Amaryl Tablets (Glimepiride) Medication Uses, Side Effects

Amaryl  Tablets (Glimepiride) 1MG, 2MG, 3MG, 4MG Medication

Amaryl Tablets is the brand name of Glimepiride. Glimepiride is an oral hypoglycemia agent. Moreover, this medications is considered as one of the best medicine for diabetes treatment without any side effects. In the same vein It belongs to sulfonylurea class. Glimepiride is chemically identified as 1-p-2-(3-ehtyl-4-methyl-2-oxo-3 pyrroline-1-carboxamido) ethyl-phenylsulfonyl-3-(trans-4-methylcyclohexyl) urea. It used to lower the blood glucose in patients with type 2 diabetes whose hyperglycemia cannot be controlled by diet and exercise alone. Furthermore, if you want to know that what is amaryl used for and how to use it as well as what type of side effects you can get? please read down all the details here.

Composition Of Amaryl Drugs:

Amaryl 1 MG Tablet  :   Each tablet contains Glimepiride 1 mg as active ingredient.

Amaryl  2 mg Tablet  :   Each tablet contains Glimepiride 2 mg as active ingredient.

3 MG Amaryl Tablet  :    Each tablet contains Glimepiride 3 mg as active ingredient.

Amaryl 4  mg Tablet  :   Each tablet contains Glimepiride 4 mg as active ingredient.

Amaryl Tablets Uses & Indications:

Non-insulin dependent (type ll) diabetes mellitus, whenever blood glucose levels cannot controlled adequately by diet, physical exercise and weight reduction alone. Amaryl Tablets may use combined with other non-betacytotropic, oral antidiabetics. On the other hand, these best Glimepiride Tablets may also uses together with insulin. Amaryl Tablet is not suitable for the treatment of insulin dependent (type 1) diabetes mellitus. e.g. (for the treatment of diabetics with a history of ketoacidosis), of diabetic ketoacidosis, or of diabetic precoma or coma.

Amaryl Tablets Dosage

In principle Amaryl Dosage is governed by the desired blood sugar levels. The Glimepiride Dosage must the lowest which is sufficient to achieve the desired metabolic control. During treatment with Amaryl  glucose levels in blood and urine must measured regularly. In addition it recommended that regular determinations of the proportion of glycated haemoglobin be carried out. Mistakes e.g. forgetting to taken a  Amaryl 4.0 mg Durg Dose must never corrected by subsequently taking a larger dose. Measures for dealing with such mistakes (in particular forgetting a dose skipping a meal). Or situation where a Amaryl Medicine Dose cannot taken at the prescribed time must discussed and agreed between physician and patients before hand.

Initial Amaryl Dose And Dose Titration

Usual initial dose is Amaryl 1 mg tablet once daily.

If necessary the daily Amaryl dosage can increased by only the professional doctor or pharmacist. Recommended that any increase guided by regular blood glucose monitoring and that the dose increased gradually i.e at intervals of one to two weeks and according to the following dose step; Amaryl 1 mg – Amaryl 2mg– Amaryl 3mg – Amaryl 4 mg – Amaryl 6 mg (8 mg).

Dose Range In Patients With Well Controlled Diabetes

Meanwhile, the usual daily doses in patients with well controlled diabetes Amaryl 1 mg to Amaryl 4 mg. Daily doses of more than Amaryl 6 mg are effective only in a minority of patients.

Distribution Of Amaryl Medication Doses

Most importantly, the timing and distribution of doses are to be decided by the physician taking into consideration the patients current life style. Normally, a single daily dose of Amaryl is sufficient. It is recommended that this dose should be taken immediately before a substantial breakfast or none is taken immediately before the first main meal. It is very important not to skip meals after the tablet have been taken. As an improvement in control of diabetes is, in itself associated with higher insulin sensitivity, Glimepiride requirements may fall as treatment proceeds. To avoid hypoglycaemia timely dose reduction or cessation of Amaryl Dosage therapy must therefore be considered. Correction of Glimepiride dosage must also be considered whenever the patients weight or life style   changes. Or other factors causing an increased susceptibility to hypoglycaemia or hyperglycaemia arise.

