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Diabetes pills

There are several different kinds of diabetes medicines in addition to insulin. These medicines can lower blood sugar levels but they’re not the same as insulin. Some of these medicines are available in pill form. Insulin can’t be taken as a pill because acids in the stomach destroy it before it can enter the bloodstream.

Also see: Diabetes pills chart

In type 2 diabetes, the body still makes some of its own insulin, but is not able to make enough to keep up with the body’s needs or use its own insulin effectively. Diabetes pills don’t replace the body’s insulin, but they can help the body make more insulin or help it more effectively use the insulin it does make.

Most people who have type 2 diabetes take diabetes pills to help them keep their blood sugar levels closer to normal. People with type 1 diabetes don’t use diabetes pills. They need to take insulin shots because their bodies can’t make any of their own insulin.

Here are some different types of diabetes medicines, grouped by how they help the body keep blood sugar levels closer to normal.

Medicine that helps the body make more insulin

Sulfonylureas (Glimepiride, glipizide, and glyburide) and meglitinides like repaglinide (Prandin) and nateglinide (Starlix) all do similar things to improve your own insulin.

Sulfonylureas have been used since the 1950s to help people lower their blood sugar levels. Over the years, better versions of this drug have become available. One of the best drugs currently available in this class is glimepiride (Amaryl).

Here’s how these pills work: Sulfonylureas help the pancreas make more insulin. When the insulin gets into the bloodstream, blood sugar levels go down. Like people who take insulin, people who take sulfonylureas need to be careful that their blood sugar levels don’t drop too low.

Meglitinides are like sulfonylureas but act faster and don’t stay in the body as long. These pills have been around since the 1990s and are designed to help the pancreas release insulin when a person eats. There’s less of a response from these pills when a person isn’t eating, so they’re less likely to cause low blood sugar levels between meals.

Medicine that makes the body more sensitive to insulin

Biguanides can make the body more sensitive to insulin and can also reduce how much glucose the liver sends into the bloodstream. The only pill of this type that’s available in the United States is metformin, also know by its brand name Glucophage.

By itself, metformin rarely causes blood sugar levels to go too low. But if taken with another diabetes pill or with insulin, it can lead to low blood sugar levels.

Metformin can cause an upset stomach, diarrhea, and gas, so it’s important to take it with food. Many people start out at a low dose and then slowly increase the dose over time. The pace of increasing the dose depends on how quickly your stomach accepts or tolerates the next increase in dose. People with heart, lung, kidney, or liver problems or who drink alcohol daily shouldn’t take metformin. Before starting metformin, your doctor will ask you to get a blood test to check your kidney function. Upset stomach can often be reduced by using different types of metformin (extended release versions). It is also good to retry metformin with different types and dose increasing timeframes. Just because you might not have been able to tolerate metformin in the past doesn’t mean you should never restart or retry metformin. Metformin is highly effective, safe and comes at a reasonable price.

Thiazolidinediones, known as glitazones, are also designed to make the body more sensitive to insulin. The first drug in this group, Rezulin (troglitazone), was taken off the market because it caused liver failure in some patients. Studies of other drugs in this category, including Actos (pioglitazone) and Avandia (rosiglitazone), found that although they can lower blood sugar, there’s no research showing that they lower the risk for other health problems related to diabetes.

Side effects from taking Actos can include swelling, low blood sugar, weight gain, higher cholesterol levels, and a greater risk of bone fractures and heart failure. Avandia also comes with serious side effects including weight gain and an increased risk of bone fractures and heart failure.

This makes it likely that the risks of taking Actos and Avandia are greater than the benefits. We don’t recommend nor do we cover the cost of either Actos or Avandia because of the risks involved in taking these medicines.

Medicine that helps slow the digestion of carbohydrates

Alpha-glucosidase inhibitors are drugs that can slow how quickly food, especially carbohydrates, are absorbed from the stomach and small intestines. There are two of these medicines available: acarbose (Precose) and miglitol (Glyset).

These drugs don’t usually lead to low blood sugar levels. But if a person takes them along with sulfonylureas, biguanides, or insulin, there is a greater chance that blood sugar levels could fall too low.

Because these drugs slow down the digestion of carbohydrates, a person who gets a low blood sugar while taking them should use a special glucose tablet or gel to bring blood sugar levels back to normal. Precose and Glyset don’t affect the digestion of these glucose tablets or gels, so they can start working right away to raise blood sugar levels.

