If a doctor prescribes a drug, immediately after its acquisition it is necessary to familiarize yourself with the instructions for use. Amaril, reviews of which on the expanses of the World Wide Web are mostly positive, will not be an exception. The drug is intended for people with diabetes. The drug is available in the form of tablets used orally.
general information
As indicated in the instructions, Amaril tablets, reviews of which are mostly positive, belong to the category of hypoglycemic names. The main active ingredient on which the product is based is glimepiride. It belongs to the third generation, based on urea sulfonyl. Under the influence of the compound in the body, the formation of insulin is activated due to the effective correction of the activity of the cellular structures of the pancreas. An additional effect that enhances the effectiveness of the drug is an increase in the sensitivity of organic tissues to insulin. According to experts, taking Amaril under the supervision of a qualified doctor and following the instructions allows you to achieve perfect control over the patient’s blood sugar.
As can be seen from the reviews, “Amaril” (the instructions for use always accompany the product) are on sale in tablet form. Capsules are packaged in blisters containing 15 tablets. One cardboard box includes two blisters. There are four options: pink, green tablets (the first type contains the active compound in an amount of 1 mg, the second contains twice the volume), pale yellow three-milligram and blue. In the latter, the concentration is maximum - 4 mg. In addition to the main component, specific additional components were used. A complete list of connections is listed in the instructions.
How it works?
The mechanism of the effect of the drug on the human body is indicated in the Amarila instructions (1 mg, 2 mg, 3 mg, 4 mg). The main compound, called glimepiride, belongs to the effective third-generation drug compounds and provokes an increased activity of the pancreatic cell structures. Under the influence of the compound, cells carrying secretion functions actively produce insulin. At the same time, glimepiride has an effect on muscle fibers, fatty structures, increasing susceptibility to the hormone.
The first effect described is called pancreatic. As indicated in the Amarila instructions (2 mg and other dosages), this result is moderate when taking the drug, which means that there is no risk of hypoglycemia with an adequate dosage of the drug. Glimepiride reduces insulin resistance, the concentration of atherogenic lipoprotein fractions in the circulatory system is reduced. Blood becomes less viscous, oxidative stress is less pronounced.
Technical points
The Amarila Instruction (4 mg and other dosage forms) will contain reference to the absolute bioavailability of the active compound. If you use the drug in the volumes recommended by the doctor and manufacturer, no cumulative effect is observed. Glimepiride in the circulatory system in maximum concentration is observed after 2.5 hours from the moment the medication is ingested. In the blood serum, the parameters of the compound are stable and are not determined by the frequency of meals. The elimination half-life is up to eight hours.
The instruction of Amaril tablets mentions the possibility of penetration of the agent through the placental barrier. Studies have shown that the active substance passes into breast milk. Using the drug during the gestation period is strongly not recommended. If conception is detected, therapy should be discontinued.
Is it possible or not?
As follows from the instructions, the drug "Amaril" must be used if the second type of diabetic disease is established. You can use the tool as the only drug method for correcting the patient's condition. It is allowed to combine the name with insulin, metformin.
It is not allowed to use the tool if a diabetic disease of the first type is detected, coma or precoma associated with diabetes. Amaryl is not suitable for the treatment of patients with ketoacidosis, as well as for those with severe functional hepatic, renal impairment. It is not allowed to use the name during the period of gestation, breastfeeding. Do not use the medication with hypersensitivity to any component used in the manufacturing process. This applies not only to individuals whose susceptibility has been identified at the moment, but also if there is a mention of it in the medical history.
Accuracy will not hurt
As indicated in the instructions for use, Amaril (2 mg and other dosage forms) can be used in some special conditions of the patient only under strict medical supervision of vital signs of the body. These include burns, planned surgical intervention, intestinal obstruction, various types of intestinal adsorption. This also includes a variety of serious injuries. If it is necessary to transfer the patient to insulin therapy, this is done only if possible, to take laboratory indicators, to monitor the patient's condition while taking the tablets.
How to use?
For Amaril, the instructions for use (3 mg and other forms of release) indicate two formats of use - as the only means for correcting the patient’s condition and as an element of complex therapy. In any of the options, the duration of the course, the amount of funds used, and the form of release are chosen by the doctor based on information obtained from laboratory tests, instrumental studies of the patient's condition. It is not allowed to use Amaril at its sole discretion, to correct the program prescribed by the doctor.