Duration Of Treatment With Amaryl Diabetes Drug

Treatment with Amaryl Drug is normally a long term therapy.

Changeover From Other Oral Anti Diabetics To Amaryl Drug

There is no exact dosage relationship between Amaryl Drug and other oral antidiabetics. When substituting Amaryl Medicine for other oral antidiabetics, it is recommended that the procedure be the same as for initial dosage starting with daily doses of Amaryl 1 mg. This applies even in cases where the patients is being switched from the maximum dose of another oral antidiabetic. Consideration must be given to the potency and duration of action of he previous antidiabetic agent. A break from medicine may be required to avoid any summation of effect entailing a risk of hypoglycaemia.

Use With Metformin

In patients not adequately controlled with the maximum daily dose of either Glimepiride or metformin. Combination therapy with both oral antidiabetic agent may be initiated. As the established therapy with either Glimepiride or metformin progresses at the same dose level. The additional metformin or Glimepiride treatment is started with a low dose, which is then titrated up depending on the desired level of metabolic control up to the maximum daily dose. Therefore, combination therapy must started immediately under close medical supervision.

Use With Insulin

In patients not adequately controlled with the maximum daily Amaryl Dose, concomitant insulin therapy can be initiated. While maintaining the Glimepiride Dose, the insulin treatment must started at low dosage and further increase depending on the desired level of metabolic control. The combination therapy should initiated under close medical supervision.

Amaryl Drug Special Population

Children:

Data are insufficient to recommended pediatric use of Glimepiride.

Renal Impairment

There is limited information available on the Amaryl Use in renal insufficiency. Patients with impaired renal function may more sensitive to the glucose lowering effect of Amaryl Medicine.

Amaryl (Glimepiride) Drug Contraindications

Amaryl Tablets  contraindicated in:

  • Patients hypersensitive to Glimepiride Durg, other sulfonylureas, other sulfonamides, or any of the excipients of Amaryl.
  • The drug contraindicated during pregnancy.
  • In breast feeding women

However, No experience has gained concerning the Amaryl Use in patients with severe impairment of liver function and in dialysis patients. Therefore, In patients with severe impairment of hepatic function, change over to insulin indicated. Furthermore, Not least to achieve optimal metabolic control.

Amaryl Tablets Drug Interactions:

Based on experience with Amaryl Tablet and on what is known of other sulfonylureas, the following drug interactions must be considered.  Glimepiride is metabolized by cytochrome P450 2C9 (CYP2C9). So, This should taken into account when Glimepiride co-administered with inducers Like. rifampicin or inhibitors Like. fluconazole of CYP 2C9. Potentitaion of the blood glucose lowering effect and thus in some instances hypoglycaemia may occur when one of the following drugs taken. For example:

  • Insulin and other oral antidiabetics
  • ACE inhibitors
  • Anabolic steroids and male sex hormones
  • Chloramphenicol
  • Coumarin derivatives
  • Cyclophosphamide
  • Disopyramide
  • Fluconazole
  • Para-aminosalicylic acid
  • Pentoxifylline
  • Phenylbutazone
  • Azapropazone
  • Oxyphenbutazone
  • Probenecid
  • Quinolones
  • Salicylates
  • Sulfinpyrazone
  • Clarithromycin
  • Sulfonamide antibiotics
  • Tetracyclines
  • Tritoqualine and trofosfamide

Furthermore, Weakening of the blood glucose lowering effect and thus, raised blood glucose levels may occur when one of the following drugs taken. For example

  • Acetazolamide
  • Barbiturates
  • Corticosteroids
  • Diazoxide
  • Diuretics
  • Epinephrine
  • Glucagon
  • Laxtives
  • Nicotinic acid
  • Oestrogens andprogestogens
  • Phenothiazines
  • Phenytoin
  • Rifampicin
  • Thyroid hormones

H2 receptor antagonists, Beta blockers, Clonidine and reserpine may lead to either potentiation or weakening of the blood glucose lowering effect. However, below the side effects of sympatholytic medicines. Like beta blockers, clonidine, guanethidine and reserpine, symptoms of adrenergic counter regulation to hypoglycaemia may reduced or totally get absent. Meanwhile, in both acute and chronic alcohol intake may potentiate or weaken the blood glucose lowering action of Amaryl in an unpredictable style. Furthermore, the effect of coumarin derivatives may potentiated or weakened.

