Amaryl (glimepiride)

Amaryl generic

Amaryl is a brand-name drug that contains the active drug glimepiride. This active drug is also available as a generic medication. A generic drug is an exact copy of the active drug in a brand-name medication.

The generic is considered to be as safe and effective as the original drug. Generics tend to cost less than brand-name drugs.

If you’re interested in taking the generic form of Amaryl, talk with your doctor. They can tell you if it comes in forms and strengths to treat your condition.

Amaryl dosage

Typically, your doctor will start you on a low dosage. Then they’ll adjust it over time to reach the amount that’s right for you. Your doctor will ultimately prescribe the smallest dosage that provides the desired effect.

The following information describes dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Drug forms and strengths: 1 mg, 2 mg, 4 mg

Amaryl comes as an oral tablet. The drug is available in three strengths: 1 milligram (mg), 2 mg, and 4 mg.

Dosage for type 2 diabetes

The typical starting dose of Amaryl is 1 mg or 2 mg. You’ll take Amaryl once daily with your first substantial meal of the day.

After starting Amaryl treatment, you should closely monitor your blood sugar level. Your doctor can explain how to check and track it. If your level remains high after about 1 to 2 weeks, your doctor will likely increase your dose.

Your doctor may continue to increase your dose every 1 to 2 weeks until they find the dose that works for you. The maximum dose of Amaryl is 8 mg.

While taking Amaryl, continue to check your blood sugar level regularly to make sure it’s within your goal range. Your doctor will also order blood tests to monitor how well the drug is working. The tests will check your A1C to measure your average blood sugar level over the last 2 to 3 months. If you have questions about your blood sugar or A1C goals, talk with your doctor.

Your doctor may prescribe a different dose of Amaryl depending on several factors. These include:

• your age
• other medications you may take
• other medical conditions you may have
• how well your kidneys are working
• the severity of your type 2 diabetes (the condition Amaryl is used to treat)

Talk with your doctor if you have questions about the dosage of Amaryl that’s right for you. You can also refer to this article for more details about Amaryl’s dosage.

What if I miss a dose?

The manufacturer of Amaryl hasn’t provided any information regarding missed doses. Ask your doctor or pharmacist what to do if you miss taking a dose of the medication.

To help make sure you don’t miss a dose, try using a medication reminder. This can include setting an alarm or using a timer. You could also download a reminder app on your phone.

Will I need to take this drug long term?

Amaryl is typically used as a long-term treatment. If you and your doctor determine that Amaryl is safe and effective for you, you’ll likely take it long term.

Amaryl side effects

Amaryl can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking this drug. These lists do not include all possible side effects.

For more information about the possible side effects of Amaryl, talk with your doctor or pharmacist. They can give you tips on how to manage any side effects that may be concerning or bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you would like to notify the FDA about a side effect you’ve had with Amaryl, you can do so through MedWatch.

Mild side effects

Mild side effects* of Amaryl can include:

• headache
• nausea
• dizziness
• weakness
• flu-like symptoms, such as body aches
• weight gain*

Most of these side effects may go away within a few days to a couple of weeks. But if they become more severe or don’t go away, talk with your doctor or pharmacist.

* This is a partial list of mild side effects from Amaryl. To learn about other mild side effects, see this article. You can also talk with your doctor or pharmacist, or view Amaryl’s prescribing information.

Serious side effects

Serious side effects from Amaryl aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include:

• Increased level of alanine aminotransferase (a type of liver enzyme), which doesn’t always cause symptoms. However, in severe cases, it can be a sign of liver damage.
• Low blood sugar.*
• Allergic reaction.*

* For more information about this side effect, see “Side effect details” below.

Side effect details

Here’s some detail on certain side effects this drug may cause. For details about how often these side effects occurred in clinical trials, see Amaryl’s prescribing information.

In addition to the information below, you can also refer to this article about Amaryl’s side effects.

Low blood sugar

Hypoglycemia (low blood sugar) is a common side effect of Amaryl. The drug is prescribed to lower blood sugar levels in adults with type 2 diabetes. But sometimes Amaryl may cause your blood sugar level to drop too low.

According to the American Diabetes Association (ADA), hypoglycemia is when your blood sugar drops to 70 milligrams/deciliter (mg/dL) or below.

Before you start Amaryl treatment, your doctor will talk with you about what to do when you first notice symptoms of low blood sugar. The first symptoms of hypoglycemia may include feeling anxious, dizzy, shaky, sweaty, or clammy.