Three newer drugs in this category are Glucagon-like Polypeptide-1 (GLP-1), Sodium glucose like transporters 2 (SGLT2), and Dipeptidyl Peptidase IV (DPP-4) inhibitors. The types of GLP-1 available are exenatide (Byetta, Bydureon Bcise), Lixisenatide (Adlyxin), albiglutide (Tanzeum), dulaglutide (Trulicity), semaglutide (Ozempic), and liraglutide (Victoza). GLP-1 drugs are taken as a shot. The types of DPP-4 inhibitors are sitagliptin (Januvia), alogliptin (Nesina), linagliptin (Trajenta), and saxagliptin (Onglyza). The SGLT2 drugs are empagliflozin (Jardiance), dapagliflozin (Farxiga), canagliflozin (Invokana), and ertugliflozin (Steglatro). This class of medications block the reabsorption of glucose in the kidneys so you urinate out more glucose. The DPP-4 and SGLT2 drugs are taken as a pill. Some of these drugs have been studied to see the effects on your heart and circulation over longer time periods and might have some protective effects.

Clinical review by Dan Kent, RPh
Kaiser Permanente
Reviewed 01/03/2019



The following serious adverse reactions are discussed in more detail below and elsewhere in the labeling:

  • Hypoglycemia
  • Hemolytic anemia

In clinical trials, the most common adverse reactions with AMARYL were hypoglycemia, dizziness, asthenia, headache, and nausea.

Clinical Trials Experience

Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.

Approximately 2,800 patients with type 2 diabetes have been treated with AMARYL in the controlled clinical trials. In these trials, approximately 1,700 patients were treated with AMARYL for at least 1 year.

Table 1 summarizes adverse events, other than hypoglycemia, that were reported in 11 pooled placebocontrolled trials, whether or not considered to be possibly or probably related to study medication. Treatment duration ranged from 13 weeks to 12 months. Terms that are reported represent those that occurred at an incidence of ≥ 5% among AMARYL-treated patients and more commonly than in patients who received placebo.

Table 1: Eleven Pooled Placebo-Controlled Trials ranging from 13 weeks to 12 months : Adverse Events (Excluding Hypoglycemia) Occurring in ≥ 5% of AMARYL-treated Patients and at a Greater Incidence than with Placebo*

N=745 %
N=294 %
Headache 8.2 7.8
Accidental Injury† 5.8 3.4
Flu Syndrome 5.4 4.4
Nausea 5.0 3.4
Dizziness 5.0 2.4
*AMARYL doses ranged from 1-16 mg administered daily
†Insufficient information to determine whether any of the accidental injury events were associated with hypoglycemia


In a randomized, double-blind, placebo-controlled monotherapy trial of 14 weeks duration, patients already on sulfonylurea therapy underwent a 3-week washout period then were randomized to AMARYL 1 mg, 4 mg, 8 mg or placebo. Patients randomized to AMARYL 4 mg or 8 mg underwent forced-titration from an initial dose of 1 mg to these final doses, as tolerated . The overall incidence of possible hypoglycemia (defined by the presence of at least one symptom that the investigator believed might be related to hypoglycemia; a concurrent glucose measurement was not required) was 4% for AMARYL 1 mg, 17% for AMARYL 4 mg, 16% for AMARYL 8 mg and 0% for placebo. All of these events were self-treated.

In a randomized, double-blind, placebo-controlled monotherapy trial of 22 weeks duration, patients received a starting dose of either 1 mg AMARYL or placebo daily. The dose of AMARYL was titrated to a target fasting plasma glucose of 90-150 mg/dL. Final daily doses of AMARYL were 1, 2, 3, 4, 6 or 8 mg . The overall incidence of possible hypoglycemia (as defined above for the 14-week trial) for AMARYL vs. placebo was 19.7% vs. 3.2%. All of these events were selftreated.

Weight gain: AMARYL, like all sulfonylureas, can cause weight gain .

Allergic Reactions: In clinical trials, allergic reactions, such as pruritus, erythema, urticaria, and morbilliform or maculopapular eruptions, occurred in less than 1% of AMARYL-treated patients. These may resolve despite continued treatment with AMARYL. There are postmarketing reports of more serious allergic reactions (e.g., dyspnea, hypotension, shock) .

Laboratory Tests

Elevated Serum Alanine Aminotransferase (ALT): In 11 pooled placebo-controlled trials of AMARYL, 1.9% of AMARYL-treated patients and 0.8% of placebo-treated patients developed serum ALT greater than 2 times the upper limit of the reference range.

Postmarketing Experience

The following adverse reactions have been identified during post-approval use of AMARYL. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.

