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What is Amaryl?

Amaryl (glimepiride) is a combined hypoglycemic (sugar-reducing) drug. It lowers the level of glycated hemoglobin, glucose in the blood (after eating and on an empty stomach), increases glucose tolerance. The drug decreases the production of glucose in the liver, increases the sensitivity to insulin tissues (increases glucose uptake and its exchange). It does not affect the production of insulin by the pancreas. In addition, the medication normalizes fat metabolism. Amaryl starts working 2.5 hours after ingestion. The drug is prescribed for type 2 diabetes mellitus, non-insulin-dependent type. It is used as an independent medication and in combination with metformin or insulin

How should I use Amaryl?

The initial and maintenance dose is determined individually based on the results of regular monitoring of glucose in the blood and urine. At the beginning of treatment, a patient usually receives 1 mg once a day; if necessary, the daily dose may be increased (by 1 mg every 1-2 weeks) to 4-6 mg. The maximum daily dose is 6 mg.

The range of daily doses for patients with well-controlled diabetes mellitus is 1 to 4 mg. The time and frequency of taking the drug is determined by the doctor taking into account the lifestyle of the patient. As a rule, a patient should take 1 dose per day. The treatment is long.

When switching from another oral hypoglycemic drug, the initial daily dose of Amaryl should be 1 mg (even if the patient is switching from the maximum dose of another drug).

Tablets should be taken whole without chewing, with plenty of water.

What are the contraindications of this medicine?

Do not use this drug if you have any of the following diseases/conditions:

  • severe lack of diabetes, which leads to the destruction of the functions of all body systems;
  • non-insulin dependent type 1 diabetes mellitus;
  • ketoacidosis;
  • diabetic precoma, coma;
  • severe dysfunction of the kidneys, liver;
  • individual intolerance to the components of the drug.

What are the side effects of Amaryl?

  • Metabolism: hypoglycemia, reduction of sodium in the blood;
  • Digestive system: nausea, vomiting, epigastric discomfort, abdominal pain, diarrhea, increased activity of hepatic transaminases, cholestasis, jaundice, hepatitis, liver failure;
  • Hematopoietic system: thrombocytopenia, leukopenia, erythropenia, granulocytopenia, agranulocytosis (due to myelosuppression), pancytopenia, hemolytic anemia;
  • Visual organs: temporary visual disturbances (at the beginning of treatment);
  • Allergic reactions: allergic or pseudo-allergic reactions (itching, urticaria, skin rash), dyspnea, a fall in blood pressure, anaphylactic shock, allergic vasculitis, photosensitization.

What may interact with this medicine?

  • insulin or other hypoglycemic drugs;
  • ACE inhibitors;
  • allopurinol;
  • anabolic steroids and male sex hormones;
  • chloramphenicol;
  • coumarin derivatives;
  • cyclophosphamide;
  • disopyramide;
  • fenfluramine;
  • phenyramidol;
  • fibrates;
  • fluoxetine;
  • guanethidine;
  • MAO inhibitors;
  • miconazole;
  • aminosalicylic acid, pentoxifylline (when injected in high doses);
  • phenylbutazone;
  • azapropazone;
  • probenecid;
  • sulfinpyrazone;
  • sulfonamides;
  • tetracyclines;
  • acetazolamide;
  • barbiturates;
  • corticosteroids;
  • diazoxide;
  • diuretics;
  • adrenaline and other sympathomimetics;
  • glucagon;
  • laxatives (after prolonged use);
  • nicotinic acid (in high doses);
  • estrogens and progestogens;
  • phenothiazine;
  • phenytoin;
  • rifampicin;
  • thyroid hormones;
  • H2 receptor blockers;
  • clonidine;
  • reserpine;
  • alcohol

What should I watch for while using this medicine?

Amaryl is prescribed with caution to patients with concomitant diseases of the endocrine system that affect carbohydrate metabolism (including thyroid dysfunction, adenohypophysial or adrenocortical insufficiency).

The drug is contraindicated for use during pregnancy. If a woman gets pregnant when taking these tablets, she should switch to insulin therapy.

Glimepiride is excreted in breast milk. During lactation, a woman should switch to insulin or stop breastfeeding.

In stressful situations (with injury, surgery, infectious diseases, accompanied by fever), it may be necessary to switch to insulin.

An overdose of the drug can cause hypoglycemia, accompanied by increased sweating, anxiety, tachycardia, increased blood pressure, palpitations, heart pain, arrhythmia, headache, dizziness, a sharp increase in appetite, nausea, vomiting, apathy, drowsiness, anxiety, aggression , impaired concentration, depression, confusion, tremor, paresis, impaired sensitivity, seizures of central origin. Sometimes the clinical picture of hypoglycemia may resemble a stroke. In some cases, coma may occur. Treatment: diet correction, intake of glucose. In severe cases, the patient must be hospitalized.

The doses of the drug are determined by the level of glucose in the blood. Amaryl should be taken in prescribed doses and at about the same time. The skip of the dose should never be corrected by the subsequent reception of a higher dose. The patient should immediately inform the doctor in case of receiving an excessive dose of the drug.

Tablets should be taken before a heavy meal (usually before breakfast). It is very important not to skip meals after taking a tablet.

When compensation for diabetes is achieved, insulin sensitivity increases, and therefore the need for these tablets may decrease during the treatment process. To avoid hypoglycemia, it is necessary to reduce the dose in time or cancel the medication.

When switching to Amaryl from another drug, it is necessary to take into account the degree and duration of the effect of the preceding hypoglycemic drug. It may be necessary to temporarily discontinue treatment in order to avoid an additive effect.

In the first weeks of treatment, the risk of hypoglycemia may increase, which requires particularly strict monitoring of the patient. The factors contributing to the development of hypoglycemia include irregular, inadequate nutrition, changes in the usual diet, alcohol consumption, especially in combination with skipping meals, changing the usual regime of physical activity, the simultaneous use of other drugs. Hypoglycemia can be quickly stopped by taking carbohydrates.

During treatment with Amaril, a patient should regularly monitor blood glucose and urine levels, as well as the concentration of glycosylated hemoglobin. Regular monitoring of blood glucose and urine helps to detect primary or secondary drug resistance.

At the beginning of treatment, when switching from another drug or when taking tablets on an irregular basis, there may be a decrease in the patient’s vigilance and reactive ability due to hypo- or hyperglycemia. This may adversely affect the ability to drive a car or to work with various machines and mechanisms.