Treating low blood sugar

The ADA recommends the “15–15” rule for managing hypoglycemia. This involves having a 15-gram (g) serving of carbohydrates, then checking your blood sugar level after 15 minutes. If your level is still lower than 70 mg/dL, have another serving of carbohydrates. You should repeat this process until your blood sugar level returns to normal.

Examples of a 15-g serving of carbohydrates are 4 ounces of fruit juice and non-diet soda. Another example is 1 tablespoon of honey or sugar. You can also eat glucose tablets or hard candies. However, check the product label to see how many you’ll need to consume for 15 g. Keep in mind that a diet soda or a diet or sugar-free candy will not treat hypoglycemia.

Very low blood sugar explained

If your blood sugar level continues to decrease, severe hypoglycemia (very low blood sugar) can occur. This is a medical emergency and may become life threatening. If you develop any of the following symptoms, you or a caregiver should seek emergency help right away:

• blurred vision
• confusion
• slurred speech
• drowsiness
• seizures
• coma

What may increase your risk

Certain factors can increase the risk of mild or severe hypoglycemia while taking Amaryl. Some examples include:

• skipping meals or eating fewer calories than usual
• burning more calories than usual due to exercise that’s more intense or longer than usual
• drinking alcohol
• taking certain medications, such as beta-blockers, that make the early symptoms of low blood sugar less noticeable than usual
• use of insulin or other diabetes medications in combination with Amaryl
• experiencing nausea and vomiting due to an illness
• being ages 65 years or older

If any of these factors apply to you, your doctor may adjust your dose of Amaryl. Keep in mind that you should closely monitor your blood sugar levels often while you take the medication.

If you have questions about managing low blood sugar with Amaryl, talk with your doctor.

Weight gain

Weight gain is a common side effect of Amaryl. In clinical trials, weight gain was more common in people who took higher doses of the medication (4 mg or 8 mg). The weight gain was usually slight.

Keep in mind that Amaryl is meant to be used in combination with regular exercise and a balanced diet. These actions may help prevent or lessen weight gain. If you have questions about managing your weight while taking Amaryl, talk with your doctor.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Amaryl.

Symptoms of a mild allergic reaction can include:

• skin rash
• itchiness
• flushing

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

• swelling under your skin, typically in your eyelids, lips, hands, or feet
• swelling of your tongue, mouth, or throat
• trouble breathing

Call your doctor right away if you have an allergic reaction to Amaryl, as the reaction could become severe. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Amaryl uses

The Food and Drug Administration (FDA) approves prescription drugs such as Amaryl to treat certain conditions.

Amaryl for type 2 diabetes

Amaryl is FDA-approved to lower blood sugar levels in adults with type 2 diabetes. It’s used in combination with regular exercise and a balanced diet.

There are certain limitations to Amaryl’s use. People with type 1 diabetes should not take this drug. Also, Amaryl should not be used to treat diabetic ketoacidosis, a serious complication of diabetes. Because of how the drug works, it would not be helpful for these conditions.

Type 2 diabetes explained

With type 2 diabetes, your blood sugar level becomes too high. This occurs because your body doesn’t respond properly to insulin, a hormone that the pancreas releases. Insulin usually tells your body to move sugar out of your blood and into your cells. Once the sugar is inside the cells, your body can use it to make energy. But if your body becomes resistant (doesn’t respond) to insulin, too much sugar stays in your blood.

This can lead to symptoms of diabetes, such as low energy levels, increased thirst, and urinating frequently. If diabetes isn’t well managed, high blood sugar often leads to long-term complications. Examples include nerve damage, kidney disease, and heart problems such as heart attack.

Fortunately, there are many diabetes medications available. Along with regular exercise and a balanced diet, effectively managing your blood sugar level can help reduce the risk of complications.

To learn more about managing diabetes, check out our diabetes hub.

Effectiveness for type 2 diabetes

Clinical trials have shown that Amaryl is effective for lowering blood sugar levels in adults with type 2 diabetes. For more information about how the drug performed in these trials, see Amaryl’s prescribing information.

Doctors don’t usually recommend Amaryl as a first-choice treatment option for adults with type 2 diabetes. This is because other treatments, such as metformin (Fortamet, Glumetza, Riomet), are generally considered safer than Amaryl. Metformin isn’t likely to cause severe hypoglycemia (very low blood sugar), which is a risk that comes with taking sulfonylureas. This is the drug class that Amaryl belongs to.

