Patients who experience hypoglycemia on glimepiride may need to discontinue the medication if the hypoglycemia persists after adjusting the dosage and improving lifestyle by consulting with a medical professional. Factors that predispose to hypoglycemia with glimepiride include: unwillingness or inability to cooperate (mostly in elderly patients), malnutrition, irregular eating schedule or skipping meals, imbalance between physical exertion and carbohydrate intake, use of alcoholic beverages, especially without meals, renal impairment, severe hepatic impairment, and overdose of glimepiride. Patients taking glibenclamide are advised to use the drug under medical supervision.