Amaryl

Glimepiride

Alone or in combination w/ insulin or metformin in the treatment of NIDDM.

Initially 1 mg once daily. May increase dose based on glycaemic control w/ 1-2 wk interval by stepwise manner of 2, 3 or 4 mg daily. Max daily dose: 6 mg. Amaryl may also be used in combination w/ insulin or metformin.

Should be taken with food: Take immediately before the 1st main meal of the day. Do not skip meals. Swallow whole, do not chew/crush.

Hypersensitivity to glimepiride, sulfonylureas or sulfonamides. Insulin-dependent (type 1) DM; diabetic ketoacidosis; diabetic coma; severe renal or hepatic dysfunction.

Possible hypoglycaemia when taken w/ meals skipped or at irregular hrs. Regular monitoring of glucose levels in blood & urine, hepatic & haematological function. Temporary changeover to insulin in stress situations (eg, accidents, acute operations, infections w/ fever). Patients w/ G6PD deficiency; consider a non-sulfonylurea alternative. Dialysis patients. Patients w/ rare hereditary problems of galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption. May impair ability to drive & use machines as a result of hypoglycaemia or hyperglycaemia. Pregnancy & lactation. Not recommended in paed.

Possibly, hypoglycaemia; dysgeusia, alopecia, wt gain; thrombocytopenia, leukopenia, granulocytopenia, agranulocytosis, erythropenia, haemolytic anaemia & pancytopenia.

Metabolism may be influenced during concomitant use w/ CYP2C9 inducers (eg, rifampicin) or inhibitors (eg, fluconazole). Increased AUC w/ fluconazole. Potentiation of the blood glucose-lowering effect by phenylbutazone, azapropazone, oxyfenbutazone, insulin & oral antidiabetic (eg, metformin), salicylates, p-aminosalicylic acid, anabolic steroids & male sex hormones, chloramphenicol, certain long-acting sulfonamides, tetracyclines, quinolone antibiotics & clarithromycin, coumarin anticoagulants, fenfluramine, disopyramide, fibrates, ACE inhibitors, fluoxetine, MAOIs, allopurinol, probenecid, sulfinpyrazone, sympatholytics, cyclophosphamide, trophosphamide & iphosphamides, miconazole, fluconazole, pentoxifylline (high dose parenteral), tritoqualine. Weakening of the blood glucose-lowering effect by oestrogens & progestogens; saluretics, thiazide diuretics; thyroid stimulating agents, glucocorticoids; phenothiazine derivatives, chlorpromazine; adrenaline & sympathicomimetics; nicotinic acid (high doses) & nicotinic acid derivatives; laxatives (long term use); phenytoin, diazoxide; glucagon, barbiturates & rifampicin; acetazolamide. Blood glucose-lowering effect may be potentiated or weakened by H₂-antagonists, β-blockers, clonidine, guanethidine & reserpine. Alcohol intake may potentiate or weaken the hypoglycaemic action. May potentiate or weaken the effects of coumarin derivatives. Reduced GIT absorption by colesevelam.

Antidiabetic Agents

A10BB12 - glimepiride ; Belongs to the class of sulfonylureas. Used in the treatment of diabetes.

POM