  • Serious hypersensitivity reactions, including anaphylaxis, angioedema, and Stevens-Johnson Syndrome
  • Hemolytic anemia in patients with and without G6PD deficiency
  • Impairment of liver function (e.g. with cholestasis and jaundice), as well as hepatitis, which may progress to liver failure.
  • Porphyria cutanea tarda, photosensitivity reactions and allergic vasculitis
  • Leukopenia, agranulocytosis, aplastic anemia, and pancytopenia
  • Thrombocytopenia (including severe cases with platelet count less than 10,000/μL) and thrombocytopenic purpura
  • Hepatic porphyria reactions and disulfiram-like reactions
  • Hyponatremia and syndrome of inappropriate antidiuretic hormone secretion (SIADH), most often in patients who are on other medications or who have medical conditions known to cause hyponatremia or increase release of antidiuretic hormone
  • Dysgeusia
  • Alopecia

Read the entire FDA prescribing information for Amaryl (Glimepiride)

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Talk to your doctor before using ethanol together with glimepiride. Alcohol may affect blood glucose levels in patients with diabetes. Both hypoglycemia (low blood sugar) and hyperglycemia (high blood sugar) may occur, depending on how much and how often you drink. What might happen: Consuming alcohol with your medicine may lead to hypoglycemia, a condition in which your blood glucose levels are too low. Symptoms of low blood sugar include pale skin, blurred vision, loss of consciousness, increased thirst, increased urination, blurred vision, fatigue, or fast, deep breathing.Your diabetic medicine may . Glimepiride and Alcohol. Alcohol can worsen the side effects of glimepiride and may cause symptoms such as flushing, headache, chest pain, nausea, vomiting, weakness, blurred vision, mental confusion, sweating, choking, difficulty breathing, and anxiety. Limit or avoid drinking alcohol while taking glimepiride. Fragmentadora de papel 20 folhas particulas beta. To begin with, you will be asked to take 1 mg-strength tablets, although the strength of your tablets may be increased over the first few weeks if needed. There are several strengths of glimepiride tablets available: 1 mg, 2 mg, 3 mg and 4 mg. There may be a negative interaction between Glimepirideand alcohol. 46 Reviews about the risks, side effects and symptoms for taking Glimepiride while drinking alcohol. . venezuela amaryl and glucotrol amaryl glimepiride 4 mg amaryl manufacturer india para que sirve amaryl m 2mg 500mg amaryl pills amaryl m2mg 500mg buy amaryl online arizona . Glimepiride (Amaryl) is an oral drug used to treat type 2 diabetes. Learn about side effects, . 1 mg, 2 mg, and 4 mg; Dosage for type 2 diabetes. Adult dosage . Drinking alcohol while taking glimepiride may affect your blood sugar levels. Alcohol kan een ‘hypo’ veroorzaken en uw lichaam herstelt hier trager van. Bij sommige mensen kan glimepiride samen met een kleine hoeveelheid alcohol een onaangenaam gevoel geven en een rood hoofd, . Afgelopen voorjaar kreeg ik 1 tablet januvia en 1 tablet glimepiride sandoz 4 mg voorgeschreven. Limit alcohol while taking this medication because it can increase your risk of developing low blood sugar. . glimepiride 4 mg tablet. color white shape oblong imprint I 4 This medicine is a white, oblong, scored, tablet imprinted with “I 4”. ‹ Back to Gallery. glimepiride 1 mg tablet. Standard dosing of glimepiride ranges from 1mg to 4 mg daily Some common side effects with glimepiride include confusion, fast heartbeat, shakiness, and anxiety, all of which are symptoms of hypoglycemia. Some less common side effects with glimepiride include dizziness, headache, nausea, and achiness. therapy. Doses of more than 4 mg of Glimepiride per day give better results only in exceptional cases. The maximum recommended dose is 6 mg Glimepiride per day. and admission into hospital. It should be ensured that there is always a pre-informed person that can call a doctor in case of emergency. If you forget to take Glimepiride Alcohol, β-blokkers, clonidine en H 2-antagonisten kunnen de hypoglykemische werking zowel versterken als verzwakken. Colesevelam bindt zich aan glimepiride, waardoor de resorptie van glimepiride wordt verminderd; adviseer om glimepiride ten minste 4 uur vóór colesevelam in te nemen. Firmware x10a america-s generic lexapro.

Glimepiride 4 Mg And Alcohol + Free Pills

Generic Name: glimepiride (glye MEP ir ide)
Brand Name: Amaryl

Medically reviewed by on May 30, 2019 – Written by Cerner Multum

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What is glimepiride?

Glimepiride is an oral diabetes medicine that is used together with diet and exercise to improve blood sugar control in adults with type 2 diabetes mellitus. glimepiride is not for treating type 1 diabetes.

