Generic name: GlimepirideBrand names: Amaryl
Amaryl is an oral medication used to treat type 2 (non-insulin-dependent) diabetes when diet and exercise alone fail to control abnormally high levels of blood sugar. Like other diabetes drugs classified as sulfonylureas, Amaryl lowers blood sugar by stimulating the pancreas to produce more insulin. Amaryl is often prescribed along with the insulin-boosting drug Glucophage. It may also be used in conjunction with insulin and other diabetes drugs.
Always remember that Amaryl is an aid to, not a substitute for, good diet and exercise. Failure to follow a sound diet and exercise plan may diminish the results of Amaryl and can lead to serious complications such as dangerously high or low blood sugar levels. Remember, too, that Amaryl is not an oral form of insulin, and cannot be used in place of insulin.
Do not take more or less of Amaryl than directed by your doctor. Amaryl should be taken with breakfast or the first main meal.
Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Amaryl.
Amaryl, like all oral antidiabetics, can result in hypoglycemia (low blood sugar). The risk of hypoglycemia can be increased by missed meals, alcohol, fever, injury, infection, surgery, excessive exercise, and the addition of other medications such as Glucophage or insulin. To avoid hypoglycemia, closely follow the dietary and exercise regimen suggested by your doctor.
Ask your doctor what steps you should take if you experience mild hypoglycemia. If symptoms of severe low blood sugar occur, contact your doctor immediately; severe hypoglycemia is a medical emergency.
Avoid Amaryl if you have ever had an allergic reaction to it.
Do not take Amaryl to correct diabetic ketoacidosis (a life-threatening medical emergency caused by insufficient insulin and marked by excessive thirst, nausea, fatigue, and fruity breath). This condition should be treated with insulin.
It's possible that drugs such as Amaryl may lead to more heart problems than diet treatment alone, or treatment with diet and insulin. If you have a heart condition, you may want to discuss this with your doctor.
When taking Amaryl, you should check your blood and urine regularly for abnormally high sugar (glucose) levels. The effectiveness of any oral antidiabetic, including Amaryl, may decrease with time. This may occur because of either a diminished responsiveness to the medication or a worsening of the diabetes.
Even people with well-controlled diabetes may find that stress such as injury, infection, surgery, or fever triggers a loss of control. If this happens, your doctor may recommend that you add insulin to your treatment with Amaryl or that you temporarily stop taking Amaryl and use insulin instead.
If Amaryl is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Amaryl with the following:Airway-opening drugs such as albuterol sulfateAspirin and other salicylate medicationsChloramphenicolCorticosteroids such as prednisoneDiuretics such as hydrochlorothiazide and chlorothiazideEstrogens such as conjugated estrogensHeart and blood pressure medications called beta blockers, including atenolol, metoprolol tartrate, and propranolol hydrochlorideIsoniazidMajor tranquilizers such as thioridazine hydrochlorideMAO inhibitors (antidepressants such as phenelzine sulfate and tranylcypromine sulfate)MiconazoleNicotinic acidNonsteroidal anti-inflammatory drugs such as diclofenac sodium, ibuprofen, mefenamic acid, and naproxenOral contraceptivesPhenytoinProbenecidSulfa drugs such as sulfamethoxazole and trimethoprimThyroid medications such as levothyroxineWarfarin
Use alcohol with care; excessive alcohol intake can cause low blood sugar.
Do not take Amaryl while pregnant. Since studies suggest the importance of maintaining normal blood sugar levels during pregnancy, your doctor may prescribe injected insulin instead. Drugs similar to Amaryl do appear in breast milk and may cause low blood sugar in nursing infants. You should not take Amaryl while nursing. If diet alone does not control your sugar levels, your doctor may prescribe injected insulin.
The usual starting dose is 1 to 2 milligrams taken once daily with breakfast or the first main meal. The maximum starting dose is 2 milligrams.
If necessary, your doctor will gradually increase the dose 1 or 2 milligrams at a time every 1 or 2 weeks. Your diabetes will probably be controlled on 1 to 4 milligrams a day; the most you should take in a day is 8 milligrams. If the maximum dose fails to do the job, your doctor may add Glucophage to your regimen.
Weakened or malnourished people and those with adrenal, pituitary, kidney, or liver disorders are particularly sensitive to hypoglycemic drugs such as Amaryl and should start at 1 milligram once daily. Your doctor will increase your medication based on your response to the drug.
Safety and effectiveness in children have not been established.
An overdose of Amaryl can cause low blood sugar (see "What side effects may occur?" for symptoms).
Eating sugar or a sugar-based product will often correct mild hypoglycemia. For severe hypoglycemia, seek medical attention immediately.