Amaramet Drug Interactions

Glimepiride: When other drugs are concomitantly administered or withdrawn from a patient receiving glimepiride, both undesired increases and decreases in the hypoglycemic action of glimepiride can occur. Based on experience with glimepiride and with other sulfonylureas, the following interactions must be considered: Glimepiride is metabolized by cytochrome P-450 2C9 (CYP2C9). Its metabolism is known to be influenced by concomitant administration of CYP2C9 inducers (e.g., rifampicin) or inhibitors (e.g., fluconazole).
Drugs Potentiating the Blood Glucose-Lowering Effect: Insulin and oral antidiabetic products, angiotensin-converting enzyme 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.
Drugs Weakening the Blood Glucose-Lowering Effect: 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.
Drugs Potentiating or Weakening the Blood Glucose-Lowering Effect: H2-antagonists, clonidine, reserpine.
Beta-blockers reduce glucose tolerance. Reduction of glucose tolerance may change metabolic control. Beta-blockers may increase the risk of hypoglycemia (due to failure of counter-regulation).
Drugs Reducing or Blocking the Signs of Adrenergic Counter-Regulation to Hypoglycemia: Sympatholytic drugs (e.g., β-blockers), clonidine, guanethidine, reserpine.
Both acute and chronic alcohol intake may potentiate or weaken the blood glucose-lowering action of glimepiride in an unpredictable fashion.
Glimepiride may either potentiate or weaken the effects of coumarin derivatives.
Metformin HCl: Lactic acidosis may occur by concomitant administration of the following drugs. When these drugs are administered concomitantly, patients should be closely monitored: Iodinated contrast materials, antibiotic having strong nephrotoxicity (gentamicin).
The hypoglycemic action of co-administration with the following drugs may be potentiated or weakened. When these drugs are administered, the blood glucose level and patient should be observed closely.
Drugs Potentiating the Effect: Insulin, sulfonamides and sulfonylureas products, α-glucosidase inhibitor (alkalosis), anabolic steroids, guanethidine, salicylates (aspirin), β-blockers (propranolol), MAOIs, angiotensin-reversion enzyme inhibitor.
Drugs Weakening the Effect: Epinephrine, sympathomimetics, corticosteroids, thyroid hormones, estrogens, oral contraceptive, thiazide and other diuretics, pyrazinamide, isoniazid, nicotinic acid, phenothiazines, phenytoin, calcium channel blockers, β2-agonists e.g., salbutamol, formoterol.