The American Diabetes Association’s treatment guidelines recommend sulfonylureas as a treatment option for people who can’t take metformin.

Doctors may prescribe sulfonylureas as an additional treatment when metformin or other diabetes medications don’t help enough.

If you’re interested in finding out if Amaryl is a suitable treatment option for you, talk with your doctor.

Amaryl and children

Amaryl is approved for use only in adults with type 2 diabetes.

Amaryl was studied in children with type 2 diabetes. However, the drug caused low blood sugar and weight gain that were too extreme. Therefore, Amaryl is not recommended for use in children.

Amaryl use with other drugs

Amaryl can be used alone or in combination with other diabetes medications. If one diabetes drug doesn’t lower your blood sugar enough, your doctor may prescribe additional treatments.

Some examples of other diabetes drugs that may be used with Amaryl include:

• metformin (Fortamet, Glumetza, Riomet)
• pioglitazone (Actos)
• sitagliptin (Januvia)
• saxagliptin (Onglyza)
• empagliflozin (Jardiance)
• dulaglutide (Trulicity)
• semaglutide (Ozempic, Rybelsus)
• insulins, such as insulin glargine (Lantus, Basaglar)

How Amaryl works

With type 2 diabetes, your blood sugar level becomes too high. This occurs because your body doesn’t respond properly to insulin, a hormone that the pancreas releases. Insulin usually tells your body to move sugar out of your blood and into your cells. Once the sugar is inside the cells, your body can use it to make energy. But if your body becomes resistant (doesn’t respond) to insulin, too much sugar stays in your blood.

Amaryl’s mechanism of action is to help your pancreas release more insulin than usual. (A drug’s mechanism of action is the way it works in the body.) Amaryl helps increase the level of insulin in your blood, which decreases your blood sugar level.

How long does it take to work?

Amaryl should lower your blood sugar within 2 to 3 hours after you take your dose. Its effects can last up to 24 hours.

It may take 2 weeks of treatment with Amaryl for you and your doctor to determine if your dosage is working well. After starting Amaryl treatment, you should closely monitor your blood sugar level. Your doctor can explain how to check and track your blood sugar. If your blood sugar level remains high after about 1 to 2 weeks, your doctor will likely increase your dose.

Amaryl’s half-life is about 5 to 8 hours on average. A medication’s half-life is different from its duration of action (how long the drug works in your body). Amaryl works in your body for up to 24 hours. The half-life of a drug is the amount of time it takes your body to remove half of the drug from your system.

Your doctor can help answer any questions about Amaryl’s half-life or duration of action.

Amaryl cost

As with all medications, the cost of Amaryl can vary. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Keep in mind that you may be able to get a 90-day supply of Amaryl. If approved by your insurance company, getting a 90-day supply of the drug could reduce your number of trips to the pharmacy and help lower the cost. If you’re interested in this option, check with your doctor, pharmacist, or insurance company.

Before approving coverage for Amaryl, your insurance company may require you to get prior authorization. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the prior authorization request and decide if the drug will be covered.

If you’re not sure if you’ll need prior authorization for Amaryl, contact your insurance company.

Financial assistance

If you need financial support to pay for Amaryl, help is available.

You can search Medicine Assistance Tool and NeedyMeds to find programs that may help decrease Amaryl’s cost. To learn more, visit their websites.

To learn more about saving money on prescriptions, check out this article.

Mail-order pharmacies

Amaryl may be available through a mail-order pharmacy. Using this service may help lower the drug’s cost and allow you to get your medication without leaving home.

If recommended by your doctor, you may be able to receive a 90-day supply of Amaryl, so there’s less concern about running out of the medication. If you’re interested in this option, check with your doctor, pharmacist, or insurance company. Some Medicare plans may help cover the cost of mail-order medications.

If you don’t have insurance, you can ask your doctor or pharmacist about online pharmacy options.

Generic version

Amaryl is available in a generic form called glimepiride. A generic drug is an exact copy of the active drug in a brand-name medication. The generic is considered to be as safe and effective as the original drug. And generics tend to cost less than brand-name drugs.

If your doctor has prescribed glimepiride and you’re interested in taking Amaryl instead, talk with your doctor. They may have a preference for one version or the other. You’ll also need to check your insurance plan, as it may only cover one or the other.

