Amaryl


Also found in: Dictionary.

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 ?
Name of Reading Comments the test F5 (new Amaryl glimepiride) Assay 100.5% 103% Conformed Friability 0.02% 0.40% Conformed Weight 1 0.1669 0.116 Conformed variation 2 0.168 0.116 3 0.1676 0.116 4 0.167 0.115 5 0.1687 0.115 6 0.1673 0.115 7 0.168 0.113 8 0.1688 0.115 9 0.1679 0.114 10 0.169 0.114 11 0.1672 0.113 12 0.169 0.115 13 0.1673 0.117 14 0.1684 0.117 15 0.169 0.115 16 0.1685 0.111 17 0.1669 0.111 18 0.1674 0.111 19 0.1678 0.115 20 0.1678 0.114 Average 0.167925 0.1141 Number Reading Number Reading Hardness 1 5.35 1 3.8 Not conformed 2 4.28 2 4.5 Conformed 3 4.06 3 4.3 Conformed 4 3.81 4 4.3 Conformed 5 5.3 5 3.5 Not conformed Disinte- 1.15 minutes 21 seconds Conformed gration time
Long-term treatment of type 2 diabetic patients with the new oral antidiabetic agent glimepiride (Amaryl): a double-blind comparison with glibenclamide.
O paciente fez uma dieta balanceada durante toda aplicacao do metodo, no dia da coleta do material 30 minutos (trinta) antes o paciente fez um alimentacao liquida de 200 ml a base de leite de soja, banana, maca, aveia e adocante stevia e fez uso da medicacao Amaryl glimepirida 2 mg.
To J.R., Caseville, Michigan: You write that generic versions of Amaryl (for diabetes) and Vasotec (for high blood pressure) often vary in color or shape, adding that you would prefer to use drugs made in America.
Treating diabetic patients with pioglitazone (Actos) helps prevent the progression of atherosclerosis, unlike the drug glimepiride (Amaryl), according to a randomized trial reported in the April 2 issue of the Journal of the American Medical Association.
Plus, in the latest JAMA study, Actos proved better than another diabetes drug, glimepiride (Amaryl), at slowing arterial clogging in 543 patients with both type 2 diabetes and heart disease.
Patients in the PERISCOPE (Pioglitazone Effect on Regression of Intravascular Sonographic Coronary Obstruction Prospective Evaluation) trial were randomized to 1-4 mg/day of glimepiride (Amaryl) or 15-45 mg/day of pigolitazone (Actos), titrated to the maximally tolerated dose by 16 weeks.
Drug mix-ups led to seven reported fatalities, including two deaths attributed to confusion over the Alzheimer's drug Reminyl (galantamine) and the antidiabetes drug Amaryl (glimepiride).
Another Maerdy Naser son, this time the December 2005 born Maerdy Amaryl CH21 made 4,300gns to HB Tudor, Llanilar, Aberystwyth.
According to an analysis of prescription claims released by Medco Health Solutions Inc., total generic dispensing rates for Allegra, Arava, Amaryl and Zithromax exceeded 87% within 30 days after the brand name counterparts became available.
Michael Gottschalk, M.D., head of endocrinology at the University of California, San Diego, presented data on a 26-week, randomized, single-blind study comparing the safety and efficacy of glimepiride (Sanofi-Aventis' Amaryl) with metformin in 263 children aged 9-17 years with type 2 diabetes who were inadequately controlled (hemoglobin [A.sub.1c] 7.1%-12.0%) on diet and exercise alone or failed oral monotherapy (Hb[A.sub.lc] greater than 7.5% for 3 or more months).