Amaryl®
Synonyms in a broader sense
Glimepiride, antidiabetic, sulfonylurea
introduction
Amaryl® is a so-called antidiabetic and is used to lower a permanently high blood sugar level. It should only be used if a suitable diet, additional exercise and weight loss are not enough to adequately lower the blood sugar level. Amaryl® contains the active ingredient glimepiride and is only suitable for type 2 diabetics, as the release of insulin from the? -Cells of the pancreas is stimulated and therefore at least part of the insulin has to be produced by the body itself for an optimal effect of the drug. This is not the case with type 1 diabetes mellitus, as the body cannot produce any insulin at all.
Mode of action
The effect of Amaryl® unfolds both within the pancreas as well as in the surrounding tissue in Liver, muscle and fat cells of the body. A Type 2 diabetes mellitus manifests itself in a insufficient insulin production by the pancreas and a decreased sensitivity to insulin in the body, one also speaks of Insulin resistance. The body is opposed to Type 1 diabetes mellitus still able to to produce insulin on their own, this is initially produced in sufficient quantities.
Gradually, however, the body cells that absorb glucose develop one Insensitivity to insulin. Without insulin can turn no absorption of glucose from the blood in the Muscle and fat cells of the body take place as a result if more glucose remains in the blood and it comes to one persistently high blood sugar levels.
The body tries to compensate to produce more insulin and pour out to the Lower blood sugar levels again to be able to (Hyperinsulinism). In proportion, however, this overproduction is not enough: the body cells react less and less to insulin and it results in a relative insulin deficiency, which no longer compensate leaves.
Amaryl® or the Active ingredient glimepiride becomes the Sulfonylureas counted. This promote insulin secretion from? cells in the pancreas (i.e. the pancreas) when there is excess glucose in the blood. More specifically, glimepiride makes for one 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.
About incoming calcium are now insulin-containing vesicles activated and distributed. The physiological release of insulin also takes place according to this pattern, but this is done first Glucose is taken up into the? Cell via GLUT2 transporter and metabolized. 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 the To increase the sensitivity of muscle and fat cells to insulin againby the Number of active glucose transport molecules is increased in the respective plasma membranes. As a result, can Glucose increased again become. Amaryl® also inhibits glucose production in the liver by adding a enzyme important for inhibition (Fructose-2,6-bisphosphate) increased intracellularly provided.
Amaryl® application method
Amaryl® is a prescription drug. It is available in 1 mg, 2 mg, 3 mg, 4 mg, and 6 mg dosages. The respective level of dose the glucose level in the urine and, of course, the blood sugar level are determined based on the blood count, liver values. Usually the starting dose is 1 mg. Amaryl® can also be used in Combination therapy With Metformin and insulin can be used.
Areas of application / indication
Usually the Taking tablets once a day if possible at the same time. The tablet in the prescribed strength should before or during the first meal of the day whole with enough liquid be included. Can in the lowest dose of 1 mg no adequate blood sugar lowering should be achieved in one 1-2 weeks apart a gradually increase the dose to 2, 3 or 4 mg.
The The maximum daily dose is 6 mg. The dose is strongly dependent on the respective metabolic situation. Changes Weight or lifestyle of the patient, should one medical dose adjustment done to that Risk of hypoglycemia or hypoglycemia (Hyper- or hypoglycaemia).
Combination therapy with Metformin you start with the Maximum dose of metformin plus a small dose of Amaryl®that can be increased to a satisfactory blood sugar levelt is reached. If the daily dose of Amaryl® is not sufficient, a additional insulin therapy respectively. Here the tain maximum Amaryl® dose and with one started low dose insulin, which can be increased until an adequate blood sugar level is obtained.
Both combination therapies should only under strict medical supervision respectively. It is also important to note that if the dose is forgotten the following one Dose not doubledbut therapy simple continues as usual should be. Otherwise the Risk of hypoglycaemia.
Side effects
It can rarely be Occurrence of hypoglycaemia (Hypoglycaemia). This can very quickly and is mostly dependent on many factors, for example the dose, Alcohol consumption or insufficient food intake.
The range of symptoms is very wide and ranges from
- a headache,
- Nausea and vomiting,
- Sleepiness,
- depression
- dizziness,
- Drowsiness / loss of consciousness
Mild symptoms can be quickly eliminated by giving carbohydrates such as glucose; in more severe cases, medical treatment is necessary.
Further rare side effects are
- reversible lowering of blood platelets
- lack of redden and white blood cells
Very rare kick heavy Hypersensitivity symptoms how
- Shortness of breath,
- skin rash
- Swelling
- Shock on
In this case it is call a doctor immediately. Also liver dysfunction up to Liver failure can occur. A doctor should be informed immediately as soon as possible first signs such as yellowing of the skin or eyes are watched. Also very rarely kick
- stomach pain
- Nausea, vomiting
- Bloating
- Diarrhea
- Hyponatremia
Other possible side effects are temporary visual disturbances, Increasing the Liver enzyme levels or light Skin allergies.
Contraindications
Amaryl® should not be used if a known allergy to the active ingredient glimepiride or others Sulfonylureas present.
In addition, therapy should not be given if the patient is present Type 1 diabetes mellitus (requires insulin), at diabetic coma or ketoacidosis (the following symptoms: fatigue, nausea, stiffness of the muscles and constant urination), as well as severe liver or kidney dysfunction.
With the latter, the Therapy switched from Amaryl® to insulin become. Patients with a glucose-6-phosphate dehydrogenase deficiency should if possible not treated with Amaryl® there is a risk of one Anemia through the breakdown of red blood cells (hemolytic anemia).
During the Pregnancy and breastfeeding should be on therapy with Amaryl® completely waived become.
