Amaryl


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glimepiride

Amaryl, Apo-Glimepiride (CA), CO Glimepiride (CA), Novo-Glimepiride (CA), PMS-Glimepiride (CA), Ratio-Glimepiride (CA), Sandoz Glimepiride (CA)

Pharmacologic class: Sulfonylurea

Therapeutic class: Hypoglycemic

Pregnancy risk category C

Action

Lowers blood glucose level by stimulating insulin release from pancreas, increasing insulin sensitivity at receptor sites, and decreasing hepatic glucose production. Also increases peripheral tissue sensitivity to insulin and causes mild diuresis.

Availability

Tablets: 1 mg, 2 mg, 4 mg

Indications and dosages

Adjunct to diet and exercise to lower blood glucose level in type 2 (non-insulin-dependent) diabetes mellitus

Adults: Initially, 1 to 2 mg P.O. daily given with first main meal; usual maintenance dosage is 1 to 4 mg P.O. daily. When patient reaches 2 mg/day, increase no more than 2 mg q 1 to 2 weeks, depending on glycemic control. Maximum dosage is 8 mg/day.

Dosage adjustment

• Renal or hepatic impairment
• Adrenal or pituitary insufficiency

Contraindications

• Hypersensitivity to drug
• Diabetic coma or ketoacidosis
• Severe renal, hepatic, or endocrine disease
• Pregnancy or breastfeeding

Precautions

Use cautiously in:
• mild to moderate hepatic or renal disease; cardiovascular disease; impaired thyroid, pituitary, or adrenal function
• elderly patients.

Administration

• Check baseline creatinine level for normal renal function before giving first dose.
• Give with first meal of day.

Adverse reactions

CNS: dizziness, drowsiness, headache, weakness

CV: increased CV mortality risk

EENT: blurred vision

GI: nausea, vomiting, diarrhea, constipation, cramps, heartburn, epigastric distress, anorexia

Hematologic: aplastic anemia, leukopenia, pancytopenia, thrombocytopenia, agranulocytosis

Hepatic: cholestatic jaundice, hepatitis

Metabolic: hyponatremia, hypoglycemia

Skin: rash, erythema, maculopapular eruptions, urticaria, eczema, angioedema, photosensitivity

Other: increased appetite

Interactions

Drug-drug.Androgens (such as testosterone), chloramphenicol, clofibrate, guanethidine, MAO inhibitors, nonsteroidal anti-inflammatory drugs (except diclofenac), salicylates, sulfonamides, tricyclic antidepressants: increased risk of hypoglycemia

Beta-adrenergic blockers: altered response to glimepiride, necessitating dosage change; prolonged hypoglycemia (with nonselective agents)

Calcium channel blockers, corticosteroids, estrogens, hydantoins, hormonal contraceptives, isoniazid, nicotinic acid, phenothiazines, phenytoin, rifampin, sympathomimetics, thiazide diuretics, thyroid preparations: decreased hypoglycemic effect of glimepiride

Warfarin: initially increased, then decreased, effects of both drugs

Drug-diagnostic tests.Alanine aminotransferase, alkaline phosphatase, aspartate aminotransferase, bilirubin, blood urea nitrogen, cholesterol, liver function tests: increased values

Glucose, granulocytes, hemoglobin, platelets, white blood cells: decreased values

Drug-herbs.Agoral marshmallow, aloe (oral), bitter melon, burdock, chromium, coenzyme Q10, dandelion, eucalyptus, fenugreek: additive hypoglycemic effects

Glucosamine: impaired glycemic control

Drug-behaviors.Alcohol use: disulfiram-like reaction

Sun exposure: increased risk of photosensitivity

Patient monitoring

• Monitor CBC with white cell differential, electrolyte levels, and blood chemistry results.
• Monitor blood glucose level regularly. Assess glycosylated hemoglobin level every 3 to 6 months.
• Evaluate kidney and liver function test results frequently, especially in patients with impairments.
• Assess neurologic status. Report cognitive or sensory impairment.

Patient teaching

• Instruct patient to self-monitor his blood glucose level as prescribed.
• Teach patient how to recognize signs and symptoms of hypoglycemia and hyperglycemia.
• Stress importance of diet and exercise to help control diabetes.
• Instruct patient to wear or carry medical identification describing his condition.
• Advise patient to keep sugar source readily available at all times in case of hypoglycemia.
• Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration and alertness.
• Tell patient he will undergo regular blood testing during therapy.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, herbs, and behaviors mentioned above.

Amaryl

(ăm′ə-rĭl)
A trademark for the drug glimepiride.

Amaryl

An agent which may be used in combination with metformin (Glucophage) as 2nd-line therapy for type-2 diabetes when monotherapy with either Amaryl or metformin fail to achieve adequate blood glucose control.

Amaryl®

Glimepiride Endocrinology An agent which may be used in combination with metformin–Glucophage® as 2nd-line therapy for type 2 diabetes when monotherapy with either Amaryl or metformin fails to achieve adequate blood glucose control.

Amaryl

A brand name for GLIMEPIRIDE.
References in periodicals archive ?
In-depth analysis of Amaryl including efficacy, safety, pricing, competition and other details which influence its sales potential
worked closely with the FDA on a name change following dispensing errors in the US, between REMINYL and the Type 2 diabetes mellitus drug known as AMARYL.
The change, made in April, was prompted by confusion that had resulted between the older name and the diabetes drug, Amaryl, marketed by Sanofi-Aventis.
99) Glimepiride Amaryl N/A (c) Meglitinides Repaglinide Prandin N/A (c) Nateglinide Starlix N/A (c) Brand name cost mg/ Generic name Brand name day (cost) (a,b) Sulfonylureas Glyburide Diabeta 1.
Generic name Trade name Mechanism of action Repaglinide Prandin [up arrow] Insulin secretion Sulfonylureas Amaryl [up arrow] Insulin secretion Glucotrol XL Glynase [alpha]-Glucosidase Precose Delays digestion and absorption of complex inhibitors Glyset carbohydrates Metformin Glucophage Insulin sensitizes (liver > muscle) Thiazolidinedione Rezulin Insulin sensitizes (Troglitazone) (muscle > liver) Effects on glycemia Generic name FPG, (a) mg/L [HbA.
Find Your Diabetes Medicines(*) Sulfonylureas Amaryl DiaBeta Diabinese Dymelor Glucotrol Glucotrol XL Glynase PresTab Micronase Orinase Tolinase Biguanides Glucophage Alpha-glucosidase Inhibitors Glyset Precose Thiazolidinediones Rezulin Meglitinides: Prandin Insulins Lispro (Humalog) Regular Premixed Ultralente NPH or Lente
A combination pill containing Avandia (rosiglitazone, a thiazolidinedione), and Amaryl (glimepiride, a sulfonylurea), as an adjunct to diet and exercise to improve glycemic control in patients with type 2 diabetes already treated with a combination of Avandia and a sulfonylurea, or inadequately controlled on a sulfonylurea alone, or needing additional glycemic control after initially responding to Avandia.
Placebo: Amaryl 2 mg, Amitriptylin-TEVA, ASS 100, Bisoprolol 5, Captohexal 50/25, Delix 2.
Janssen Pharmaceutica has agreed to change the name of its Alzheimer's drug Reminyl in response to inadvertent dispensing of the oral blood glucose-lowering drug Amaryl in its place.
Full year 2011 sales of Amaryl [R] were euro 436 million, down 7.
The name change, made in April, was prompted by confusion between the older name of the drug, Reminyl, and the diabetes drug, Amaryl, marketed by Sanofi-Aventis.