Amaryl M SR (2/500mg) 30 Tablets

Metformin is a medication used to help manage blood sugar levels in people with diabetes. It works in several ways to lower blood sugar. First, it reduces the amount of glucose the liver produces. Second, it slightly slows down how quickly glucose is absorbed from the intestines after eating. Finally, it helps the body use insulin more effectively, allowing cells to take in and use glucose better. By affecting these processes, metformin helps keep blood sugar levels in check both before and after meals. Glimepiride is an oral medication used to treat type 2 diabetes. Glimepiride works by stimulating the pancreas to release more insulin. It does this by binding to sulfonylurea receptors (SUR1) on the surface of pancreatic beta cells. This binding triggers the closure of potassium channels in these cells, leading to the opening of calcium channels. The influx of calcium into the cells promotes the release of insulin into the bloodstream. The increased insulin helps lower blood sugar levels by allowing glucose to enter cells, where it is used for energy.

Biguanide, Sulfonylurea

This tablet is used to control:

• Type 2 Diabetes
• Blood Glucose
• Insulin Production
• Long-term Glycemic Control

Amaryl M SR (2/500mg) Dosage Recommendations are:

• Type 2 diabetes management - Take 1 tablet daily with the evening meal. The starting dose of Metformin is 500 mg once daily, which can be gradually increased up to 2000 mg daily. The starting dose of Glimepiride is 1-2 mg once daily, which can be increased up to a maximum of 8 mg daily, based on blood glucose levels and individual patient needs.

Seek immediate medical attention. Overdose may cause severe hypoglycemia. Symptoms may include dizziness, sweating, confusion, and loss of consciousness. Treatment may involve glucose administration and supportive care.

Take the missed dose as soon as you remember. If it is close to the time of the next dose, skip the missed dose. Do not take double doses.

Take tablet daily with food to minimize gastrointestinal side effects and improve absorption.

The combination of metformin and glimepiride should not be taken in the following situations:

• Hypersensitivity to either medication or any of the product's ingredients
• Severe renal impairment or hepatic disease
• Diabetic ketoacidosis or type 1 diabetes

Unraveling the side effects lurking behind this product are the following:

• Hypoglycemia
• Nausea
• Diarrhea
• Stomach upset
• Weight gain

For Glimepiride, avoid use during lactation. Adjust dosage if risk factors for hypoglycemia are present and monitor closely for severe hypoglycemia. Temporary use of insulin may be required in exceptional stress situations such as trauma, surgery, or infection with fever. Regularly check blood and urine glucose levels as well as glycated hemoglobin (HbA1c) levels. Be cautious as this medication may impair the ability to drive or operate machinery. For Metformin, there is an increased risk of lactic acidosis in patients with hepatic impairment, renal dysfunction, hypoxemia, dehydration, sepsis, or excessive alcohol intake. Discontinue Metformin immediately if lactic acidosis occurs or if hypoxic states develop. Stop Metformin at least 2 days before any x-ray exams involving iodinated contrast material and restart no earlier than 48 hours after. Discontinue treatment 48 hours before elective surgery involving general, spinal, or epidural anesthesia and resume no sooner than 48 hours after. Regularly monitor fasting blood glucose and glycosylated hemoglobin levels. Be cautious with concomitant therapies that may affect renal function or interact with Metformin’s disposition such as cationic drugs. Avoid excessive alcohol intake whether acute or chronic as it may increase the risk of adverse effects. When used in combination with sulfonylureas or alcohol, monitor closely for potential interactions. Annually measure vitamin B12, folic acid, and iron levels during long-term treatment to check for deficiencies. Avoid use in patients with hepatic diseases.

Drug interactions with metformin and glimepiride include:

• Insulin (may increase risk of hypoglycemia)
• Diuretics (e.g., furosemide) (may increase risk of hypoglycemia or dehydration)
• Beta-blockers (e.g., propranolol) (may mask symptoms of hypoglycemia)
• CYP2C9 inhibitors (e.g., fluconazole) (may increase glimepiride levels)
• CYP2C9 inducers (e.g., rifampin) (may decrease glimepiride levels)
• NSAIDs (e.g., ibuprofen) (may increase risk of renal impairment)
• Alcohol (may enhance hypoglycemic effects)
• Metformin and glimepiride generally have minimal interaction with other medications, but individual patient scenarios should always be reviewed for potential interactions.

Store at room temperature in a tightly closed container. Dispose of unused or expired medication by returning it to a pharmacy for safe disposal.