David Snyder, PharmD, BCPP, is a board-certified clinical pharmacist and psychopharmacology expert at McLean Hospital in Belmont, Massachusetts.
Amaryl (glimepiride) is an orally administered medication prescribed in conjunction with proper diet and exercise to achieve glycemic control, known as the management of hyperglycemia (high blood sugar) in adults 18 and older with type 2 diabetes.
Amaryl belongs to a class of drugs prescribed to treat type 2 diabetes and is categorized as a second-generation sulfonylurea.
As a sulfonylurea, Amaryl works by causing the pancreas to produce insulin and subsequently use that insulin more efficiently. Furthermore, sulfonylureas work best when complimented with a strict diet and exercise regimen.
The active ingredient present in Amaryl, glimepiride, is available by itself as a generic product that is administered via oral tablets.
Nonetheless, Amaryl, a brand-name drug that will be featured in this article, can be used alone or in combination with other antidiabetic drugs and is administered in the form of oral tablets.

Generic Name: Amaryl
Brand Name:  Glimepiride
Drug Availability: Prescription
Therapeutic Classification: Hypoglycemic
Available Generically: Yes
Controlled Substance: N/A
Administration Route: Oral 
Active Ingredient: Glimepiride
Dosage: Tablet
The Food and Drug Administration (FDA) approved Amaryl to control blood sugar levels in adults 18 and older with type 2 diabetes.
Type 2 diabetes is a disease in which the body either fails to produce enough insulin (an enzyme responsible for the breakdown of sugar in the body) or resists insulin.
However, this medication will only help lower blood sugar in people with residual pancreatic beta-cell activity, or people whose bodies produce insulin naturally. Therefore, it is not prescribed for people with type 1 diabetes.

Of note, it is the only second-generation sulfonylurea drug approved by the FDA for combination therapy (meaning supplemental) with insulin in people who are nonresponsive to combination therapy.
Finally, Amaryl can be prescribed as monotherapy (therapy that uses one type of treatment) in people that are unable to tolerate the antidiabetic drug, metformin.

Read the instructions on the prescription label, and ask your healthcare provider about any part you do not understand. Take Amaryl by mouth with breakfast or with the first meal of the day.
Take the tablet once daily or as prescribed by your healthcare provider. The dose of Amaryl depends on your health condition and your response to treatment.
To help remember to take the tablet, take it at the same time every day. Do not skip doses. Take medicine exactly as directed. Do not take more, less, or more often than prescribed.
The healthcare provider may initially prescribe a low dose and gradually increase the dose if needed.  Follow your provider’s instructions carefully.
Consult your healthcare provider if your blood sugar test results have been higher or lower than normal during your treatment. Continue to take Amaryl even if you feel well. Do not stop taking medicine without talking to your provider.

Store Amaryl at room temperature, away from direct heat, moisture, and light. Keep the medication out of reach and out of sight of children and pets.

Amaryl takes nearly two to three hours to reach its full effect after one dose.
This is not a complete list of side effects, and others may occur. A medical professional can advise you on side effects. If you experience other effects, contact your pharmacist or a medical professional. You may report side effects to the FDA at fda.gov/medwatch or 800-FDA-1088.

The most common side effects associated with the use of Amaryl are:
Call your healthcare provider right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency.
Serious side effects and their symptoms associated with the use of Amaryl include:
Amaryl is typically a long-term treatment for type 2 diabetes. Therefore, discuss with your healthcare provider the potential for long-term side effects during and following your use of Amaryl.
Notably, the use of oral antidiabetic medications has been linked with an increase in cardiovascular mortality in comparison with diet alone or diet plus insulin, per the University Group Diabetes Program (UGDP).
Amaryl may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.
If you experience a serious side effect, you or your provider may send a report to the FDA’s MedWatch Adverse Event Reporting Program or by phone (800-332-1088).
The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
The following modifications (changes) should be kept in mind when using Amaryl:
Severe allergic reaction: Avoid using Amaryl if you have a known allergy to it or any of its ingredients. Ask your healthcare provider for a complete list of the ingredients if you’re unsure.
Pregnancy: ​​Despite limited studies, it is recommended that the use of sulfonylureas (including Amaryl) should be discontinued at least two weeks before expected delivery. Be sure to consult with your healthcare provider if you’re pregnant, or planning on becoming pregnant before starting Amaryl.
Breastfeeding: Caution is recommended with breastfeeding as data are limited on its effects. Talk with your healthcare provider if you plan to breastfeed to weigh the risks and benefits of taking Amaryl.
Children: Amaryl is not prescribed for children. Talk with a provider about safe and effective antidiabetic treatment options for your child.
People who smoke: Smoking can lower Amaryl’s effectiveness. Try to stop smoking before starting Amaryl, and avoid smoking while taking the medication. Your healthcare provider can help you with this goal.