Amaryl interactions

Amaryl can interact with several types of medications.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe.

Amaryl and other medications

Before taking Amaryl, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

The lists below include the types of medications that could interact with Amaryl. These lists do not contain all drugs that may interact with Amaryl.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Amaryl and drugs that may increase the risk of low blood sugar

Some drugs can increase the risk of hypoglycemia (low blood sugar) or make this side effect worse when taken with Amaryl. If you take any of these medications, it’s important to monitor your blood sugar level very closely. Your doctor will explain how to recognize the first symptoms of low blood sugar and ways to quickly correct it. Examples of these medications include:

• angiotensin converting enzyme (ACE) inhibitors, such as lisinopril (Prinivil, Zestril)
• insulins, such as insulin glargine (Lantus, Basaglar)
• other oral diabetes medications, such as pioglitazone (Actos)
• H2 blockers, such as famotidine (Pepcid)
• certain antibiotics, such as clarithromycin (Biaxin)
• certain antifungal drugs, such as fluconazole (Diflucan) and oral miconazole
• a blood thinner called warfarin (Jantoven)
• an antidepressant called fluoxetine (Prozac)
• nonsteroidal anti-inflammatory drugs (NSAIDs), such as naproxen (Aleve) and ibuprofen (Advil)

Amaryl and drugs that may cause high blood sugar

Some medications may cause hyperglycemia (high blood sugar). If you take them with Amaryl, which lowers blood sugar levels, the combination could make your diabetes more difficult to manage. Some examples of these drugs include:

• protease inhibitors, such as ritonavir
• atypical antipsychotic drugs, such as clozapine (Clozaril) and olanzapine (Zyprexa)
• corticosteroids, such as prednisone
• thiazide diuretics, such as hydrochlorothiazide
• thyroid hormone drugs, such as levothyroxine (Synthroid)
• drugs that contain estrogens, such as certain birth control pills
• sympathomimetic drugs, such as albuterol (ProAir, Ventolin HFA) and epinephrine (Adrenaclick, Auvi-Q)

Amaryl and drugs that may hide early symptoms of low blood sugar

Taking certain medications can make the early symptoms of low blood sugar less noticeable. And hypoglycemia is a common side effect of Amaryl that may become serious if it’s not recognized and treated right away. These medications include:

• beta-blockers, such as atenolol (Tenormin) and metoprolol (Lopressor, Toprol XL)
• clonidine (Kapvay)
• reserpine

Amaryl and colesevelam

A drug called colesevelam (Welchol) is used to lower cholesterol. Taking a dose of colesevelam too close to a dose of Amaryl can make Amaryl less effective. If you use both of these medications, be sure to take your Amaryl dose at least 4 hours before your dose of colesevelam.

Amaryl and herbs and supplements

There aren’t any herbs or supplements that have been specifically reported to interact with Amaryl. However, it’s possible that some herbs may lower your blood sugar level. This could increase the risk of low blood sugar while taking Amaryl. Examples include cinnamon, bitter melon, and fenugreek. It’s important to always check with your doctor or pharmacist before taking any herbs or supplements while taking Amaryl.

Amaryl and foods

There aren’t any foods that are known to interact with Amaryl. If you have any questions about eating certain foods with Amaryl, talk with your doctor.

Amaryl and alcohol

Drinking alcohol while taking Amaryl may make it harder than usual for you to manage your blood sugar. This is because consuming alcohol may increase the risk of low blood sugar, a common side effect of Amaryl. (To learn more about low blood sugar, see the “Amaryl side effects” section above.)

Short- or long-term alcohol consumption use may also affect how well Amaryl works to lower your blood sugar.

For more information about alcohol and diabetes, talk with your doctor. You can ask them how much alcohol is safe for you to consume while taking Amaryl.

Alternatives to Amaryl

Other drugs are available that can treat type 2 diabetes. Some may be a better fit for you than others. If you’re interested in finding an alternative to Amaryl, talk with your doctor. They can tell you about other medications that may work well for you.

Note: Some of the drugs listed here are used off-label to treat these specific conditions. Off-label drug use is when a drug that’s approved by the Food and Drug Administration (FDA) is used for a purpose other than what it’s approved for.

