Amaryl (Glimepiride 1mg)

Amaryl general information

What is Amaryl used for?

Amaryl tablets 1mg are an antidiabetic medication used to control blood sugar levels in people with type-2 diabetes mellitus (also called non insulin-dependent diabetes or maturity onset diabetes) who are unable to achieve adequate glycaemic control (normal blood sugar levels) with diet and exercise alone.  Amaryl tablets 1mg should be used in conjunction with diet, exercise and weight loss to lower blood sugar levels in type-2 diabetes mellitus and can be used alone as monotherapy, in conjunction with diet and exercise, or in combination with other antihyperglycaemic medication (lowers blood sugar), like metformin, when a single drug does not result in adequate glycaemic control.  However, Amaryl tablets 1mg are not suitable for treatment of type-1 diabetes mellitus or insulin-dependent diabetes.  Diabetes increases the risk of serious health complications, including diabetic retinopathy (damage to the retina in the eye with loss of vision), diabetic neuropathy (nerve damage) and diabetic nephropathy (kidney damage).  Maintaining glycaemic control with Amaryl tablets 1mg reduces the risk of developing these vascular complications.

How does Amaryl work?

Amaryl tablets 1mg contain glimepiride, an oral antihyperglycaemic medication belonging to the sulfonylurea group of drugs.  Glimepiride in Amaryl tablets 1mg controls blood glucose (sugar) primarily by acting directly on the beta cells, which are the insulin-producing cells of pancreatic islet tissue, to increase their sensitivity to glucose and to stimulate the cells to produce and release more insulin.  Insulin is normally produced in response to food and increased blood glucose levels and it controls postprandial (after eating) blood glucose levels (glycaemic control).  In diabetes, resistance to insulin results in loss of glycaemic control.  Glimepiride in Amaryl tablets 1mg helps the body to produce sufficient insulin to maintain normal blood glucose levels after a meal as well as between meals and is effective for up to 24 hours.  It is also thought that as well as acting as an insulin secretagogue (stimulates insulin secretion) glimepiride in Amaryl tablets 1mg also acts on insulin-responsive cells in the liver, muscle and fat cells to increase the number of receptors, which means that insulin control of glucose production by the liver and uptake of insulin into peripheral tissues for energy and storage, is more efficient.

What does Amaryl contain?

Amaryl tablets 1mg contain the active ingredient glimepiride, an oral antihyperglycaemic medication belonging to the sulfonylurea group of drugs, used to treat type-2 diabetes.  They also contain lactose monohydrate, sodium starch glycollate, povidone, microcrystalline cellulose and magnesium stearate, iron oxide red

Treating type 2 diabetes with Amaryl

Amaryl tablets 1mg contain glimepiride, an oral antihyperglycaemic medication, used to control blood sugar levels in people with type-2 diabetes mellitus (also called non insulin-dependent diabetes or maturity onset diabetes) who are unable to achieve adequate glycaemic control (normal blood sugar levels) with diet and exercise alone.  Glimepiride in Amaryl tablets 1mg controls blood glucose (sugar) primarily by acting directly on the insulin-producing beta cells of pancreatic islet tissue, to stimulate the cells to produce more insulin.  Insulin is normally produced in response to food and increased blood glucose levels, and it controls postprandial (after eating) blood glucose levels (glycaemic control).  In diabetes, resistance to insulin results in loss of glycaemic control.  Amaryl tablets 1mg help the body to produce sufficient insulin to maintain normal blood glucose levels after a meal as well as between meals and is effective for up to 24 hours.  It is also thought that as well as stimulating insulin secretion, glimepiride in Amaryl tablets 1mg also acts on insulin-responsive cells in the liver, muscle and fat cells to increase the number of receptors, which means that insulin control of glucose production by the liver and insulin uptake into peripheral tissues for energy and storage, is more efficient.  Maintaining glycaemic control with Amaryl tablets 1mg reduces risk of serious health complications associated with diabetes, including diabetic retinopathy (damage to the retina in the eye with loss of vision), diabetic neuropathy (nerve damage) and diabetic nephropathy (kidney damage). 

What are the side effects of Amaryl?

The most commonly reported side effects when taking Amaryl tablets 1mg include: gastrointestinal complaints like nausea, diarrhoea, constipation and stomach or abdominal pain; allergic skin reactions like, redness (erythema), itching (pruritus), hives (urticaria); dizziness, drowsiness, headache, visual disturbances, confusion, malaise and tremor, which are usually transient and may be signs of hypoglycaemia.  A more serious side effect of taking Amaryl tablets 1mg is severe hypoglycaemia (very low blood glucose), as glimepiride continues to work between meals to reduce blood sugar levels, so it is important to eat regularly; also certain other conditions like liver or kidney problems, or taking other medications like beta blockers, can make you more susceptible to hypoglycaemia.  Other symptoms of hypoglycaemia include headache, hunger, restlessness, loss of consciousness, which can result in coma.

