Tablets Amaryl: instructions for use. Instructions for use of tablets Amaryl Amaryl 4 mg instructions for use

Type 2 diabetes is a common condition in which blood sugar is too high. Modern medicines successfully fight the disease. One of them is Amaryl, the instructions for use of which are discussed in the article. Amaryl medicine is classified by experts as a group of hypoglycemic drugs that can reduce the glucose content in the blood lymph of people with type 2 diabetes mellitus.

Usually, Amaryl is prescribed by an endocrinologist as the main remedy for lowering the level of glucose in the blood lymph. Sometimes tablets for diabetes, according to indications, are prescribed in complex therapy, together with insulin and metmorphine.

At the heart of Amaryl, as stated in the instructions for use, is a substance that has an international non-proprietary name (INN) - glimepiride. He is responsible for the necessary production of insulin, so that he, in turn, begins to perform the main function - to lower sugar levels. This happens due to the release of insulin from pancreatic cells, which react to the action of glucose itself. More precisely, the production of insulin occurs due to its interaction with groups of potassium channel proteins (ATP channels) that are located on the surface of cells. Glimepiride is able to selectively bind to proteins and regulate the activity of ATP channels, they open and close in a controlled manner.

Glimepiride is able to have another important effect. It releases calcium from the blood, which enters the tissue cells and prevents the formation of atherosclerotic plaques on the walls of blood vessels.

If the maximum dose to the patient is insufficient, then metmorphine is connected to therapy. The latter inhibits the process of gluconeogenesis in the liver, reduces the absorption of glucose from the intestine. It also increases the utilization of glucose and the sensitivity of the tissues themselves. As prescribed by the doctor, insulin can be connected to therapy together with metformin or separately from it.

In the body, the active component is completely absorbed. Food has a slight effect on absorption, it can slow down its speed a little. Excretion of glimepiride, like most drugs of the latest generation, occurs through the intestines, as well as the kidneys. It was found that the substance does not remain unchanged in the urine. Studies do not determine the accumulation of glimepiride in the body.

Amaryl M is a combination of two active ingredients metformin and glimepiride, instructions for its use indicate all the necessary characteristics of the drug. In pharmacies, the drug is usually sold: 1 mg of glimepiride + 250 mg of metformin, 2 mg of glimepiride + 500 mg of metformin.

Release forms

The medicine is available in the form of oval tablets (1-4 mg). On one side of the tablet, the inscription HD125 is read. There are 15 pieces in one blister. The blisters themselves are packed in cardboard boxes. You can buy the drug in packs of two, four, six or eight blisters. Tablets are different in color: pinkish contain 1 mg; green 2 mg, Amaryl 3 mg - orange in color and Amaryl 4 mg - pale blue tablets.

As part of one tablet:

third generation glimepiride - the main component that lowers glucose, a substance released from sulfamide;
povidone - a chemical element, enterosorbent;
lactose with a water molecule (monohydrate);
cellulose microcrystalline;
sodium carboxymethyl starch - a food additive, a thickener that increases stickiness;
indigo carmine - food safe dye
magnesium stearate (stabilizing defoamer).

The drug Amaryl is convenient to use, the tablet only needs to be taken once in the morning. Instructions for use, as well as the price are quite affordable for every patient with this endocrine disease.

Contraindications

For all its effectiveness, Amaryl has a number of contraindications, taking pills, this must be taken into account.

Diabetes mellitus of the first type. Unlike type 2 diabetes, it is characterized by an absolute deficiency of insulin, which occurs due to the destruction of pancreatic cells.
Diabetic ketoacidosis is a complication of diabetes mellitus, usually type 1. Disturbances in carbohydrate metabolism due to an acute lack of insulin.
Diabetic coma or precoma occurs due to lack of insulin or eating disorders, abuse of fatty foods, carbohydrates and alcohol.
Significant metabolic disorder.
Severe diseases of the liver, as well as kidneys, with a violation of the functionality of these vital organs. In particular, conditions that lead to a violation of these functions are taken into account - infections, shock, etc.
Carrying out hemodialysis.
Ischemia, respiratory dysfunction, myocardial infarction, coronary heart disease. These conditions can lead to tissue hypoxia.
Lactic acidosis is a rare complication of diabetes that causes excess lactic acid in the body.
Injuries, burns, surgeries, septicemia (one of the types of blood poisoning).
Depletion of the body, intentional starvation - consumption of food and drinks containing less than 1000 calories per day.
Intestinal obstruction, intestinal paresis, diarrhea, vomiting.
Alcohol abuse, acute alcohol poisoning.
Lactase deficiency (an enzyme necessary for the production of lactose), intolerance to galactose (one of the sugars).
Expecting a baby, breastfeeding.
Age up to 18 years, due to insufficient research on this issue.
Individual intolerance to one or more components of Amaryl.

Immediately after the appointment of Amaryl, initial control over the effect of the drug and the general condition of the patient is required.

At first, without control, hypoglycemia may occur, which can cause serious health consequences.

However, patients may not be available for medical supervision. For example, some are unwilling or unable to contact a doctor. This is especially true for the elderly. Also here can be attributed patients who, for various reasons, do not follow their diet, alcoholics. People who perform monotonous heavy physical work.

Under the supervision of a physician, Amaryl should be taken in patients with impaired thyroid function, as well as adrenal glands, with other common endocrine disorders. In this case, strict control of blood glucose levels and diagnosing signs of hypoglycemia are necessary, some dose adjustment may be required.

Particular attention should be paid to taking Amaryl in a situation where patients are simultaneously taking other drugs. The doctor must understand their compatibility and tell patients the rules of admission.

Dosage

The medicine for diabetes Amaryl is prescribed exclusively by a specialist - an endocrinologist. He makes appointments only after determining the level of glucose in the patient's blood. Endocrinologists take into account the same way a person lives - his diet, physical activity, age, side diseases and many other factors.

The minimum dose is 1 mg. One tablet should be taken once a day in the morning before or during the first breakfast. It is not recommended to chew the tablets, however, it should be washed down with water (at least half a glass). If necessary, the doctor may prescribe a large dose - from 2 to 3 mg; 4 mg is considered the standard high dose, 6 and 8 mg are prescribed in extremely rare cases. Do not abruptly increase the dose, the interval between new appointments should be at least seven days. While taking the drug for diabetes Amaryl and especially dose adjustments, it is necessary to take control tests.