Bile Acid Sequestrant:

Colesevelam binds to Glimepiride and reduces Glimepiride absorption from the gastro intestinal tract. Furthermore, No drug interaction observed when Glimepiride taken for at least 4 hours before colesevelam. Therefore Glimepiride should administered at least 4 hours prior to colesevelam.

Amaryl (Glimepiride) During Pregnancy And Lactation

Amaryl must not taken during pregnancy. Otherwise there is risk of harm to the child. So most importantly in the pregnancy the patient must change over to insulin. Therefore if Patients planning a pregnancy must inform their physician. It recommended that such patients change over to insulin.

Lactation

Meanwhile, To prevent possible ingestion with the breast milk and possible harm to the child, Amaryl must not taken by breast feeding women. So, in this condition the patient can switch towards insulin or must stop breast feeding.

Driving Vehicles Or Performing Other Hazardous Tasks

Alertness and reactions may impaired due to hypo or hyperglycaemia. Especially when beginning or after altering treatment or when Amaryl  not taken regularly. So it can affect the ability to drive or to operate machinery.

Amaryl (Glimepiride) Side Effects:

Metabolism And Nutrition Disorders

As a result of the blood glucose lowering action of Amaryl, hypoglycaemia may occur. Which based on what known of other sulfonylureas may also prolonged. Possible symptoms of hypoglycaemai includes

  • Headache
  • Ravenous Hunger
  • nausea
  • Vomiting
  • Lassitude
  • Sleepiness
  • Disordered Sleep
  • Restlessness
  • Aggressiveness
  • Impaired concentration
  • Impaired alertness and reactions
  • Depression
  • Confusion
  • Difficulty in Speaking
  • Visual Disorders
  • Tremor
  • Pareses
  • Sensory Disturbances
  • Dizziness
  • Helplessness
  • Loss ofSelf Control
  • Delirium
  • Cerebral convulsions
  • Somnolence
  • Loss of Consciousness
  • Coma
  • Shallow respiration
  • Slow heart rate

In addition the signs of adrenergic counter regulation may be present such as

  • Sweating
  • Clammy skin
  • Anxiety
  • Rapid heart rate
  • Hypertension
  • Palpitations
  • Angina pectoris
  • Cardiac Arrhythmias

However, The clinical picture of a severe hypoglycaemic attack may resemble that of a stroke. Symptoms of hypoglycaemia nearly always subside when hypoglycaemia  corrected.

Eye Disorder

Especially at the start of treatment, temporary visual impairment may occur due to the change in blood glucose levels. Moreover that effect is a temporary alteration in the turgidity and hence the refractive index of the lens, this being dependent on blood glucose level.

Gastrointestinal Disorders

Occasionally, the gastrointestinal symptoms such as

  • Nausea
  • Vomiting
  • Sensations of pressure or fullness in the epigastrium
  • Abdominal pain
  • Diarrhoea

Meanwhile, In isolated cases there may be hepatitis elevation of liver enzyme levels and cholestasis and jaundice. Which may progress to life threatening liver failure but can regress after withdrawal of Amaryl.

General Disorders

Occasionally allergic or pseudoallergic reactions may occur e.g. in the form of itching, urticaria or rashes. However, Such mild reactions may develop into serious reactions with dyspnea and a fall in blood pressure, sometimes progressing to shock. Therefore, If urticaria occurs, a physician must be notified immediately. Meanwhile, In isolated cases a decrease in serum sodium concentration, inflammation of blood vessels, allergic vasculitis, or hypersensitivity of the skin to light may occur.

Amaryl Tablets Storage Instructions

Firstly, Store Amaryl Drug below 25 C temperature. On the other hand, also Protect from heat and sun light. Most importantly, also keep all the medicine out of the reach of the children.

Amaryl (1 MG, 2 MG, 3 MG, 4 MG) Glimepiride Tablets Price

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