As the only medication, Amaril is prescribed first in a minimal format - no more than a milligram per day. Over time, an increase in concentration is allowed, but not more than a milligram in two weeks. The instructions for the use of Amaril tablets contain an indication of the limitation of the daily dose to not more than 6 mg. Each capsule should be taken orally, without violating the integrity of the instance, drink plenty of water. Amaryl is used once a day, either before breakfast, or during the first meal of the day. To prevent hypoglycemia, it is necessary to eat food after Amarila is ingested.
Combine for your own benefit
Instructions for use "Amaril" contains indications of the rules of use in combination with other medicinal names. It is possible to use the drug if the patient is undergoing treatment with metformin. While maintaining the dosage of this agent, Amaril acts as an additional component of therapy. Initially, the name in question is prescribed in the amount of 1 mg per day, gradually increasing concentration over time, until a stable hypoglycemic result can be achieved.
For a day, the manufacturer in the instructions for use of Amaril recommends prescribing no more than 6 mg of the active substance. Glimepiride and insulin therapy can reduce the need for a second name by 40% (sometimes less).
Unpleasant consequences: what to prepare for?
As can be seen from the reviews, instructions, Amaril can cause negative side effects. There is nothing surprising in this - they are characteristic of a wide variety of drugs designed to reduce the level of sugar in the circulatory system. Amaryl can cause hypoglycemia. As a rule, the patient at the same time feels weak, sleepy, headache, hunger, nausea is possible. It is known that when using "Amaril" there is a possibility of upset stool, activity of the stomach, intestinal tract. With prolonged therapy, there is a risk of negative changes in the circulatory system. There is a risk of anemia, thrombocytopenia. Possible allergic response, increased sensitivity to light.
Reviews, instructions "Amarila" mention a certain probability of sleep disturbances. Official studies have shown that the chances of such a side effect are categorically small, however, they are greater than zero. Also, with an extremely low degree of probability, disturbing, restless states are possible. Some patients feel dizzy, tremor develops, sensitivity malfunctions are observed, problems with coordination of movement are possible. In isolated cases, violations of the rhythm of the heartbeat, convulsions, confusion were recorded. When adjusting the glucose concentration in the blood, there is a possibility of visual acuity disorders, but such changes are completely reversible.
Rules of use: it is important to follow
The Amarila instruction provides guidance on some special cases. In particular, if an excessively large amount of the active ingredient enters the body, there is a risk of hypoglycemia. To eliminate the negative consequences, the introduction of glucose is required. The event must be carried out strictly under the supervision of a doctor, but as soon as possible.
Use according to the instructions “Amaryl” can be used in combination with some other medicinal names, but it is important to take into account the mutual influence of the components. The hypoglycemic effectiveness of oral administration is activated if the patient uses insulin, takes anabolics, steroids, metformin, androgen compounds, allopurinol, coumarin, as well as derivatives of this substance. With great accuracy, Amaril is prescribed to persons who are forced to undergo therapy with chloramphenicol, antidepressants from the group that prevent the capture of MAO, miconazole. The effect of taking Amaril may increase unpredictably when quinolones, tetracycline, and pentoxifylline are ingested. Particular restrictions are imposed by the use of salicillates, certain names from the category of sulfonamides.
What else to look for?
The Amarila instruction indicates that with a certain combination with other drug names there is a risk of a decrease in the hypoglycemic effect. This is possible with the use of barbiturates and certain types of diuretics, as well as stopping the inflammatory processes of corticosteroids. "Amaril" works weaker if the patient takes laxative, female sex hormones and thyroid hormones. A decrease in hypoglycemic effectiveness is observed in combination with nicotinic acid, sympathomimetics, and rifampicin.
The Amarila instruction draws attention to a decrease in the effectiveness of a medication if the patient eats irregularly, inadequately, and abuses alcohol. The effectiveness of the intake is lower if the diet is saturated with carbohydrates. In some cases, it is necessary to adjust the maximum dosage of the drug, focusing on the patient's body weight. The doctor selects the best option using special calculation formulas.
Long and intense
A long course of taking Amaril is possible only under conditions of constant monitoring of the concentration of glucose in the circulatory system. In addition, it is necessary to check the functionality of the liver and kidneys, to monitor the uniform blood elements.
If an overdose is observed, there is a risk of a decrease in concentration. This is especially important if the patient in everyday life drives or encounters other situations that require utmost care and a high reaction rate.
