Amaryl 4 mg is used in non-insulin-dependent diabetes mellitus (type 2) when diet, therapy, and physical exercise are ineffective.
Each tablet contains:
Glimepiride – 4 mg
Excipients: lactose, sodium starch glycolate, povidone K30, microcrystalline cellulose, magnesium stearate, iron oxide red (E172).
Used for the treatment of non-insulin-dependent diabetes mellitus (type 2) when diet, therapy, and physical activity alone are ineffective. Amaryl can also be used in combination with insulin in patients with type 2 diabetes.
The initial and maintenance doses are individualized based on regular blood and urine glucose monitoring. Regular monitoring helps identify primary or secondary resistance to the medication.
Initial dose and dose selection:
Start with 1 mg once daily. If necessary, the dose can be gradually increased every 1-2 weeks under blood glucose control as follows: 1 mg, 2 mg, 3 mg, 4 mg, 6 mg, and in exceptional cases up to 8 mg. The typical daily dose range for well-controlled diabetes is 1–4 mg. Therapeutic effects at doses above 6 mg are rare. The maximum daily dose is 8 mg.
Dose adjustment:
As diabetes control improves, insulin sensitivity may increase, potentially requiring dose reduction or temporary discontinuation to avoid hypoglycemia. Dose adjustments may also be needed with changes in body weight, lifestyle, or other factors increasing hypo- or hyperglycemia risk.
Switching from other glucose-lowering drugs to Amaryl:
There is no exact dose equivalence. When switching, start with 1 mg daily regardless of the previous maximum dose of the other drug. Dose increases should follow the above titration scheme and consider prior drug efficacy and duration. Temporary discontinuation might be necessary to avoid additive effects and hypoglycemia risk.
Use in combination with insulin:
If maximum doses of Amaryl do not achieve glycemic control, insulin therapy may be added. The Amaryl dose remains unchanged, and insulin is started at a low dose, gradually increased with glucose monitoring. Combined therapy requires medical supervision.
Take Amaryl orally once daily, preferably before breakfast. If missed, take before the next main meal as soon as possible. Swallow tablets whole with 100-200 ml of water. Do not skip meals after taking Amaryl.
Usually long-term. Take the prescribed dose at the scheduled time. Missed doses should not be compensated by doubling the next dose. Consult a physician about missed doses or dose timing issues. Report any overdose immediately.
Hypersensitivity to glimepiride or any tablet component
Insulin-dependent diabetes mellitus (type 1)
Diabetic ketoacidosis, diabetic precoma and coma
Severe liver dysfunction
Severe kidney dysfunction (including patients on hemodialysis)
Contraindicated in pregnancy. Women planning pregnancy or suspected pregnancy should switch to insulin. Glimepiride is excreted in breast milk; therefore, Amaryl is contraindicated during breastfeeding. Switch to insulin or discontinue breastfeeding.
Store below 25°C in a place inaccessible to children.
