Glimepiride, antidiabetic, sulfonylureaAmaryl® is a so-called antidiabetic and is used to lower permanently high blood sugar levels. It should only be used when a suitable diet, additional exercise and weight loss are not sufficient to lower blood sugar levels adequately. Amaryl® contains the active ingredient glimepiride and is suitable exclusively for type 2 diabetics, as the release of insulin from the ?-cells of the pancreas is stimulated and therefore, for the drug to have an optimal effect, at least part of the insulin must be produced by the body itself.
This is not the case with type 1 diabetes mellitus, as the body cannot produce insulin at all in this clinical picture. The effect of Amaryl® unfolds both within the pancreas and in the surrounding tissue in liver, muscle and fat cells of the body. Diabetes mellitus type 2 manifests itself in insufficient insulin production by the pancreas and reduced sensitivity to insulin in the body, also known as insulin resistance.
In contrast to diabetes mellitus type 1, the body is still able to produce insulin itself, which is initially produced in sufficient quantities. Gradually, however, the glucose absorbing body cells develop an insensitivity to insulin. Without insulin, glucose cannot be absorbed from the blood into the body’s muscle and fat cells.
As a result, more glucose remains in the blood and a permanently high blood sugar level develops. In order to compensate, the body now tries to produce and release more insulin to lower the blood sugar level again (hyperinsulinism). In relative terms, however, this overproduction is not enough: the body’s cells react less and less to the insulin, resulting in a relative insulin deficiency that can no longer be compensated.
Amaryl® and the active ingredient glimepiride are classified as sulfonylureas. These promote insulin secretion from the ?-cells of the pancreas in the event of an excess of glucose in the blood. More specifically, glimepiride causes a potassium channel blockage in the cell membrane of the ?-cells.
The electrical potential of the cell then changes to positive and voltage-dependent calcium channels open. Insulin-containing vesicles are now activated and released via inflowing calcium. The physiological insulin release also follows this pattern, but here glucose is first taken up and metabolized by GLUT2 transporters in the B-cell.
The resulting metabolic product ATP (adenosine triphosphate) then closes the potassium channels and insulin can be released. The effect of Amaryl® outside the pancreas is to increase the sensitivity of muscle and fat cells to insulin again by increasing the number of active glucose transport molecules in the respective plasma membranes. As a result, glucose can be reabsorbed in greater quantities.
In addition, Amaryl® inhibits the production of glucose in the liver by providing an enzyme (fructose-2,6-bisphosphate), which is important for inhibition, in increased quantities intracellularly. Amaryl® is a prescription drug. It is available in the dosages 1 mg, 2 mg, 3 mg, 4 mg and 6 mg.
The respective dose level is determined on the basis of blood count, liver values of glucose levels in urine and, of course, blood sugar levels. As a rule, the starting dose is 1 mg. Amaryl® can also be used in combination therapy with metformin and insulin. As a rule, the tablets are taken once a day, preferably at the same time of day.
The tablet in the prescribed potency should be taken unchewed with sufficient liquid before or during the first daily meal. If the lowest dose of 1 mg does not achieve an adequate reduction in blood sugar levels, the dose should be gradually increased to 2, 3 or 4 mg at intervals of 1-2 weeks. The maximum daily dose is 6 mg.
The dose is strongly dependent on the respective metabolic situation. If the patient’s weight or lifestyle changes, the dose should be adjusted by a physician to avoid the risk of hypoglycaemia. Combination therapy with metformin is started with the highest dose of metformin plus a low dose of Amaryl®, which can be increased until a satisfactory blood glucose level is reached.
If the daily dose of Amaryl® is not sufficient, additional insulin therapy should be given. The maximum dose of Amaryl® is maintained and started with a low dose of insulin, which can be increased until an adequate blood glucose level is reached. Both combination therapies should only be used under strict medical supervision.
It is important to note that if a patient forgets to take a dose, the subsequent dose should not be doubled, but the therapy should simply be continued as usual. Otherwise there is a risk of hypoglycaemia. In rare cases, hypoglycaemia (low blood sugar) may occur.
This can happen very quickly and usually depends on many factors, for example the dose, alcohol consumption or insufficient food intake. The range of symptoms is very wide and ranges from mild symptoms can be quickly eliminated by giving carbohydrates such as glucose, in more severe cases medical treatment is necessary. Other rare side effects are Very rarely occur severe hypersensitivity symptoms such as In this case a doctor must be called immediately.
Liver dysfunction and even liver failure can also occur. A doctor should be informed immediately if the first signs such as yellowing of the skin or eyes are observed. Other possible side effects are temporary visual disturbances, an increase in liver enzyme values or slight skin allergies.
- Nausea and vomiting,
- Dizziness / loss of consciousness
- Reversible lowering of the blood platelets
- Red and white blood cell deficiency
- Shortness of breath,
- Skin rash
- Shock at
- Abdominal pain
- Nausea, vomiting
- Feeling of fullness ̈hl
Amaryl® should not be used if there is a known allergy to the active ingredient glimepiride or other sulfonylureas. In addition, it should not be used in the presence of diabetes mellitus type 1 (insulin-dependent), diabetic coma or ketoacidosis (following symptoms: symptoms: tiredness, nausea, stiffness of the muscles and constant urination), as well as in the case of severe functional disorders of the liver or kidney. In the latter case, therapy should be switched from Amaryl® to insulin.
Patients with a glucose-6-phosphate dehydrogenase deficiency should not be treated with Amaryl® if at all possible. There is a risk of anaemia due to the breakdown of red blood cells (haemolytic anaemia). During pregnancy and while breastfeeding, therapy with Amaryl® should be avoided completely. Other topics that might interest you: All information from the field of drugs can also be found under Drugs A-Z! – Diabetes mellitus
- Therapy Diabetes
- Drugs Diabetes mellitus