One of the most common anti-diabetic drugs from the sulfanylurea group is - Amaryl.
Due to the active and additional components, the drug helps to lower the glucose concentration and effectively reduces the severity of the symptoms of diabetes mellitus.
Medicinal antidiabetic drug Amaryl is taken to use for oral administration. The commonly accepted international name for the drug is Amaryl. The drug is manufactured in Germany, the manufacturer - the company Aventis Pharma Deutschland GmbH.
On this page you will find all information about Amaryl: the full instructions for use on this medication, average prices in pharmacies, complete and incomplete analogs of the drug, as well as reviews of people who have already used Amaril. Want to leave your opinion? Please write in the comments.
Clinical and pharmacological group
Oral hypoglycemic drug.
Conditions of leave from pharmacies
It is released on prescription.
How much does Amaril cost? 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.
Form of issue 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. As auxiliary substances, lactose monohydrate, povidone, magnesium stearate, microcrystalline cellulose and E172 or E132 dyes are used.
Regardless of the dosage, all tablets have a separation risk and engraving. As a distinctive feature - the color of the tablet itself: 1 mg pink, 2 mg - green, 3 mg - pale yellow and 4 mg - blue.
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 reduces the amount of sugar in the blood.
Due to the action of glimepiride, calcium from the blood enters the tissue cells and helps to prevent the formation of atherosclerotic plaques on the walls of the vessels.
Metformin also helps to reduce blood glucose, but in a different way: it improves the hepatic blood circulation and turns blood sugar into glycogen - a substance that is safe for patients with diabetes mellitus. In addition, metmorphine promotes better absorption of glucose by muscle cells.
It has been established that glimepiride acts more efficiently in combination with metformin. For this reason, Amaril M was created, a drug that is convenient for patients, and for doctors.
Indications for use
According to the instructions, Amaril 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 exchange in cells, and also helps to prevent the formation of atherosclerotic plaques on the walls of blood vessels.
According to the instructions, Amaril is contraindicated in the following cases:
- Rare hereditary diseases (lack of lactase, intolerance to galactose, glucose-galactose malabsorption);
- Hypersensitivity to the active or auxiliary components of the drug;
- Type 1 diabetes mellitus;
- Severe liver dysfunction;
- Diabetic precoma and coma, diabetic ketoacidosis;
- Pregnancy and breastfeeding;
- Severe violations of liver function (including patients on hemodialysis);
In applying Amaril, care should be taken when:
- Disruption of absorption of food and drugs from the gastrointestinal tract (intestinal paresis, intestinal obstruction);
- The presence of risk factors for the development of hypoglycemia;
- Intercurrent illnesses in the process of therapy, or when the patient's lifestyle changes (changing diet or meal time, reducing or increasing physical activity);
- Insufficiency of glucose-6-phosphate dehydrogenase.
Application in pregnancy and lactation
Amaryl is contraindicated in pregnancy. In the case of a planned pregnancy or at the onset of pregnancy, a woman should be transferred to insulin therapy.
It has been established that glimepiride is excreted in breast milk. During lactation, a woman should be transferred to insulin or to stop breastfeeding.
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 excretion in the urine.
- First, use the drug 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 the dose of amaril more than 6 mg / day. The multiplicity and time of drug use is determined individually by the doctor, which depends on the patient's lifestyle. Typically, the daily dose of amaril is prescribed 1 time per day during or before a copious first meal (breakfast). In case the morning dose was not taken, then during or before the second meal. Therapy is long.
Using a combination of amaryl-metformin. Those patients who take metformin, and they have an insufficient reduction in glucose in the blood serum, you can begin an additional reception of amaril. If the daily dosage of metformin does not change, then amaril therapy starts with a dose of 1 mg / day. Subsequently, the dose of amaril can be increased to achieve the desired reduction in serum glucose to a maximum of 6 mg / day.
Using a combination of amaryl-insulin. To stabilize the glucose level in the blood serum in cases where monotherapy or the use of the amaryl-metformin combination is ineffective, a combination of insulin and amaryl is used. In this case, the dose of amaril is kept the same, and insulin therapy begins with small doses. In the future, it is possible to increase the insulin administered. Therapy should be accompanied by monitoring of the concentration of glucose in the blood serum. The treatment is carried out under the supervision of the attending physician. The insulin-amaryl scheme can reduce the need for injected insulin by about 40%.
Replacing another antidiabetic drug with amaryl. Starting treatment starts with 1 mg / day of amaril, regardless of the dose of the previous drug (even if it was maximal). Depending on the therapeutic effect of amaril, you can increase the dose according to the rules given above. In some cases it is necessary to cancel amaryl because of possible hypoglycemia (especially if a drug with a high half-life value, chloropropramide, was used before amaril). The therapy is stopped for several days (because of the probable additive effect).
Replacement of insulin with amaryl. In those cases when patients with type 2 diabetes mellitus are prescribed insulin, but they retain a preserved insulin secretion function of beta cells of the pancreas, it is possible to transfer the patient to the reception of amaril with the exception of insulin. In this case, amaril therapy is started with a dose of 1 mg / day.
The use of Amaril may provoke the following adverse reactions:
- Digestive system: rarely - abdominal pain, bouts of nausea, diarrhea, vomiting, a feeling of overflow and heaviness in the epigastrium; in selected cases - increased activity of cholestasis and / or hepatic enzymes, hepatitis, jaundice, life-threatening liver failure.
