Amaramet

Adjunct to diet & exercise in non-insulin dependent type 2 DM sufficiently controlled by sulfonylureas or metformin therapy alone or at max tolerated dose.

Individualized dosage based on blood glucose levels. Administer once daily. Max daily recommended dose: glimepiride 8 mg + metformin 2,000 mg.

Should be taken with food: Take before or w/ breakfast or 1st main meal. Do not crush/chew. Swallow whole.

Hypersensitivity to glimepiride, metformin, sulfonylureas, sulfonamides or biguanide. Insulin dependent (type 1) diabetes (eg, diabetics w/ history of ketonemia), diabetic ketonemia, diabetic coma or precoma. Patients w/ severe hepatic dysfunction or hemodialysis.

Increased risk of CV mortality. Lactic acidosis may occur due to metformin accumulation. Avoid in patients w/ clinical or lab evidence of hepatic disease. Caution against excessive alcohol intake (acute or chronic). Alertness & reactions may be impaired; may affect ability to drive or operate machinery. Should not be taken by pregnant or lactating women. Safety & effectiveness in ped have not been established. Care should be taken in elderly (more likely to have decreased renal function).

Nausea, vomiting, diarrhea, abdominal pain, anorexia; taste disturbance or metallic taste; transient vision disorder; allergic or pseudo-allergic reactions (eg, itching, urticaria or rashes); changes in blood picture; leukopenia, hemolytic anemia; aplastic anemia & pancytopenia.

Glimepiride: Metabolism is influenced w/ CYP2C9 inducers (eg, rifampicin) or inhibitors (eg, fluconazole). Potentiated blood glucose-lowering effect w/ insulin & oral antidiabetic products, ACE inhibitors, allopurinol, anabolic steroids, male sex hormones, chloramphenicol, coumarin anticoagulants, cyclophosphamide, disopyramide, fenfluramine, fenyramidol, fibrates, fluoxetine, guanethidine, ifosfamide, MAOIs, miconazole, fluconazole, para-aminosalicylic acid, pentoxifylline (high-dose parenteral), phenylbutazone, probenecid, quinolone antibiotics, salicylates, sulfinpyrazone, clarithromycin, sulfonamide, tetracyclines, tritoqualine, trofosfamide, sympathetic inhibitor. Weakened blood glucose-lowering effect w/ acetazolamide, barbiturates, corticosteroids, diazoxide, diuretics, epinephrine (adrenaline) or sympathomimetics, glucagons, laxatives (long-term use), nicotinic acid (high dose), estrogens, progestogens, phenothiazines, phenytoin, rifampicin, thyroid hormones. Potentiated or weakened blood glucose-lowering effect w/ H₂-antagonists, clonidine, reserpine. Reduced glucose tolerance w/ β-blockers. Reduces or blocks signs of adrenergic counter regulation to hypoglycemia w/ sympatholytic drugs (eg, β-blockers), clonidine, guanethidine, reserpine. Acute & chronic alcohol intake may potentiate or weaken blood glucose-lowering action of glimepiride. Potentiates or weakens effects of coumarin derivatives. Metformin HCl: Lactic acidosis may occur w/ iodinated contrast materials; antibiotic having strong nephrotoxicity (gentamicin). Potentiated effect w/ insulin, sulfonamides, sulfonylureas products, α-glucosidase inhibitor (alkalosis), anabolic steroids, guanethidine, salicylates (aspirin), β-blockers (propranolol), MAOIs, angiotensin-reversion enzyme inhibitor. Weakened effect w/ epinephrine, sympathomimetics, corticosteroids, thyroid hormones, estrogens, OCs, thiazide & other diuretics, pyrazinamide, INH, nicotinic acid, phenothiazines, phenytoin, Ca channel blockers, β₂-agonists (eg, salbutamol, formoterol).

Antidiabetic Agents

A10BD02 - metformin and sulfonylureas ; Belongs to the class of combinations of oral blood glucose lowering drugs. Used in the treatment of diabetes.

Rx