Glimepiride may also be used for purposes not listed in this medication guide.

Important Information

You should not use glimepiride if you have diabetic ketoacidosis, or if you are allergic to sulfa drugs.

Before taking this medicine

You should not use glimepiride if you are allergic to it, or if you have:

  • an allergy to sulfa drugs; or

  • diabetic ketoacidosis (call your doctor for treatment).

Tell your doctor if you have ever had:

  • heart disease;

  • liver or kidney disease; or

  • an enzyme deficiency called glucose-6-phosphate dehydrogenase deficiency (G6PD).

Glimepiride may increase your risk of serious heart problems, but not treating your diabetes can also damage your heart and other organs. Talk to your doctor about the risks and benefits of glimepiride.

Follow your doctor’s instructions about using this medicine if you are pregnant. Blood sugar control is very important during pregnancy, and your dose needs may be different during each trimester.

Medications similar to glimepiride have caused severe hypoglycemia in newborn babies whose mothers used the medicine near the time of delivery. If you take glimepiride during pregnancy, stop taking this medicine at least 2 weeks before your due date.

If you breastfeed while taking glimepiride, call your doctor if your baby shows signs of hypoglycemia (extreme drowsiness, feeding problems, mottled skin, blue lips, feeling cold or jittery, or having a seizure).

Glimepiride is not approved for use by anyone younger than 18 years old.

How should I take glimepiride?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

Glimepiride is usually taken once a day with breakfast or the first main meal of the day. Follow your doctor’s instructions. Take glimepiride with a full glass of water.

Your blood sugar will need to be checked often, and you may need other blood tests at your doctor’s office.

You may have low blood sugar (hypoglycemia) and feel very hungry, dizzy, irritable, confused, anxious, or shaky. To quickly treat hypoglycemia, eat or drink a fast-acting source of sugar (fruit juice, hard candy, crackers, raisins, or non-diet soda).

Your doctor may prescribe a glucagon injection kit in case you have severe hypoglycemia. Be sure your family or close friends know how to give you this injection in an emergency.

Blood sugar levels can be affected by stress, illness, surgery, exercise, alcohol use, or skipping meals. Ask your doctor before changing your dose or medication schedule.

Glimepiride is only part of a treatment program that may also include diet, exercise, weight control, blood sugar testing, and special medical care. Follow your doctor’s instructions very closely.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. A glimepiride overdose can cause life-threatening hypoglycemia.

Symptoms of severe hypoglycemia include extreme weakness, confusion, tremors, sweating, fast heart rate, trouble speaking, nausea, vomiting, rapid breathing, fainting, and seizure (convulsions).

What should I avoid while taking glimepiride?

Avoid drinking alcohol. It lowers blood sugar and may interfere with your diabetes treatment.

Avoid exposure to sunlight or tanning beds. Glimepiride can make you sunburn more easily. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.

Glimepiride side effects

Get emergency medical help if you have signs of an allergic reaction (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling).

Call your doctor at once if you have:

  • pale or yellowed skin, dark colored urine;

  • confusion, weakness; or

  • fever.

Common side effects may include:

  • headache;

  • dizziness, weakness;

  • nausea; or

  • low blood sugar.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Glimepiride dosing information

Usual Adult Dose for Diabetes Type 2:

Initial dose: 1 to 2 mg orally once a day
Maintenance dose: Increase in 1 or 2 mg increments no more frequently than every 1 to 2 weeks based on glycemic response
Maximum dose: 8 mg per day

-Administer with breakfast or first main meal of the day.
-In patients who are at increased risk for hypoglycemia, start with 1 mg orally once a day and titrate slowly.
-When patients are being transferred to this drug from a longer half-life sulfonylurea, monitor 1 to 2 weeks for overlapping drug effect.
Use: As an adjunct to diet and exercise to improve glycemic control in patients with type 2 diabetes mellitus.

Usual Geriatric Dose for Diabetes Type 2:

Initial dose: 1 mg orally once a day; titrate slowly and monitor closely

Usual Pediatric Dose for Diabetes Type 2:

Not recommended because of adverse effects on body weight and hypoglycemia.

What other drugs will affect glimepiride?

Glimepiride may not work as well when you use other medicines at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective.

If you also take colesevelam, take your glimepiride dose at least 4 hours before you take colesevelam.

Other drugs may affect glimepiride, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Copyright 1996-2018 Cerner Multum, Inc. Version: 11.01.

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More about glimepiride

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  • Drug class: sulfonylureas

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Other brands: Amaryl

Professional resources

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Related treatment guides

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