- Body of vision: at the beginning of therapy, transient visual impairments, provoked by changes in blood glucose levels, are possible.
- The hemopoietic system: in some cases - granulocytopenia, leukopenia, pancytopenia, hemolytic anemia, agranulocytosis and erythrocytopenia; rarely - thrombocytopenia. In post-marketing use of Amaril, cases of severe thrombocytopenia and thrombocytopenic purpura have been reported.
- Allergic manifestations: rarely - pseudoallergic and allergic reactions (hives, skin rashes and itching). Such reactions usually have an easy form, but can go into severe reactions with a sharp decrease in blood pressure, dyspnea, anaphylactic shock, allergic vasculitis (in rare cases).
- Metabolism: as with other sulfonylureas, 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 disorders, loss of vigilance and reaction rate, visual disorders, depression, delirium, confusion, speech disorders, aphasia, tremor, dizziness, cerebral convulsions, shallow breathing, loss of consciousness right up to coma. In addition, there may be signs of adrenergic counterregulation in response to hypoglycemia (anxiety, appearance sticky cold sweat, stenocardia, tachycardia, heart rhythm disturbances, palpitations and hypertension). The clinical picture of severe hypoglycemia resembles stroke.
- Other: in some cases - photosensitivity, hyponatremia.
Symptoms of overdose: severe, life-threatening hypoglycemia (with long-term treatment with glimepiride in high doses and acute drug overdose).
In case of an overdose with Amaril, there may be nausea, abdominal pain, vomiting. Perhaps the emergence of hypoglycemia, which can develop tremors, anxiety, visual impairment, drowsiness, impaired coordination, convulsions, coma.
When an overdose shows a gastric lavage, after - the use of enterosorbents. As soon as possible, it is necessary to begin the introduction of glucose. Further therapy is symptomatic. In severe overdose, hospitalization in the intensive care unit is required.
The doctor, when assigning the patient Amaryl or Amaryl M, should warn about the possibility of developing side effects, and most importantly - the emergence of hypoglycemia in the event that the patient takes the medicine, but forgets to eat. In this case, the patient is advised to always carry sweets or sugar in pieces in order to be able to quickly raise the blood sugar level.
In addition to systematic testing of blood and urine glucose levels, the composition of blood and liver function are regularly monitored with Amaril and Amaril M.
In stressful circumstances, accompanied by the release of adrenaline into the blood, the effectiveness of Amaril and Amaril M is reduced. Such situations can be accidents, conflicts in the family or at work, diseases with high temperature rise. In such cases, a temporary transfer of the patient to the intake of insulin is practiced.
The hypoglycemic effect is enhanced by the simultaneous use of amaril with insulin, other hypoglycemic drugs, certain antibiotics (tetracyclines, sulfonamides, clarithromycin), high doses of pentoxifylline, fluoxetine, fluconazole, anabolic steroids, ACE inhibitors (captopril, enalapril, ramipril, perindopril, lisinopril, etc.). The reverse action will have a combination of amaril with barbiturates, laxatives, diuretics, high doses of nicotinic acid, rifampicin.
Amplification and reduction of hypoglycemic action of amaril can cause beta adrenoblockers (carvedilol, atenolol, bisoprolol, metoprolol, etc.), reserpine, clonidine, coumarin derivatives and alcohol.
During the time of application of Amaryl for type 2 diabetes, the reviews received positive results from many patients. This is confirmed by the fact that with the right choice of dosage the drug effectively fights with hyperglycemia. In addition to the effectiveness, many buyers named the color of the tablets as a positive quality of the drug - this helps not to mix drugs with different dosage of glimepiride.
The feedback received on Amaril confirmed not only its effectiveness, but also the side effects specified in the instructions to Amaril. The most common signs of hypoglycemia are seen in patients taking the medicine:
- Trembling all over the body.
- Increased appetite.
Often, as a result of hypoglycemia in diabetes mellitus, there is a danger of losing consciousness. Therefore, those who take Amaril, have to constantly carry with them sugar-containing products (for example, sweets), so that if necessary, be able to quickly raise the sugar level and improve well-being. However, according to doctors, the change in the level of sugar is not an indicator of the inefficiency of the drug. If you have these symptoms, you just need to adjust the dose.
A common problem with drivers who are forced to take hypoglycemic drugs is a worsening of the reaction when driving a car. A similar side effect is indicated in the instructions, in the list of possible side effects. The decrease in the reaction is explained by the influence of glimepiride on the nervous system.
Among the elderly patients with diabetes in the reviews of Amaril, many noted another negative aspect: despite the effectiveness with which it reduces the level of sugar Amaryl, a cure for diabetes price is too high, since the drug can cost more than some analogs, including Russian-made.
The structural analogues of Amaril include preparations: Glemaz, Glumex, Meglomide, Diamerid.
Before using analogues, consult your doctor.
Storage conditions and shelf life
To store Amaril you need a dark, childproof place, with a temperature of up to 30 C. A shelf life of 3 years.
How to choose probiotics for the intestine: a list of drugs.
Effective and inexpensive cough syrups for children and adults.
Modern non-steroidal anti-inflammatory drugs.
Review of tablets from the increased pressure of the new generation.
Antiviral drugs are inexpensive and effective.