Appearances, passwords
Amaril is presented at pharmacy shelves at prices ranging from 250 to 1000 rubles. Small adjustments are possible, a lot depends on the pricing policy of a particular outlet. The most affordable options are a milligram dosage, and the most expensive ones are 4 mg. Packages containing capsules with 2 mg of the active compound cost about 500 rubles, and 3 mg - about 770 rubles.
If it is not possible to receive the selected product, Amarila analogues may come to the rescue. The instructions for use when choosing an alternative agent will have to be observed very accurately, and the replacement itself should only be done in agreement with the treating doctor, otherwise there is a risk of a negative response from the body, and the therapy is not sufficiently effective. Of the analogues, the names Oltar, Diabresid, and Glemaz are widely distributed. Sometimes doctors recommend staying with one of the following remedies:
- Glibetic;
- Maninil;
- Panmicron.
More about analogues: Glimepiride
Under this name, a medication based on the corresponding active compound is on sale. There are five formats: 1, 2, 3, 4, 6 mg. In addition to the main substance, auxiliary components were used. It is especially important to familiarize yourself with the complete list if the patient suffers from intolerance to lactose, cellulose, or other compounds used in the pharmaceutical industry. All Glimepiride tablets contain dyes that provide individual color differences. The smallest dosage is painted in red iron oxide, for two milligrams yellow iron oxide or aluminum varnish is used. 3 mg are decorated with yellow iron oxide, 4 mg with indigo carmine.
Capsules are packaged in aluminum and polyvinyl chloride blisters. One cardboard box contains one blister. Each individual instance is a flat cylindrical tablet equipped with a notch, marks.
When to use?
Glimepiride is intended for the treatment of persons with diabetes in a form independent of insulin, that is, the second type. Under the influence of the active compound, the cellular activity of the pancreas is corrected, insulin is released by beta-structures. The drug, like others belonging to the same group, is able to block the potassium channel, dependent on ATP, in the membranes of the pancreas. This process provokes beta-cell depolarization, stimulates the opening of calcium channels, against which insulin is released. A distinctive feature of this appellation is the fast entry into strong bonds with membrane proteins, although the bond is realized through other channels. This distinguishes Glimepiride from other agents from the sulfonylurea class.
Reception of "Glimepiride" does not provoke blocking of cardiac myocytic channels of ATP, dependent on potassium. Under the influence of the compound, the susceptibility of muscle fibers, adipose tissues to insulin is activated. Hepatic cells utilize the hormone with less activity. Glimepiride is able to activate the activity of certain enzyme structures, which leads to an increase in glyco-, hypogenesis. The level of actual exposure is determined by the selected dosage of the drug. Acute physical activity in combination with the use of the drug is accompanied by a decrease in insulin production (as in the absence of specific support). The medication has antioxidant properties, reduces blood viscosity, has an antiatherogenic effect.
Features of use
"Glimepiride", as shown by clinical studies, is adsorbed from the gastrointestinal tract to an equal extent with and without a meal. The bioavailability is almost absolute, estimated as very close to one hundred percent. To achieve the highest level of concentration in the circulatory system, about 150 minutes are needed. The clearance of the drug is quite slow, and the binding to plasma proteins is increased. Rough estimates give an indicator of 95%. "Glimepiride" is able to penetrate the placenta, observed in breast milk, which became the basis for the ban on such therapy during pregnancy. A low percentage of the active compound is able to cross the blood-brain barrier.
The half-life is at least five hours, but no more than eight with the adequate functioning of body systems and tissues. Large time intervals are required if the patient is prescribed high doses of the drug. It is known that glimepiride is transformed in the liver cells, and the CYP2C9 enzyme takes part in the reaction. A little more than half of the metabolites leave the body through the urinary system, about a third - with feces. There is no cumulative effect. Pharmacokinetics is very slightly related to gender, age of the patient.
Indications and contraindications
"Glimepiride" is used if the second type of diabetes mellitus is established, that is, independent of insulin. They resort to the drug only if it is impossible to correct the patient's condition with gentle methods - weight loss, physical activity, normalization of diet.
“Glimepiride” cannot be taken if ketoacidosis is diagnosed, diabetes has caused precoma, coma, failure of the liver and kidneys in severe form has been identified. Glimepiride is not intended for the treatment of patients suffering from the first type of diabetes mellitus, as well as women bearing a fetus or breastfeeding. The tool is not used in identifying the allergic response of the body to any of the components used in the manufacture of Glimepiride.