Adjustment is usually required for changes in the patient's lifestyle. For example, drinking alcohol, breaking a diet, sudden weight gain or loss. These include disorders of carbohydrate metabolism, overdose, complications in the functioning of the kidneys and liver.

When Amaryl M is prescribed, the same principle is used to determine the dosage. Usually this drug is also taken once a day. Special attention is paid to the selection of doses for patients over 65 years of age. The medicine is prescribed, having carefully studied the side diseases of the elderly, especially the work of the liver and kidneys.

The dose of Amaryl should not be increased at a subsequent dose if the patient has not taken the daily tablet due to forgetfulness. This day is left without taking the medicine, and the next day you need to take the standard dose.

After taking the pills, the patient must definitely eat, otherwise, the sugar level will drop below normal. The following meals should also not be skipped, otherwise the opposite effect of therapy may be observed. Preparations of this type are indicated for taking a long period of time. If the diabetes medicine does not have the desired effect, a combined Amaryl M is prescribed, or other hypoglycemic drugs are administered - metformin and insulin.

Side effects

Recent clinical studies of glimepiride, the main active ingredient in Amaryl, have identified side effects. They can manifest themselves in the metabolism, digestion, vision, cardiovascular and immune systems. In addition, photosensitization (increase in the body's susceptibility to ultraviolet rays), hyponatremia (a decrease in the amount of sodium ions in the blood) are possible.

Hypoglycemia can manifest itself for a long time, with metabolic disorders, its symptoms are:

migraines, dizziness, loss of consciousness, sometimes to the development of coma;
constant desire to eat;
urge for nausea and vomiting;
weakness, insomnia, or a constant desire to sleep;
sudden manifestation of aggression;
decrease in attentiveness, slowing down of the main reactions;
delirium (mental disorder with impaired consciousness);
depression;
confusion of consciousness;
speech disorders (aphasia)
blurred vision;
tremor, convulsions;
violation of the sensitivity of organs;
loss of control over oneself;
difficulty breathing;
severe sweating, stickiness of the skin;
anxiety attacks;
increase in heart rate;
increase in blood pressure;
heart rhythm disturbances, sinus rhythm disturbances.

Vision. Significant deterioration in vision, usually at the beginning of taking Amaryl. This happens due to a violation of the swelling of the lenses, this process directly depends on the amount of glucose in the blood. The refractive index of the lenses is impaired, vision becomes worse.

Digestion. The patient may feel sick, vomiting, a feeling of fullness in the stomach, acute pain in the stomach, bloating, diarrhea. There may be an aversion to food.

Liver, bile ducts. Perhaps the development of hepatitis, cholestasis and jaundice, they can significantly worsen the patient's health and even threaten life, due to the progression of liver failure. However, after the abolition of Amaryl, a rapid recovery of liver function may occur.

The immune system. Allergic manifestations (urticaria, rash) are observed. These reactions are usually well tolerated, however, in some cases, there is severe shortness of breath. Pressure decreases, anaphylaxis is possible (acute reaction to an allergen). Allergic vasculitis (immune pathological inflammation of blood vessels) was detected.

Price

The price of the medicine is low, but may differ in pharmacies of different companies. For example, prices on some large online pharmacy resources where you can buy Amaryl are shown in the table.

Analogues

The drug is used to treat type 2 diabetes. However, it may not be suitable for the patient due to his side diseases or other reasons. Analogues of Amaryl are also based on the active substance glimepiride. They can differ in the number of tablets in a pack, the place of production, excipients and their individual intolerance by patients. To analogs of Amaryl, experts include the following drugs.

Glemaz. The active substance is similar - glimepiride. The drug is available in tablets, it is prescribed when planning long-term treatment, under medical supervision. Unlike Amaryl, only 4 mg tablets are available. The average price is 650 rubles.
Glemauno. The action of the medicine is similar to that of Amaryl. It has a not-so-long list of caveats on admission. However, instructions are given not to engage in activities requiring attention during the appointment. The drug is released only by prescription. The average price of 2 mg is 476 rubles.
Glimepiride. A remedy similar to Amaril is able to lower the level of sugar in the patient's blood lymph. Usually, tablets are also taken once a day before a dense carbohydrate breakfast, washed down with water in sufficient quantities. In case of insufficient effectiveness, additional insulin is administered. Reviews about it are positive, at a cost the medicine is cheaper than similar drugs. The average price is 2 mg 139 rubles.

Overdose

An overdose is dangerous due to the occurrence of hypoglycemia - the concentration of glucose in the blood is critically reduced, hypoglycemic coma is possible. This condition can last from one day to three days. If symptoms of an overdose occur, the patient is offered foods rich in carbohydrates. You can eat a sugar cube, drink juice or sweet tea. If the patient has lost consciousness, then dextrose and glucagon are administered parenterally, bypassing the gastrointestinal tract.

If the patient's condition worsens after an overdose, an ambulance is called and, if necessary, hospitalization is carried out.

One of the most common antidiabetic drugs from the sulfonylurea group is Amaryl.

Thanks to the active and additional components, the drug helps to lower the concentration of glucose and effectively reduces the severity of symptoms of diabetes.

The antidiabetic drug Amaryl is accepted for oral use. The generally accepted international name of the drug is Amaryl. The drug is produced in Germany, the manufacturer is Aventis Pharma Deutschland GmbH.

On this page you will find all the information about Amaryl: full instructions for use for this drug, average prices in pharmacies, complete and incomplete analogues of the drug, as well as reviews of people who have already used Amaryl. Want to leave your opinion? Please write in the comments.

Clinical and pharmacological group

Oral hypoglycemic drug.

Terms of dispensing from pharmacies

Released by prescription.

Prices

How much is Amaryl worth? The average price in pharmacies depends on the form of release:

Amaryl tablets 1 mg, 30 pcs. - from 262 rubles.
Amaryl tablets 2 mg, 30 pcs. - from 498 rubles.
Amaryl tablets 3 mg, 30 pcs. - from 770 rubles.
Amaryl tablets 4 mg, 30 pcs. - from 1026 rubles.

Release form and composition

Amaryl is available in tablet form in several dosages: 1, 2, 3 and 4 mg. Its properties are due to the active substance - glimepiride, a sulfonylurea derivative. Lactose monohydrate, povidone, magnesium stearate, microcrystalline cellulose and dyes E172 or E132 are used as excipients.