Alternatives for type 2 diabetes

Examples of other drugs that may be used to treat type 2 diabetes include:

• glipizide (Glucotrol)
• glyburide (DiaBeta)
• chlorpropamide
• glimepiride/pioglitazone (Duetact)
• insulins, such as insulin glargine (Lantus, Basaglar)
• metformin (Fortamet, Glumetza, Riomet)
• pioglitazone (Actos)
• sitagliptin (Januvia)
• saxagliptin (Onglyza)
• dulaglutide (Trulicity)
• semaglutide (Ozempic, Rybelsus)

Amaryl precautions

Amaryl comes with two contraindications. (A contraindication is a factor or condition that could prevent your doctor from prescribing a drug due to risk of harm.) These include:

• Allergic reaction. If you’ve had an allergic reaction to Amaryl or any of its ingredients, your doctor will likely not prescribe Amaryl.
• Sulfonamide allergy. If you’ve had an allergic reaction to sulfonamides (commonly called sulfa drugs), your doctor will likely not prescribe Amaryl.

If either of these contraindications pertain to you, ask your doctor what other medications may be better options for you.

Amaryl also comes with several precautions. Before taking Amaryl, talk with your doctor about your health history. Amaryl may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

• Heart or blood vessel problems. Sometimes you may need to take a sulfonylurea drug, such as Amaryl, for a long period of time. Long-term treatment with a sulfonylurea drug may increase the risk of death due to heart or blood vessel problems. If you already have a heart or blood vessel problem, your doctor may recommend another treatment option for you.
• G6PD deficiency. If you have a genetic disorder called a G6PD deficiency, your doctor will likely not prescribe Amaryl. Taking the drug if you have the deficiency may increase your risk of hemolytic anemia. Amaryl may cause your red blood cells to break down. Be sure to tell your doctor if you have G6PD deficiency. They can also test you to check if you have the deficiency.
• Pregnancy. Treatment with Amaryl isn’t usually recommended during pregnancy. For more information, see the “Amaryl and pregnancy” section above.
• Breastfeeding. Treatment with Amaryl isn’t usually recommended while breastfeeding. For more information, see the “Amaryl and breastfeeding” section above.

Note: For more information about the potential negative effects of Amaryl, see the “Amaryl side effects” section above.

How to take Amaryl

You should take Amaryl according to the instructions your doctor gives you.

Amaryl comes as an oral tablet.

When to take

You’ll take the medication once daily with breakfast or your first substantial meal of the day.

It’s best to take Amaryl around the same time each day. However, if you don’t eat breakfast, then wait to take your dose with your first substantial meal of the day.

If you aren’t eating because you’re ill, fasting, or for another reason, you should not take your dose of Amaryl. This is because it’s meant to be taken with food.

To help make sure you don’t miss a dose, try using a medication reminder. This can include setting an alarm or using a timer. You could also download a reminder app on your phone.

Accessible labels and containers

If your prescription label is hard to read, talk with your doctor or pharmacist. Some pharmacies offer labels that have large print, braille, or a code you scan with a smartphone to convert text to speech. If your local pharmacy doesn’t have these options, your doctor or pharmacist may be able to direct you to one that does.

If you have trouble opening medication bottles, ask your pharmacist if they can put Amaryl in an easy-open container. They may also recommend tools that can make it simpler to open lids.

Taking Amaryl with food

You should take Amaryl with food. You’ll take it once daily with your first substantial meal of the day.

When you eat a meal, your blood sugar level rises. Amaryl is meant to lower your blood sugar level when taken with a substantial meal. If you take a dose without food or not enough food, your level may drop. This may result in hypoglycemia (low blood sugar).

Can Amaryl be crushed, split, or chewed?

Amaryl tablets are scored, so you may be able to split them. However, be sure to first check with your doctor or pharmacist.

The manufacturer of Amaryl hasn’t provided information about whether the tablets can be crushed or chewed. If you have trouble swallowing Amaryl whole, talk with your doctor or pharmacist. They can provide guidance on how to take this medication.

Amaryl and pregnancy

Doctors may prescribe Amaryl during pregnancy, but it isn’t common. The use of Amaryl isn’t usually recommended while pregnant. Other available treatment options may be safer for managing your blood sugar during this time.

If your doctor prescribes Amaryl during your pregnancy, they’ll likely have you stop treatment at least 2 weeks before your due date. If you don’t, your child could be born with severe hypoglycemia (very low blood sugar) that could last up to 10 days. They may also have trouble breathing or be large.

If you become pregnant while taking Amaryl, talk with your doctor. They can advise you on the safest treatment options for managing your blood sugar during pregnancy.