What is hypoglycaemia (hypo)

Having a hypo is an unpleasant episode experienced by diabetics and refers to extreme hypoglycaemia or very low blood glucose.  Glimepiride in Amaryl tablets 1mg continue to work between meals to reduce blood sugar levels and therefore if glucose levels fall too low, by missing a meal or waiting too long between eating, severe hypoglycaemia, which is very low blood glucose, can be the result.  Symptoms of hypoglycaemia include headache, hunger, nausea, vomiting, restlessness, sensory disturbances, delirium, loss of consciousness, which can result in shallow respiration, bradycardia (slow heart beat) and coma. 

When should Amaryl not be used?

You should not use Amaryl tablets 1mg if you:

• are allergic to glimepiride or any ingredients in Amaryl
• are pregnant or are breastfeeding
• have kidney or liver or thyroid disease
• have type 1 (insulin-dependent) diabetes or suffer from diabetic coma or diabetic ketoacidosis
• have G6PD deficiency as you may be at risk of haemolytic anaemia
• are malnourished or have adrenal or pituitary insufficiency, as this may increase risk of hypoglycaemia
• are taking medicines that interact with Amaryl, including: the antifungals miconazole and fluconazole, non steroidal anti-inflammatory agents (NSAID) like phenylbutazone, salicylate analgesicis like aspirin, beta-blockers like propranolol for high blood pressure and certain heart conditions, ACE Inhibitors like benezapril for high blood pressure, cimetidine for peptic ulcers, monoamine oxidase inhibitors for depression, probenecid for gout, the anticoagulant warfarin, the antibiotic chloramphenicol, sulphonamide antibiotics, corticosteroids for inflammation, bronchodilators like salbutamol, thiazides and other diuretics, thyroid hormones, oestrogens and progestogens for oral contraceptives and HRT, phenytoin for epilepsy, nicotinic acid for high cholesterol, calcium channel blocking drugs like verapamil for angina, isoniazid for tuberculosis

What medications interact with Amaryl?

Several medications interact with Amaryl tablets 1mg and should either not be taken while you are taking Amaryl or only after discussion and instruction from your doctor:

• Drugs that affect Amaryl tablets 1mg and cause hypoglaemia (low blood sugar) by increasing its glucose-lowering effect: the antifungals miconazole and fluconazole, non steroidal anti-inflammatory agents (NSAID) like phenylbutazone, salicylate analgesics like aspirin, beta-blockers like propranolol for high blood pressure and certain heart conditions, ACE Inhibitors like benezapril for high blood pressure, cimetidine for peptic ulcers, monoamine oxidase inhibitors for depression, probenecid for gout, the anticoagulant warfarin, the antibiotic chloramphenicol, sulphonamide antibiotics, bronchodilators like salbutamol
• Drugs that affect Amaryl tablets 1mg and cause hyperglycaemia (high blood sugar) by reducing its glucose-lowering effect: Danazol for hormone treatment, the antipsychotic chlorpromazine, corticosteroids for inflammation, bronchodilators like salbutamol, thiazides and other diuretics, thyroid hormones, oestrogens and progestogens for oral contraceptives and HRT, phenytoin for epilepsy, nicotinic acid for high cholesterol, calcium channel blocking drugs like verapamil for angina, isoniazid for tuberculosis

How should Amaryl be taken?

You should take your Amaryl tablets 1mg swallowed whole with a glass of water just before breakfast of if you only have a light breakfast, then take your Amaryl tablets just before your midday meal.  It is important that you do not skip a meal while taking Amaryl tablets 1mg.  The dose you take depends on how well you respond and your doctor may increase your dose until your blood glucose has reached normal levels and remains controlled.  You should continue to take your Amaryl tablets 1mg for as long as recommended by your doctor, as they with help maintain your blood sugar levels but will not cure your diabetes.

How long should you take Amaryl?

You should continue to take your Amaryl tablets 1mg for as long as recommended by your doctor, as they with help maintain your blood sugar levels but will not cure your diabetes.

Missed dose of Amaryl

If you miss a dose of Amaryl tablets 1mg take it as soon as you remember, unless it is time to take the next dose, then skip the missed dose.  Do not take a double dose.

How should Amaryl be stored?

You should store your Amaryl below 25°C in a cool dry place.