Regardless of the dosage, all tablets have a separating risk and engraving. As a distinguishing feature - the color of the tablet itself: 1 mg is pink, 2 mg is green, 3 mg is pale yellow and 4 mg is blue.

pharmachologic effect

Glimepiride - the active substance of the drug - has a positive effect on the pancreas, helps regulate the production of insulin and its entry into the blood. In turn, insulin lowers the amount of sugar in the blood.

Due to the action of glimepiride, calcium from the blood enters the tissue cells and helps prevent the formation of atherosclerotic plaques on the walls of blood vessels.

Metformin also helps to reduce blood glucose, but in a different way: it improves hepatic circulation and converts blood sugar into glycogen, a substance that is safe for patients with diabetes. In addition, metmorphine promotes better absorption of glucose by muscle cells.

Glimepiride has been found to be more effective in combination with metformin. For this reason, Amaryl M was created - a drug that is convenient for both patients and doctors.

Indications for use

According to the instructions, Amaryl is prescribed for type 2 diabetes mellitus (non-insulin dependent diabetes).

The active substance glimepiride stimulates the production of insulin by the pancreas and its entry into the blood. Insulin, in turn, reduces the amount of sugar in the blood. Glimepiride improves potassium metabolism in cells, and also helps to prevent the formation of atherosclerotic plaques on the walls of blood vessels.

Contraindications

According to the instructions, Amaryl is contraindicated in the following cases:

Rare hereditary diseases (lactase deficiency, galactose intolerance, glucose-galactose malabsorption);
Hypersensitivity to the active or auxiliary components of the drug;
Type 1 diabetes;
Severe liver dysfunction;
Diabetic precoma and coma, diabetic ketoacidosis;
Pregnancy and breastfeeding;
Severe liver dysfunction (including patients on hemodialysis);
Childhood.

In the application of Amaryl, care should be taken when:

Violation of the absorption of food and drugs from the gastrointestinal tract (intestinal paresis, intestinal obstruction);
The presence of risk factors for the development of hypoglycemia;
Intercurrent diseases during therapy or when changing the patient's lifestyle (change in diet or meal times, decrease or increase in physical activity);
Deficiency of glucose-6-phosphate dehydrogenase.

Use during pregnancy and lactation

Amaryl is contraindicated for use during pregnancy. In the event of a planned pregnancy or when pregnancy occurs, the woman should be transferred to insulin therapy.

Glimepiride has been found to be excreted in breast milk. During lactation, a woman should be transferred to insulin or breastfeeding should be stopped.

Instructions for use Amaryl

The instructions for use indicate that Amaryl tablets are taken orally, they are not chewed, they are washed down with water about 150 ml. It is important not to forget to eat after taking the drug. The starting and maintenance dosage is set by the doctor individually, depending on the level of glucose in the blood serum and its excretion in the urine.

First, the drug is used at 1 mg / day, if necessary, you can gradually increase the daily dose to 6 mg. The dose is increased at intervals of 1-2 weeks according to the scheme: 1 mg / day - 2 mg / day - 3 mg / day - 4 mg / day - 6 mg / day Amaryl. It is recommended not to exceed doses of Amaryl more than 6 mg/day. The frequency and time of use of the drug is determined individually by the doctor, which depends on the lifestyle of the patient. As a rule, the daily dose of amaryl is prescribed 1 time per day during or before a heavy first meal (breakfast). If the morning dose has not been taken, then during or before the second meal. The therapy is long.

Use of amaryl-metformin combination. For those patients who are taking metformin, and they have insufficient reduction in serum glucose, you can start additional intake of amaryl. If the daily dosage of metformin does not change, then therapy with amaryl begins with a dose of 1 mg / day. Subsequently, the dose of Amaryl may be increased to achieve the desired reduction in serum glucose levels up to a maximum of 6 mg/day.

Use of amaryl-insulin combination. To stabilize the glucose content in the blood serum in cases where monotherapy or the use of a combination of amaryl-metformin is ineffective, a combination of insulin with amaryl is used. At the same time, the dose of amaryl is left unchanged, and insulin therapy is started with small doses. In the future, it is possible to increase the amount of insulin administered. Therapy should be accompanied by monitoring of the concentration of glucose in the blood serum. Treatment is carried out under the supervision of the attending physician. The insulin-amaryl regimen can reduce the need for injectable insulin by about 40%.

Changing another antidiabetic agent to Amaryl. Starting treatment begins with 1 mg/day of Amaryl, regardless of the dose of the previous drug (even if it was the maximum). Depending on the therapeutic effect of amaryl, the dose can be increased according to the above rules. In some cases, it is necessary to cancel amaryl due to possible hypoglycemia (especially if a drug with a high half-life, chlorpropramide, was used before amaryl). Therapy is stopped for several days (due to the likely additive effect).

Replacement of insulin with amaryl. In cases where patients with type 2 diabetes are treated with insulin, but their insulin-secreting function of pancreatic beta cells remains intact, the patient can be transferred to Amaryl with the exception of insulin. In this case, therapy with amaryl begins with a dose of 1 mg / day.

Side effects

The use of Amaryl can provoke the following adverse reactions:

Digestive system: rarely - abdominal pain, nausea, diarrhea, vomiting, feeling of fullness and heaviness in the epigastrium; in some cases - an increase in the activity of cholestasis and / or liver enzymes, hepatitis, jaundice, life-threatening liver failure.
Organ of vision: at the beginning of therapy, transient visual disturbances are possible, provoked by a change in the level of glucose in the blood.
Hematopoietic system: in some cases - granulocytopenia, leukopenia, pancytopenia, hemolytic anemia, agranulocytosis and erythrocytopenia; rarely - thrombocytopenia. Cases of severe thrombocytopenia and thrombocytopenic purpura have been reported with post-marketing use of Amaryl.
Allergic manifestations: rarely - pseudo-allergic and allergic reactions (urticaria, skin rashes and itching). Such reactions are usually mild, but can turn into severe reactions with a sharp decrease in blood pressure, shortness of breath, anaphylactic shock, allergic vasculitis (in rare cases).
Metabolism: As with other sulfonylurea derivatives, prolonged hypoglycemia is possible. Signs of this disorder are nausea, headache, vomiting, hunger and fatigue, impaired concentration, drowsiness, paresis, sleep disturbances, loss of self-control, anxiety, bradycardia, aggressiveness, sensory disturbances, loss of vigilance and reaction speed, visual disturbances, depression , delirium, confusion, speech disorders, aphasia, tremor, dizziness, cerebral convulsions, shallow breathing, loss of consciousness up to coma. In addition, there may be signs of adrenergic counterregulation in response to hypoglycemia (anxiety, the appearance of clammy cold sweat, angina pectoris, tachycardia, cardiac arrhythmias, palpitations and arterial hypertension). The clinical picture of severe hypoglycemia resembles a stroke.
Other: in some cases - photosensitivity, hyponatremia.