If you have missed a dose of Amaryl, take it as soon as you remember. If it is almost time for your next dose, skip the missed one and take the regular dose. Do not take a double dose to make up for the missed one.
Do not take more or less Amaryl than instructed by a healthcare provider. While rare, an overdose of Amaryl can cause severe hypoglycemia.
Symptoms of hypoglycemia include tremors, heart palpitations (an irregular heartbeat), tachycardia (a fast or pounding heartbeat), nausea, sweating, anxiety, confusion, headache, fatigue, drowsiness, and the potential for seizures.
If you think you or someone else may have overdosed on Amaryl, call a healthcare provider or the Poison Control Center (800-222-1222).
If someone collapses or isn’t breathing after taking Amaryl, call 911 immediately.
It is very important that your doctor check your progress at regular visits to make sure that this medicine is working properly. Blood and urine tests may be needed to check for unwanted effects.
It is very important to follow carefully any instructions from your health care team about:
Check with your doctor right away if you start having chest pain or discomfort; nausea; pain or discomfort in the arms, jaw, back, or neck; shortness of breath; sweating; or vomiting while you are using this medicine. These may be symptoms of a serious heart problem, including a heart attack.
Too much glimepiride can cause low blood sugar (hypoglycemia) when it is used under certain conditions. Symptoms of low blood sugar must be treated before they lead to unconsciousness (passing out). Different people may feel different symptoms of low blood sugar. It is important that you learn which symptoms of low blood sugar you usually have so that you can treat it quickly and call someone on your health care team right away when you need advice.
Symptoms of low blood sugar include anxiety; behavior change similar to being drunk; blurred vision; cold sweats; confusion; cool, pale skin; difficulty in thinking; drowsiness; excessive hunger; fast heartbeat; headache (continuing); nausea; nervousness; nightmares; restless sleep; shakiness; slurred speech; or unusual tiredness or weakness.
If symptoms of low blood sugar occur, eat glucose tablets or gel, corn syrup, honey, or sugar cubes; or drink fruit juice, non-diet soft drink, or sugar dissolved in water. Also, check your blood for low blood sugar. Glucagon is used in emergency situations when severe symptoms such as seizures (convulsions) or unconsciousness occur. Have a glucagon kit available, along with a syringe or needle, and know how to use it. Members of your household also should know how to use it.
This medicine may cause dizziness, drowsiness, or less alert than they are normally. Make sure you know how you react to this medicine before you drive, use machines, or do other jobs that require you to be alert or able to think well.
This medicine may cause serious types of allergic reactions, including anaphylaxis. These conditions may be life-threatening and require immediate medical attention. Stop using this medicine and check with your doctor right away if you have a blistering, peeling, or red skin rash; itching; a large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs; trouble with breathing; or chest tightness while you are using this medicine.
Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.
Amaryl is not appropriate for everyone.
You should not take this medication if you are allergic to glimepiride or any other ingredient in Amaryl.
Additionally, make your healthcare provider aware if any of the following applies before starting treatment with Amaryl:
Tell your healthcare provider about all of the medicines you take, including prescription and over-the-counter (OTC) medicines, and vitamins or supplements. If needed, there may be a need to change the dose of your medicines or monitor you carefully for side effects.
Medications that may negatively interact with Amaryl include:
This list may not contain all the medications that interact with Amaryl.
Keep a list of all the medicines you take and consult with your healthcare provider or pharmacist regarding drug-drug interactions. 

Second-generation sulfonylureas include Amaryl, Glucotrol XL (glipizide), and DiaBeta (glyburide). These drugs are effective in lowering blood sugar levels.
Amaryl has several clinical advantages over conventional sulfonylureas. Notably, it provides more stable blood glucose control and decreases the risk of hypoglycemia over some second-generation sulfonylureas.
Amaryl is safe and well-tolerated in people with type 2 diabetes and is effective with other oral agents or with insulin treatment.

Amaryl is used to treat type 2 diabetes, a condition causing hyperglycemia when the body doesn’t make enough insulin or the insulin produced within the body doesn’t work properly.
Amaryl does not treat type 1 diabetes, a condition in which the body does not produce insulin.
Amaryl reduces the glucose level in the blood by stimulating the release of insulin from the pancreas and boosting the use of sugar by the cells that require it.
Amaryl reduces blood sugar levels within two to three hours.
Do not stop taking Amaryl without first consulting your healthcare provider.
Prolonged high blood sugar can cause life-threatening complications, including heart disease, stroke, kidney problems, nerve damage, and vision problems.
Taking Amaryl, making lifestyle changes, and checking your blood sugar regularly may help manage your diabetes and improve your health.
Visit your healthcare provider for regular checkups. Monitor your hemoglobin A1C (HbA1C; a test to monitor the amount of glucose in your blood) blood tests regularly and keep a close check on your blood sugar levels.
Do not skip your meals, and always carry a quick source of sugar to manage sudden hypoglycemia while on treatment with Amaryl.
Verywell Health’s drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.
Food and Drug Administration. Amaryl (glimepiride) prescribing information.
DailyMed. Label: glimepiride tablet.
Centers for Disease Control and Prevention. Type 2 diabetes.
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Kim HS, Kim DM, Cha BS, et al. Efficacy of glimepiride/metformin fixed-dose combination vs metformin uptitration in type 2 diabetic patients inadequately controlled on low-dose metformin monotherapy: a randomized, open label, parallel group, multicenter study in Korea. J Diabetes Investig. 2014;5(6):701-708. doi:10.1111/jdi.12201
MedlinePlus. Glimepiride.
National Health Organization. Low blood sugar (hypoglycaemia).
Prescribers’ Digital Reference. Glimepiride – drug summary
Dills DG, Schneider J. Clinical evaluation of glimepiride versus glyburide in NIDDM in a double-blind comparative study. Glimepiride/glyburide research group. Horm Metab Res. 1996;28(9):426-429. doi:10.1055/s-2007-979831

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