Hoechst Marion-Roussel Inc, Kansas City, MO.