Overdose symptoms: severe, life-threatening hypoglycemia (during long-term treatment with high doses of glimepiride and acute overdose of the drug).

Overdose

In case of an overdose of Amaryl, nausea, abdominal pain, and vomiting may occur. Hypoglycemia may occur, in which tremor, anxiety, visual disturbances, drowsiness, impaired coordination, convulsions, coma can develop.

In case of an overdose, gastric lavage is indicated, after which the use of enterosorbents. Glucose administration should be started as soon as possible. Further therapy is symptomatic. In case of severe overdose, hospitalization in the intensive care unit is required.

special instructions

The doctor, prescribing Amaryl or Amaryl M to the patient, should warn about the possibility of developing side effects, and most importantly, about the occurrence of hypoglycemia if the patient takes the medicine but forgets to eat. In this case, the patient is advised to always carry sweets or sugar in pieces with him in order to be able to quickly raise the level of sugar in the blood.

In addition to systematically checking blood and urine glucose levels, blood composition and liver function are also regularly monitored during treatment with Amaryl and Amaryl M.

In stressful circumstances, accompanied by the release of adrenaline into the blood, the effectiveness of Amaryl and Amaryl M decreases. Such situations can be accidents, conflicts in the family or at work, diseases with a high rise in temperature. In such cases, a temporary transfer of the patient to insulin is practiced.

drug interaction

Enhances the hypoglycemic effect of the simultaneous use of Amaryl with insulin, other hypoglycemic drugs, some antibiotics (tetracyclines, sulfonamides, clarithromycin), high doses of pentoxifylline, fluoxetine, fluconazole, anabolic steroids, ACE inhibitors (captopril, enalapril, ramipril, perindopril, lisinopril, etc.) . The reverse effect will have a combination of amaryl with barbiturates, laxatives, diuretics, high doses of nicotinic acid, rifampicin.

Strengthening and decreasing the hypoglycemic effect of amaryl can cause beta-blockers (carvedilol, atenolol, bisoprolol, metoprolol, etc.), reserpine, clonidine, coumarin derivatives and alcohol.

Amaryl is considered popular among diabetics. Its reception allows patients to control their condition, to minimize the likelihood of developing hyperglycemia. This medication is prescribed only for people with type II diabetes.

Composition

The active ingredient in Amaryl is glimepiride. The composition of the tablets also includes auxiliary components. Their list will depend on the dosage of glimepiride. A different combination of additional substances in tablets is due to a different color.

INN (international name): glimepiride (Latin name Glimepiride).

Pharmacies also sell Amaryl M1, M2. The composition of the tablets, in addition to glimepiride, includes metformin in an amount of 250 or 500 mg, respectively. This combined drug can only be prescribed by an endocrinologist.

Release form

Amaryl goes on sale in the form of tablets. The color depends on the dosage of the active substance:

1 mg glimepiride - pink;
2 - green;
3 - light yellow;
4 - blue.

They differ in the labeling on the tablets.

pharmachologic effect

Glimepiride has a hypoglycemic effect on the body. It is a third generation sulfonylurea derivative.

Amaryl has a primary prolonged effect. When using tablets, the pancreas is stimulated, the work of beta cells is activated. As a result, insulin begins to be released from them, the hormone enters the bloodstream. This helps to lower the concentration of sugar after eating.

At the same time, glimepiride has an extrapancreatic effect. It increases the sensitivity of muscle, adipose tissue to insulin. When using the drug, a general antioxidant, antiatherogenic, antiplatelet effect is observed.

Amaryl differs from other sulfonylurea derivatives in that when it is used, the content of released insulin is less than when using other hypoglycemic drugs. Due to this, the risk of hypoglycemia is minimal.

Strengthening the process of glucose utilization in muscle, fatty tissues becomes possible due to the presence of special transport proteins in cell membranes. Amaryl increases their activity.

The drug practically does not block ATP-sensitive potassium channels of cardiac myocytes. They retain the ability to adapt to ischemic conditions.

When treated with Amaryl, the production of glucose by liver cells is blocked. This effect is due to the increasing content of fructose-2,6-biophosphate in hepatocytes. This substance stops gluconeogenesis.

The drug contributes to blocking the secretion of cyclooxygenase, reducing the process of transformation of thromboxane A2 from arachidonic acid. This reduces the intensity of platelet aggregation. Under the influence of Amaryl, the severity of oxidative reactions that are observed in non-insulin-dependent diabetes decreases.

Indications

Prescribe drugs based on glimepiride to patients with type II disease, if physical activity, diet do not allow control of sugar levels.

The instructions for use indicate that it is allowed to combine Amaryl with metformin, insulin injections.

Dr. Bernstein insists that the prescription of hypoglycemic agents is not justified, even if there are indications for use. He argues that the drugs are harmful, increasing the metabolic disorders that have arisen. To normalize the condition, you can use not sulfonylurea derivatives, but a diet in combination with a special treatment regimen.

Contraindications

Amaryl should not be prescribed to patients who:

insulin dependence;
ketoacidosis, diabetic coma;
impaired kidney function (including in cases where hemodialysis is necessary);
malfunctions in the functioning of the liver;
individual intolerance or hypersensitivity to glimepiride, excipients, other drugs of the sulfonylurea group;
childhood.

Physicians should not prescribe the drug to patients who are malnourished, eat irregularly, limit the caloric content of the diet, consuming less than 1000 kcal. A contraindication is a violation of the process of absorption of food from the gastrointestinal tract.

Side effects

Before you start taking Amaryl, you should read the annotation to the drug. Patients should be aware of what complications may occur.

