Amaryl (glimepiride)

Amaryl

GENERIC AVAILABLE: Yes

Yes

• Glimepiride is used for controlling blood sugar in adults with type 2 diabetes in addition to diet and exercise.
• Management of blood sugar with glimepiride can help decrease the risk of eye, kidney, and nerve damage.
• It is not used for treating type 1 diabetes.

Common side effects of glimepiride include:

• Dizziness
• Headache
• Nausea
• Vomiting

A rash and allergic reactions also may occur. Flu-like symptoms have also been reported with glimepiride therapy.

Possible serious side effects of glimepiride include:

• Anemia
• Low blood platelets
• Low sodium
• Sensitivity to sunlight
• Liver dysfunction
• Serious allergic reactions

Low blood sugar (hypoglycemia) can occur during glimepiride therapy. Symptoms of low blood sugar include:

• Hunger
• Nausea
• Tiredness
• Perspiration
• Headache
• Heart palpitations
• Numbness around the mouth
• Tingling in the fingers
• Tremors
• Muscle weakness
• Blurred vision
• Chilliness
• Excessive yawning
• Irritability
• Confusion
• Loss of consciousness

Glimepiride is a derivative of a sulfonamide drug. People allergic to other sulfonamide-related drugs may develop an allergic reaction to glimepiride. Anyone who has an allergic reaction to sulfa drugs should not take glimepiride.

Like other medicines used to treat diabetes, the dose of glimepiride is individualized using periodic measurements of blood sugar to determine the best dose. The usual starting dose is 1 or 2 mg given orally once daily with breakfast or the first major meal of the day. The dose may be increased by 1-2 mg in 1-2 weeks interval up to 8mg maximum based on blood sugar response and given once daily.

• Some medications when given with glimepiride may reduce its ability to lower blood sugar. These drugs include diuretics, for example, hydrochlorothiazide (Microzide, and many combinations with other drugs), loop diuretics (for example, furosemide [Lasix]), corticosteroids such as prednisone and methylprednisolone (Medrol), phenytoin (Dilantin), colesevelam (Welchol), danazol and somatropin (Genotropin). Rifampin increases the breakdown of glimepiride by liver enzymes. This might reduce the effect of glimepiride and result in higher levels of sugar in the blood.
• Beta blockers such as propranolol (Inderal) and atenolol (Tenormin) can cause low or high blood sugar. Additionally, they can directly reverse the sugar-lowering effect of sulfonylureas and render them less effective. Beta blockers also can blunt some of the body's protective responses to low blood sugar, thus making it difficult for patients to recognize reactions due to low blood sugar (hypoglycemia).
• Certain drugs when given with glimepiride may increase the risk of low blood sugar (hypoglycemia). These include nonsteroidal anti-inflammatory drugs or NSAIDs (for example ibuprofen), sulfa drugs, warfarin (Coumadin), miconazole (Oravig), fluconazole (Diflucan), chloramphenicol, cimetidine (Tagamet HB), ranitidine (Zantac), clarithromycin (Biaxin), MAO Inhibitors (for example, isocarboxazid [Marplan] and phenelzine [Nardil]), mifepristone (Mifeprex), probenecid, quinolone antibiotics and selective serotonin reuptake inhibitors or SSRIs (for example paroxetine [Paxil], fluoxetine [Prozac] and sertraline [Zoloft]) and voriconazole (Vfend). Blood sugar should be closely monitored when interacting drugs are given with glimepiride.
• Combination glimepiride with insulin and use in patients with congestive heart failure may increase risk of other heart related side effects.

• In animal studies, glimepiride and other sulfonylureas were associated with a higher risk of fetal death. However, there have been no good studies in women. Abnormal blood sugar concentrations (high or low) during pregnancy increase the risk of abnormalities in the fetus. Therefore, physicians must carefully weigh the benefits and risks of sulfonylurea treatment during pregnancy. Insulin is the drug of choice for treating diabetes in pregnant women.
• It is not known if glimepiride is excreted in breast milk like other sulfonylureas. Because of the risk of low blood sugar in the infant, it is recommended that glimepiride be discontinued in nursing mothers. If therapy other than diet and exercise is needed, insulin is preferred.

What preparations of glimepiride are available?

Tablets: 1, 2, and 4 mg

How should I keep glimepiride stored?

Tablets should be stored at room temperature, between 15 C and 30 C (59 F and 86 F).