Amaryl 2: Uses, How It Works, Side Effects

What is Amaryl 2 used for?

Amaryl 2 is a prescription medicine. It is used, on a doctor's advice, to help control blood sugar in adults with type 2 diabetes.

• Lowering blood sugar in adults with type 2 diabetes, together with diet and physical activity
• Not for type 1 diabetes or for diabetic ketoacidosis

How does Amaryl 2 work?

Glimepiride acts on the insulin-making cells of the pancreas and makes them release more insulin. More insulin helps the body move sugar out of the blood. It works only while the pancreas can still make insulin.

What happens in your body after you take it

1. You swallow the tablet

   The tablet dissolves in the gut and glimepiride is absorbed into the blood. It is usually taken with the first main meal of the day.

2. It reaches the pancreas

   Glimepiride travels in the blood to the pancreas, where it attaches to the insulin-making (beta) cells.

3. The cells release more insulin

   Attaching to the cells makes them release more insulin, whether or not blood sugar is high at that moment.

4. Blood sugar falls

   With more insulin available, muscles and other tissues take up more sugar from the blood, and blood sugar comes down. Too much effect, or a missed meal, can bring it down too far.

5. The body clears it

   The liver breaks glimepiride down and the products leave through the urine and stool. People with kidney or liver problems clear it more slowly, so low blood sugar is more likely.

How to take Amaryl 2

Take Amaryl 2 exactly as your doctor has prescribed or as printed on the pack. Your doctor decides the dose and may change it after blood tests.

• It is usually taken once a day with breakfast or the first main meal. Follow the label or your doctor's advice.
• Do not skip meals while taking it: with no food, blood sugar can fall too low.
• If you miss a dose, ask your doctor or pharmacist what to do; do not take two doses together to make up for it.
• Do not stop taking it on your own, because blood sugar may rise again; talk to your doctor first.
• Your doctor will arrange regular blood sugar and HbA1c tests.

Side effects of Amaryl 2

Low blood sugar is the main side effect of Amaryl 2. Other effects are usually milder, but a few need medical help.

Uncommon or mild

• Low blood sugar: shaking, sweating, hunger, headache, dizziness, confusion or a fast heartbeat
• Nausea, vomiting, stomach discomfort or diarrhoea
• Dizziness
• Weight gain
• Blurred vision, especially when blood sugar changes

Who should be careful

Some people need to check with a doctor before taking Amaryl 2, or need extra care while taking it.

• Low blood sugar is more likely if you skip or delay meals, drink alcohol, exercise hard, are older, or have kidney, liver or adrenal problems. Know the warning signs and tell family or colleagues what to do
• Allergy to sulfonamide medicines (sulfa drugs): glimepiride may also cause a reaction
• G6PD deficiency: red blood cells may break down; tell your doctor
• Beta-blocker medicines can hide the warning signs of low blood sugar
• Illness with vomiting, diarrhoea, fever or not eating: blood sugar can fall or rise; contact your doctor or pharmacist for advice on what to do with your diabetes medicines. Do not stop on your own unless told
• Surgery, a procedure with fasting, or a new serious illness or injury: tell the doctor that you take it
• Driving or using machinery: low blood sugar can affect concentration. Check with your doctor
• Pregnancy and breastfeeding: not usually used; the baby can have low blood sugar after birth. Tell your doctor if you are pregnant, planning a baby or breastfeeding
• Kidney or liver disease: your doctor may need to take extra care

Medicines and things that interact with Amaryl 2

Amaryl 2 can change how other medicines work, and some medicines change its effect. Tell your doctor or pharmacist about everything you take, including herbal remedies and painkillers bought over the counter.

• Insulin and other diabetes medicines: low blood sugar becomes more likely, and doses may need to change
• Fluconazole and miconazole (antifungal medicines): they can raise its effect and cause severe low blood sugar
• NSAID painkillers such as ibuprofen or diclofenac, and ACE inhibitors: they can strengthen the blood-sugar-lowering effect
• Beta-blockers: they can mask the signs of low blood sugar
• Steroids (corticosteroids), thiazide water tablets, rifampicin and oestrogens: they can raise blood sugar and weaken its effect
• Colesevelam: it reduces absorption, so your doctor will advise on timing
• Alcohol: it can cause low blood sugar and unpredictable effects

If someone takes too much

Storage

Store below 30 C in a dry place, protected from moisture, in the original strip, and out of the reach of children. Do not use after the expiry date. Check the pack for the exact storage instructions.

Regulatory status in India

Approved for sale in India as a prescription medicine. Single-ingredient glimepiride is not on the CDSCO list of medicines banned under section 26A of the Drugs and Cosmetics Act, but several fixed-dose combinations of glimepiride with pioglitazone or metformin have been banned, so check the ingredient list on the pack. Amaryl 2 contains glimepiride only.

Other brands with the same medicine

Glimepiride 2 mg tablets are sold under other brand names and as generic medicines. They contain the same medicine; check the label for the strength. Some products with a similar brand name also contain metformin or other medicines, so do not switch between them without asking your doctor.

Other strengths and forms

Glimepiride is sold in different strengths, and in combination tablets with metformin and other diabetes medicines. Several combinations with pioglitazone or metformin have been banned in India, so check the ingredient list on the pack of the one you have.

Common questions