The most well-known side effect is metabolic disorders. The patient may begin to develop hypoglycemia shortly after taking the pill. At home, this condition is difficult to normalize, you will need the help of doctors. But a sudden drop in blood glucose is rare, occurring in less than 1 in 1,000 patients.

When taking Amaryl, there are also such complications from:

Gastrointestinal tract: diarrhea, feeling of hunger, epigastric pain, jaundice, nausea, hepatitis, development of liver failure;
hematopoietic organs: thrombocytopenia, agranulocytosis, erythrocytopenia, leukopenia;
nervous system: increased drowsiness, fatigue, headaches, increased anxiety, aggressiveness, speech disorders, confusion, paresis, cerebral convulsions, the appearance of sticky cold sweat;
organs of vision: transient disorders due to changes in blood sugar levels.

Some develop hypersensitivity reactions. Patients complain of itching, skin rash, urticaria, allergic vasculitis. Usually, such side effects are mild, in individual cases, the possibility of anaphylactic shock cannot be ruled out.

Instructions for use

It is allowed to take Amaryl according to the prescription of the attending physician. The specialist will select the initial dosage for each patient personally. It depends on the concentration of glucose in the blood, the intensity of the excretion of sugar in the urine.

At the beginning of therapy, it is recommended to drink tablets containing 1 mg of glimepiride. It is necessary to increase the dose gradually. They switch to 2 mg tablets no earlier than 1-2 weeks after the start of therapy. At the initial stages, the doctor monitors the patient's condition, adjusts the treatment depending on the reaction to the drug. The maximum allowable daily dose is 6-8 mg of glimepiride.

If the desired therapeutic effect cannot be achieved even when taking the maximum allowable amount of Amaryl, then insulin is additionally prescribed.

It is necessary to take tablets before the main meal 1 time per day. Doctors recommend drinking the drug before breakfast. If necessary, it is allowed to shift the reception time for lunch.

It is strictly forbidden to refuse food after drinking Amaryl. After all, this will provoke a sharp drop in the concentration of glucose. Hypoglycemia can lead to neurological disorders, cause diabetic coma, and death.

Tablets are swallowed whole without chewing.

Overdose

It is necessary to use Amaryl in the quantities prescribed by the doctor. An overdose causes the development of hypoglycemia. A sharp drop in sugar sometimes provokes a diabetic coma.

If the allowable rate of use is exceeded, nausea, vomiting, epigastric pain appear. Various side effects may occur:

visual impairment;
drowsiness;
tremor;
convulsions;
coma;
problems with coordination.

In case of overdose, it is necessary to wash the stomach. After cleaning give enterosorbents. At the same time, a glucose solution is administered intravenously. Further tactics of action are developed depending on the patient's condition. In severe cases, the patient is hospitalized in the intensive care unit.

Interaction

Before prescribing Amaryl, the doctor must find out what drugs the patient is taking. Some drugs enhance, others reduce the hypoglycemic effect of glimepiride.

When conducting research, it was found that a sharp decrease in blood sugar is observed when using:

oral antidiabetic agents;
Phenylbutazone;
oxyphenbutazone;
Azapropazon;
Sulfinpyrazone;
Metformin;
Tetracycline;
miconazole;
salicylates;
MAO inhibitors;
sex male hormones;
anabolic steroids;
quinol antibiotics;
Clarithromycin;
Fluconazole;
sympatholytics;
fibrates.

Therefore, it is not recommended to start drinking Amaryl on your own without obtaining an appropriate prescription from a doctor.

Weaken the effectiveness of glimepiride such means:

progestogens;
estrogens;
thiazide diuretics;
saluretics;
glucocorticoids;
nicotinic acid (when used in high doses);
laxative medicines (subject to long-term use);
barbiturates;
Rifampicin;
Glucagon.

This effect must be taken into account when choosing a dosage.

Sympatholytics (beta-blockers, Reserpine, Clonidine, Guanethidine) have an unpredictable effect on the hypoglycemic effect of Amaryl.

When using coumarin derivatives, please note: glimepiride enhances or weakens the effect of these drugs on the body.

The doctor selects drugs for the patient for hypertension, non-steroidal anti-inflammatory drugs, and other popular drugs.

Combine Amaryl with insulin, metformin. This combination is required when glimepiride fails to achieve the desired metabolic control. The dosage of each drug is set by the doctor individually.

metformin;
sitagliptin;
glimepiride.

This combination of active ingredients improves the effectiveness of therapy, helps to better control the condition of diabetics.

Terms of sale

In pharmacies, you can buy Amaryl if you have a prescription from your doctor.

Storage Features

Tablets based on glimepiride should be stored in a dark place, protected from direct sunlight, out of the reach of children. Storage temperature - up to +30 ° C.

Best before date

Use of the drug is allowed for 36 months from the date of issue.

Analogues

The attending endocrinologist should select a suitable substitute for Amaryl. He can prescribe an analogue made on the basis of the same active substance, or pick up a medicine made from other components.

Patients can be prescribed the Russian substitute Diameride, which is relatively cheap. For 30 tablets of a preparation made on the basis of glimepiride, with a dosage of 1 mg in a pharmacy, patients will pay 179 rubles. As the concentration of the active substance increases, the cost increases. For Diameride at a dosage of 4 mg, it will be necessary to pay 383 rubles.

If necessary, replace Amaryl with Glimepiride, which is produced by the Russian company Vertex. These tablets are inexpensive. For a pack of 30 pcs. 2 mg each will have to pay 191 rubles.

The cost of Glimepiride Canon, which is produced by Canonpharma, is even lower. The price of a package of 30 tablets of 2 mg is considered cheap, it is 154 rubles.

In case of intolerance to glimepiride, patients are prescribed other analogues produced on the basis of metformin (Avandamet, Glimecomb, Metglib) or vildagliptin (Galvus). They are selected taking into account the individual characteristics of the patient's body.

Alcohol and Amaryl

It is impossible to predict in advance how alcohol-containing drinks will affect a person who takes drugs based on glimepiride. Alcohol is able to weaken or enhance the hypoglycemic effect of Amaryl. Therefore, they cannot be used at the same time.

Hypoglycemic medication has to be taken over a long period. Because of this, a categorical ban on the use of alcoholic beverages becomes a problem for many.