Amaryl and birth control

Amaryl isn’t commonly prescribed during pregnancy. If you’re sexually active and you or your partner can become pregnant, talk with your doctor about birth control needs while you’re taking Amaryl.

For more information about taking Amaryl during pregnancy, see the “Amaryl and pregnancy” section above.

Amaryl and breastfeeding

Your doctor will likely recommend you do not take Amaryl while breastfeeding. If you take the drug during this time, it could lead to side effects in your child. Examples of these side effects include hypoglycemia (low blood sugar), extreme sleepiness, poor feeding, and seizures.

Before taking Amaryl, it’s important to talk with your doctor if you’re breastfeeding or planning to breastfeed. They may recommend other treatment options for you.

Common questions about Amaryl

Here are answers to some frequently asked questions about Amaryl.

If I have kidney problems, can I take Amaryl? Does the drug cause kidney-related side effects?

If you have kidney problems, you may be able to take Amaryl. The drug does not cause kidney-related side effects.

Having kidney problems can increase your risk of hypoglycemia (low blood sugar). This is a common and sometimes serious side effect of Amaryl. If you have kidney problems and your doctor prescribes the drug, they’ll likely recommend a low dosage. For example, 1 milligram (mg) once daily. Your doctor will also usually advise you to monitor your blood sugar very closely while taking the drug.

If you have questions about whether this medication is safe for you, talk with your doctor.

Can older people take Amaryl?

Yes. Amaryl’s clinical trials included adults ages 65 years and older with type 2 diabetes. The drug worked the same in older adults as it did in younger adults. Amaryl’s side effects were also the same in both age groups.

Doctors usually prescribe a low starting dose of 1 milligram (mg) to older adults. This is because they may be more sensitive to the drug’s side effects than younger adults. For example, Amaryl commonly causes low blood sugar. A symptom of low blood sugar is dizziness. If an older person becomes dizzy, they’re more likely to become seriously injured if they fall.

Older people may also be less likely to notice early symptoms of low blood sugar. That’s why it’s important for them to monitor their blood sugar while taking Amaryl. (For more information, see “Low blood sugar” in the “Amaryl side effects” section above.)

If you have additional questions about the use of Amaryl in older adults, talk with your doctor.

Can Amaryl be prescribed with insulin?

Yes. A doctor may prescribe both Amaryl and insulin to treat type 2 diabetes. However, both of these medications commonly cause low blood sugar. So taking both drugs can further increase your risk of low blood sugar.

If you take Amaryl and insulin, it’s important to monitor your blood sugar level very closely. Your doctor can explain how to check and track your blood sugar. They’ll also advise you on how to recognize the first symptoms of low blood sugar and ways to quickly correct it. (For more information, see “Low blood sugar” in the “Amaryl side effects” section above.)

Your doctor can help answer any other questions you have about taking both Amaryl and insulin.

Does Amaryl cause anemia?

A type of anemia called hemolytic anemia can occur with Amaryl. Anemia is a low level of red blood cells. Hemolytic anemia is a disorder that causes red blood cells to break down faster than your body can make them.

Hemolytic anemia wasn’t reported in people who took Amaryl in clinical trials. However, this side effect has been reported in people who took the drug after it was approved. It’s important to note that it isn’t known if Amaryl caused the anemia. Hemolytic anemia has also occurred in people who took other sulfonylureas (the class of drugs Amaryl belongs to).

People with a genetic condition called G6PD deficiency may have an increased risk of hemolytic anemia. For details, see the “Amaryl precautions” section below.

If you develop symptoms of hemolytic anemia, talk with your doctor. These may include:

• fatigue
• fast heartbeat
• headache
• skin that appears more pale than usual
• dark urine
• fever
• pain in your abdomen

Your doctor can also help answer other questions you have about your risk of developing anemia with Amaryl.

Amaryl overdose

Do not take more Amaryl than your doctor recommends. Taking more than the recommended dosage of Amaryl can lead to severe hypoglycemia (very low blood sugar.)

Overdose symptoms

Symptoms of an overdose of Amaryl tablets are the same as the symptoms of very low blood sugar, which can include:

• seizures
• loss of consciousness
• coma

What to do in case of overdose

If you think you’ve taken too much of this drug, call your doctor. You can also call America’s Poison Centers at 800-222-1222 or use its online tool. But if your symptoms are severe, call 911 or your local emergency number, or go to the nearest emergency room right away.