Amaryl

How does it work?

Amaryl tablets contain the active ingredient glimepiride, which is a type of medicine called a sulphonylurea. (NB. Glimepiride is also available without a brand name, ie as the generic medicine.) Glimepiride is used to help control blood sugar levels in people with type 2 diabetes.

People with type 2 diabetes (non-insulin dependent diabetes) have a deficiency of a hormone called insulin. Insulin is produced by the pancreas and is the main hormone responsible for controlling sugar levels in the blood. It normally makes the cells of the body remove excess sugar from the blood. In type 2 diabetes insulin is produced inefficiently in response to surges of blood sugar, eg following a meal. The cells of the body also become resistant to the action of insulin that is produced, which means that blood sugar levels can become too high.

Glimepiride works mainly by stimulating the cells in the pancreas that produce insulin. These cells are called beta cells. Glimepiride causes the beta cells to produce more insulin and this insulin removes sugar from the blood.

Glimepiride also increases the uptake of sugar from the blood into muscle and fat cells and decreases the production of sugar by the liver.

All these actions help to decrease the amount of sugar in the blood of people with type 2 diabetes.

Glimepiride tablets are normally taken once a day, shortly before or during the first meal of the day.

Glimepiride is a first line option for treating type 2 diabetes in people who are not overweight. It is used when diet and exercise have failed to control blood sugar levels. It can also be used in combination with other antidiabetic medicines to provide better control of blood sugar.

What is it used for?

Type 2 (non-insulin dependent) diabetes, when diet has failed to fully control blood sugar.

Warning!

Your doctor may want you to check your blood sugar level from time to time while you are taking this medicine. Make sure you discuss how to do this and how often with your GP, pharmacist or diabetes specialist.

On rare occasions, low blood sugar can occur as a side effect of this medicine. This is more likely to happen if you suddenly do more exercise than normal, have your meals at irregular times or miss meals altogether. For this reason, it is important that you are aware of the symptoms of hypoglycaemia (these may include cold sweats, cool pale skin, tremor, anxious feeling, unusual tiredness or weakness, confusion, difficulty in concentration, excessive hunger, temporary vision changes, headache or nausea) and what to do if you experience these symptoms. Discuss this with your GP, pharmacist or diabetes specialist.

People who are taking antidiabetic tablets should only drink alcohol in moderation and accompanied by food. This is because alcohol can make your warning signs of low blood sugar less clear, and can cause delayed low blood sugar, even several hours after drinking.

If you get an infection or illness, or have an accident while taking this medicine you should let your doctor know, because when the body is put under stress this medicine may become less effective at controlling your blood sugar. In these cases your doctor may need to temporarily replace your treatment with insulin. You should also consult your doctor about your diabetes treatment if you are due to have surgery under a general anaesthetic, or if you get pregnant. In these situations blood sugar is normally controlled by insulin.

This type of medicine can occasionally cause liver problems. For this reason, you should consult your doctor if you develop any of the following symptoms while taking this medicine, so that your liver can be checked: unexplained nausea, vomiting, abdominal pain, fatigue, loss of appetite, darkened urine or yellowing of the eyes or skin (jaundice).

It is recommended that your liver function and the levels of blood cells in your blood are regularly monitored while you are taking this medicine.

Use with caution in

Elderly people

Decreased kidney function

Decreased liver function

Problems with the production of natural steroid hormones by the adrenal glands.

Not to be used in

Type 1 (insulin dependent) diabetes

Diabetic keto-acidosis

Diabetic coma or precoma

Severely decreased liver function

Severely decreased kidney function

Hereditary blood disorders called porphyrias

Pregnancy

Breastfeeding

Allergy to other sulphonylurea medicines

Allergy to sulphonamide medicines.

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

This medicine should not be used during pregnancy. Diabetes is usually controlled using insulin during pregnancy, because this provides a more stable control of blood sugar. If you get pregnant while taking this medicine, or are planning a pregnancy, you should seek medical advice from your doctor.

This medicine may pass into breast milk. As this could cause low blood sugar in the nursing infant, this medicine should not be used by breastfeeding mothers. Discuss this with your doctor.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

Disturbances of the gut such as diarrhoea, constipation, nausea, vomiting or abdominal pain

Temporary visual disturbances at start of treatment

Weight gain

Low blood sugar level (hypoglycaemia)

Allergic skin reactions such as rash or itching

Disturbance in liver function

Inflammation of the liver (hepatitis)

Cholestatic jaundice

Disturbance in the normal numbers of blood cells in the blood

Allergy to active ingredients (hypersensitivity)

The side effects listed above may not include all of the side effects reported by the drug's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

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