Pregnancy, lactation

During the period of intrauterine gestation of a baby, breastfeeding a newborn, it is impossible to use sulfonylurea derivatives. In the blood of a pregnant woman, the concentration of glucose should be within the normal range. After all, hyperglycemia leads to an increase in the risk of congenital malformations, increases infant mortality rates.

Pregnant women are transferred to insulin. It will be possible to exclude the possibility of a toxic effect of the drug on the child in utero if you refuse sulfonylurea drugs at the stage of conception planning.

During lactation, Amaryl therapy is prohibited. The active substance passes into breast milk, the body of the newborn. When breastfeeding, it is necessary that the woman completely switches to insulin therapy.

Amaryl Tablets for Type 2 Diabetes: Find out everything you need to know. The instructions for use are written in plain language below. Study the indications, contraindications, dosages, side effects, the ratio of benefits and harms to the body. Understand how to take Amaryl correctly, after how many hours the drug begins to act, whether it is compatible with alcohol. In the article, this remedy is compared with Diabeton, Glucophage and Janumet tablets. Inexpensive analogues of domestic production are also listed. The drug Amaryl is not cheap in pharmacies, but it is convenient, because it is enough to drink it once a day. The active substance is glimepiride.

The cure for type 2 diabetes Amaryl: a detailed article

Instructions for use

pharmachologic effect

Glimepiride causes the pancreas to produce more insulin and release it into the blood. Thanks to this, sugar is reduced, especially after eating. In the liver, the active substance is oxidized with the participation of cytochrome P450 IIC9. Problems may arise when taking other drugs that compete for the same enzyme, such as rifampicin or fluconazole, at the same time. It is excreted 60% by the liver and 40% by the kidneys.

Indications for use

Type 2 diabetes - Patients in whom diet and physical activity do not sufficiently help maintain normal blood sugar levels. Official medicine says that glimepiride can be used in combination with metformin and insulin injections. argues that this drug is harmful, and its use should be abandoned. Read more why Amaryl is harmful and what to replace it with.

Taking Amaryl, like any other diabetes pills, you need to follow a diet.

How to take Amaryl: before meals or after?

Amaryl is taken before meals so that it has time to start working by the time the food eaten is digested. As a rule, the doctor instructs the diabetic to take this medicine before breakfast. And if the patient usually does not eat breakfast, then take a pill before dinner. Analogues containing the active substance glimepiride should be taken in the same way.

Do not try to skip a meal after taking Amaril. You must definitely eat, otherwise the medicine will lower blood sugar too much and will. This is an acute complication that can cause symptoms of varying severity. From nervousness and palpitations to coma and death. The risk of hypoglycemia is one of the reasons why glimepiride is not recommended. You have a safe and effective one at your disposal.

Is this medicine compatible with alcohol?

Instructions for the use of Amaryl tablets require diabetics to completely abstain from alcohol during the entire period of treatment with this drug. Because drinking alcohol increases the risk of hypoglycemia and liver problems. The incompatibility of the drug glimepiride with alcohol is a serious problem. Because it is a drug for long-term, life-long use, and not for short-term course treatment.

At the same time, patients with type 2 diabetes, who do not take harmful pills and are treated according to, are not prohibited from drinking alcohol in moderation. Read the details in the article "". You can keep perfectly normal sugar and allow yourself to occasionally drink a glass or two without harm to health.

How long after taking it does it start working?

Unfortunately, there is no exact data on how long after taking Amaryl begins to act. Blood sugar drops as much as possible after 2-3 hours. Most likely, the effect of the drug begins much earlier, after 30-60 minutes. So do not delay eating, so that hypoglycemia does not happen. The effect of each dose of glimepiride taken lasts more than a day.

Read about products for diabetics:

Which is better: Amaryl or Diabeton?

Both of these drugs are included in. It is better to refrain from taking them.

Try to familiarize the doctor who prescribed Amaryl or Diabeton to you with the materials on this page. The original drug Diabeton catastrophically increased mortality among patients who took it. Therefore, it was quietly removed from sale. Now you can only buy pills. They act more gently, but are still harmful.

What is better to drink: Amaryl or Glucophage?

Amaryl is a harmful medicine.. - another matter. It is the original drug Metformin, an important part of the step-by-step treatment regimen for type 2 diabetes. - the medicine is not harmful, but rather very useful. For good control of diabetes, you must first switch to. A healthy diet is supplemented by taking Glucophage medication, and if necessary, also with insulin injections in low doses.

Can Janumet and Amaryl be taken at the same time?

Amaryl and other tablets containing glimepiride should not be taken for the reasons listed above. Janumet is a combination medicine containing metformin. At the time of writing, it is very expensive and has no cheap analogues. In principle, it can be accepted. But you can try switching from it to pure metformin, best of all. If you can do this without compromising your diabetes control, you'll be saving a lot of money each month.

Analogues of the drug Amaryl

At the time of preparation of the article, only Glimepiride-Teva manufactured by Pliva Hrvatska, Croatia was sold in pharmacies from imported analogues. At the same time, Amaryl has many Russian substitutes, which are much cheaper than the original drug.

Russian analogues of the drug Amaryl

Each manufacturer produces all dosage options for glimepiride - 1, 2, 3 and 4 mg. Check the availability of drugs and prices in pharmacies.

The original drug Amaryl or cheap analogues: what to choose

Read Why Amaryl and its analogues are harmful why you need to stop taking them and what is better to replace them with. The site site teaches you to reach the norm and keep it stably normal without starvation, taking harmful and expensive drugs, injections of large doses of insulin.

Amaryl M: combination medicine

Amaryl M is a combination drug for type 2 diabetes. It contains two active ingredients in one tablet - glimepiride and. As you read above, glimepiride is harmful and should not be taken. But metformin is not at all harmful, but rather very useful for diabetics. This remedy lowers blood sugar, protects against the complications of diabetes, helps to lose weight and prolongs life.

What are the analogues of Amaryl M tablets?

Amaryl M is a combined tablet containing two active ingredients: glimepiride and metformin. All drugs containing glimepiride are harmful. They can reduce blood glucose levels for several years, and then the disease progresses to severe type 1 diabetes. In diabetics who are treated with these pills, the risk of death from heart attack and stroke is not reduced, but rather even increased.

Instead of looking for analogues of the drug Amaryl M, switch to pure metformin. Best of all is the original imported drug Glucophage. It has a known good quality, and at the same time it has an affordable price. Also use . You will be able to keep your sugar levels stable, as in healthy people, without a “hungry” diet and heavy physical exertion.

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Comments:

To Amaryl, the instructions for use contain information about a new representative of drugs for the treatment of type II diabetes mellitus. The most effective antidiabetic drug in recent years has been Glibenclamide-HB-419. It belongs to the group of sulfonylurea. The drug was successfully used by more than 2/3 of all patients with type II diabetes mellitus. Amaryl is the result of work to improve the Glibenclamide formula. It was created taking into account the increased requirements for the treatment of the disease.

Description of the drug

Amaryl is a hypoglycemic agent. Hypoglycemic drugs lower the concentration of sugar in the blood. The active ingredient in Amaryl is glimepiride. Like Glibenclamide, the medication belongs to the sulfonylurea group. Sulfonylureas increase the production and secretion of the hormone insulin from the beta cells of the islets of Langerhans (a section of the pancreas).

The necessary action is achieved by blocking ATP - a sensitive potassium channel. After the connection of sulfonylurea with receptors that are on the membranes of beta cells, the activity of K-ATPase changes. Closing of potassium channels and an increase in the ratio of ATP/ADP levels in the cytoplasm leads to membrane depolarization. As a result, calcium channels open and the level of cytosolic calcium increases. The stimulation of calcium-dependent exocytosis (the process of excretion of a substance into the intercellular space by the cell) of secretory granules results in the release of their contents (the hormone insulin) into the intercellular fluid and blood.

Glimepiride belongs to the III generation of sulfonylureas. It quickly enhances insulin secretion, and also makes muscle and adipose tissue more sensitive to the hormone.
The acceleration of glucose processing by peripheral tissues occurs due to transport proteins that are located in cell membranes.
In non-insulin dependent disease, the movement of glucose into these tissues slows down.
Glimepiride causes an increase in the number of transport proteins and enhances their activity.
The extrapancreatic effect causes a decrease in insulin resistance (resistance of tissue cells to insulin).

Amaryl inhibits the production of glucose in the liver by increasing the concentration of fructose - 2,6-bisphosphate. It has antiplatelet (inhibits the process of blood clotting), antiatherogenic (lowers the level of "bad" cholesterol) and antioxidant action. A decrease in the severity of the oxidative process occurs due to an increase in the concentration of endogenous alpha-tocopherol and the intense activity of antioxidant enzymes.

Glimepiride greatly reduces the concentration of sugar in the blood. In this case, small doses of a hypoglycemic substance are used.

Absorption, metabolism and excretion of the drug

Glimepiride is completely processed by liver enzymes. Therefore, even after prolonged treatment, the drug does not accumulate in the body. In the process of metabolism, 2 metabolites are formed: a hydroxymetabolite and a carboxymetabolite (hydroxylated and carboxylated derivative of glimepiride). Hydroxymetabolite has some pharmacological action, providing a long-term and persistent therapeutic effect.

The maximum concentration of the active substance occurs in the patient's blood serum after 2.5 hours. The drug has absolute bioavailability (100%). The absorption of the active substance does not depend on the type of products that a person consumes after taking the medicine.

Glimepiride is excreted slowly, its clearance (the rate of purification of biological fluids and tissues of the body) is 48 ml / min. The elimination half-life ranges from 5-8 hours.

Stable improvement appears even with violations of the liver. In elderly people over 65 years of age and in patients with liver diseases, the required concentration of the active substance is achieved.

Release form and application of Amaryl

The drug is made in the form of oval-shaped tablets. The dividing strip allows, if necessary, to easily separate them into 2 parts.

Tablets may have a different color. Pink coating on glimepiride 1 mg tablets. Amaryl 2 tablets contain 2 mg of the active ingredient. They are colored green.

By a light yellow tint, you can recognize the drug Amaryl 4. Its tablets contain 4 mg of glimepiride. Different coloring of dosage forms minimizes the risk of exceeding the dose prescribed by the doctor.

Tablets are sealed in blisters of 15 pieces. The blisters are packed in a cardboard box. One package contains 2 or 6 blisters.

Interaction with other medicines

Patients with diabetes are often diagnosed with other diseases. Patients suffer from high blood pressure, cardiovascular disease, metabolic disorders, kidney and liver failure. Having a "bouquet" of diseases, they have to take several different drugs at the same time.

To prevent the development of cardiovascular diseases, patients are prescribed drugs containing aspirin. Although acetylsalicylic acid is able to displace glimepiride from protein compounds, its concentration in blood serum does not decrease. The effect of taking the drug is not reduced, and sometimes even enhanced.

The action of Amaryl can be enhanced while taking Allopurinol, Insulin, anabolic steroids, coumarin derivatives, Guanethidine, Chloramphenicol, Fenfluramine, Fluoxetine, Pheniramidol, fibric acid derivatives, Pentoxifylline, Miconazole, Azapropazone, Phenylbutazone, quinolones, Probenecid, salicylates, Oxyphenbutazone, Sulfinpyrazone, tetracyclines, tritoqualin and sulfonamides.

The effect of treatment with Amaryl may be insufficient due to the simultaneous use of Epinephrine, Acetazolamide, glucocorticosteroids, Glucagon, Diazoxide, barbiturates, saluretics, laxatives, thiazide diuretics, nicotinic acid, Phenytoin, Phenothiazine, Rifampicin, Chlorpromazine, lithium salts, as well as progestogens and estrogens.

The combination of Amaryl with histamine H2 receptor blockers, Reserpine and Clonidine can cause an unpredictable result. The sugar level may go down or up. A similar effect is observed with the use of alcoholic beverages.

Amaryl does not affect the action of ACE inhibitors (Ramipril) and anticoagulant agents (Warfarin).

How to use Amaryl

Amaryl tablets should be swallowed with 150 ml of water. You can't chew them up. Immediately after taking the medicine you need to eat.

The dosage of the drug and the course of therapy should be determined by the attending physician, based on the results of blood and urine tests.

An overdose of the drug may cause hypoglycemia. Hypoglycemia is a pathological condition resulting from a decrease in glucose in the lymph (below 3.5 mmol / l) and in the blood (below 3.3 mmol / l). It can be observed 12-72 hours.

Combinations with antidiabetic drugs and analogues

If it is necessary to replace the antidiabetic agent with Amaryl tablets, use the minimum dose (1 mg). Even if another drug was used in maximum doses. After switching to Amaryl, it is necessary to monitor the patient's condition and, if necessary, increase the dosage. This should be done gradually over 1-2 weeks.

If a drug with a high half-life was used before the use of Amaryl, after its withdrawal, a break of several days should be taken. Otherwise, hypoglycemia may develop.

If patients have preserved the function of insulin production, Insulin can be completely replaced by Amaryl. In this case, you need to start therapy with a dose of 1 mg per day.

When treatment with Metmorphine does not give the desired result, Amaryl can be additionally prescribed. While maintaining the existing dosage of Metmorphine, add the minimum dose of Amaryl (1 mg). If the desired effect is absent, the dosage of Amaryl is gradually increased over 1-2 weeks. Do not exceed the daily dosage of 6 mg.

If therapy with Metmorphine and Amaryl is ineffective, the patient is prescribed Insulin, and Metmorphine is canceled. The dosage of Amaryl is maintained. The introduction of insulin is carried out with minimal doses. If the level of sugar concentration in the blood does not decrease enough, the dose of insulin is increased. With the simultaneous use of insulin and Amaryl, the dosage of the hormone can be reduced by 40% compared with insulin monotherapy.

You can take analogs or substitutes instead of Amaryl: Glimepiride, Diapiride, Glemaz, Diameprid, Reklid, Amaperide, Amiks, Diaglizid, Glyri, Glampid, Glianov, Glibamide, Panmicron, Oltar, Glibenclamide, Dimaryl, Maniglid, Glibetik, Gliklada, Diabrex, Gliclazide, Glimaril, Manil, Glimed, Maninil, Glinez, Glioral, Olior, Glipomar, Glirid, Gluktam, Glurenorm, Diabeton, Diabreside.

Contraindications and adverse reactions

The active substance Amaryl is able to overcome the placental barrier and penetrate into breast milk. Therefore, the drug is not prescribed to women during pregnancy and lactation.

If a woman plans to become pregnant, she must be transferred to insulin therapy in advance, excluding Amaryl. Nursing mothers are advised to continue taking insulin. If it becomes necessary to administer Amaryl, breastfeeding should be discontinued.

A contraindication to the use of the drug is a diabetic coma and a pre-coma state. You can not enter Amaryl with an acute complication of diabetes mellitus (ketoacidosis).

Patients diagnosed with type I diabetes mellitus are not prescribed Amaryl.

Amaryl is not used to treat patients on hemodialysis. Contraindication is acute renal failure and other severe renal impairment. It is not allowed to administer Amaryl to patients with serious liver pathology.

You can not prescribe the drug if the patient has intolerance to glimepiride or other drugs of the sulfonylurea group, as well as sulfonamides.

During treatment, hypoglycemic reactions are sometimes observed. Patients may feel dizzy or dizzy. They suffer from drowsiness, sleep disturbances, anxiety, cold sweats, tremors and speech disorders. You may experience hunger, nausea, diarrhea, or abdominal pain. Unpleasant sensations in the liver and jaundice are noted. Patients may develop palpitations and skin rashes. There are violations of the function of hematopoiesis.

Feedback on the use of Amaryl

Reviews of doctors will tell a lot about Amaril. Constantly faced with various manifestations of type II diabetes mellitus and observing the reaction of patients to the drug, it is easy to conclude that the drug is effective. Endocrinologists say that with the right dosage, in most cases, it is possible to achieve a lasting positive effect.

Judging by the reviews of the buyers of the medicine, with the help of Amaryl, it is possible to quickly reduce blood sugar levels. Most patients who have experienced side effects of the drug complain of hypoglycemic reactions that occur after taking the pill.

Thanks for the feedback

Comments

Megan92 () 2 weeks ago

Has anyone managed to completely cure diabetes? They say it is impossible to cure completely ...

Daria () 2 weeks ago

I also thought it was impossible, but after reading this article, I had long forgotten about this "incurable" disease.

Megan92 () 13 days ago

Daria () 12 days ago

Megan92, so I wrote in my first comment) I will duplicate it just in case - link to article.

Sonya 10 days ago

Isn't this a divorce? Why sell online?

Yulek26 (Tver) 10 days ago

Sonya, what country do you live in? They sell on the Internet, because shops and pharmacies set their markup brutal. In addition, payment is only after receipt, that is, they first looked, checked and only then paid. And now everything is sold on the Internet - from clothes to TVs and furniture.

Editorial response 10 days ago

Sonya, hello. This drug for the treatment of diabetes mellitus addiction is really not sold through the pharmacy network in order to avoid overpricing. Currently, you can only order official website. Be healthy!

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Pregnancy and breastfeeding	Glimepiride and other sulfonylurea derivatives should not be taken during pregnancy and breastfeeding. If you are faced with high blood sugar during pregnancy, read the articles "" and "". Treat as written in them. Do not take any glucose-lowering pills on your own.
Interaction with other drugs	Amaryl can interact negatively with blood pressure pills, non-steroidal anti-inflammatory drugs, and many other popular medications. For more information, read the instructions for use, which is in the package with the drug. Consult your doctor! Tell him about all the medicines you take.

Contraindications	Type 1 diabetes mellitus, diabetic ketoacidosis, coma. Severe diseases of the liver and kidneys. Intolerance to the active substance glimepiride or other sulfonylurea derivatives. Malnutrition, irregular meals, malabsorption of food in the gastrointestinal tract, restriction of caloric intake to 1000 kcal per day or less. Age up to 18 years.
special instructions	Hypoglycemia is to be feared. Read the article "" carefully. Learn the symptoms of this acute complication, how to provide emergency care. In the first weeks of taking glimepiride, it is better not to do work that requires a quick physical and mental reaction. Treatment may increase the risk of driving.
Dosage	A suitable dose of Amaryl medicine is prescribed by a doctor. Diabetics should not do this on their own. The drug is available in various dosages - tablets of 1, 2, 3 and 4 mg. Take once a day before breakfast or the first main meal. Tablets can be divided in half, but should not be chewed, should be washed down with liquid.
Side effects	is a common and dangerous side effect. Other problems are rare. These are nausea, vomiting, a feeling of fullness in the stomach, diarrhea, skin itching, rash. The sensitivity of the skin to the sun's rays may increase, and sodium deficiency in the body may develop. Due to the rapid decrease in blood sugar, vision may temporarily deteriorate.