Diaryl 2 mg

Description

Indications
Diaryl tablets are indicated for the following conditions:

• Diaryl is used as an adjunct to diet and exercise to help reduce blood glucose levels in patients with Type II (non-insulin dependent) diabetes mellitus (NIDDM), whose hyperglycemia cannot be controlled by diet and exercise alone.
• Diaryl can be used alongside metformin when diet, exercise, and either Diaryl or metformin alone fail to provide adequate control over blood glucose levels.
• It is also indicated for use in combination with insulin to control blood glucose in patients whose hyperglycemia cannot be managed by diet, exercise, and oral hypoglycemic agents.
• Combining Diaryl with insulin may increase the risk of hypoglycemia.

Pharmacology
Glimepiride, the active ingredient in Diaryl, is a sulfonylurea class antidiabetic agent that lowers blood glucose levels. Its primary action is to stimulate the release of insulin from functioning pancreatic beta cells. Additionally, Glimepiride enhances the sensitivity of beta cells to glucose, promoting insulin secretion in response to physiological glucose stimuli. It also has extrapancreatic effects, including the reduction of basal hepatic glucose production, increased peripheral tissue sensitivity to insulin, and enhanced glucose uptake. In non-fasting diabetic patients, a single dose of Glimepiride provides a hypoglycemic effect that lasts up to 24 hours.

Dosage
The dosage of Glimepiride should be the minimum amount required to achieve the desired blood glucose control. Dosage adjustments are based on regular blood and urine glucose tests to monitor both primary and secondary therapeutic failures.

• Initial Dose and Dose Titration: The recommended initial dose is 1 mg once daily. If necessary, the dose can be gradually increased based on regular monitoring of blood glucose levels. Adjustments should be made in increments of 1 to 2 weeks, and follow the sequence: 1 mg → 2 mg → 3 mg → 4 mg → 6 mg.
• Dosage in Well-Controlled Diabetic Patients: For patients with well-controlled diabetes, the usual daily dose ranges from 1 mg to 4 mg.
• Dose Timing and Distribution: The physician will determine the most appropriate timing and distribution of doses based on the patient’s lifestyle. Typically, a single daily dose is sufficient and should be taken just before a substantial breakfast or the first main meal. Skipping meals after taking the medication is not advised.

Secondary Dose Adjustments: As diabetes control improves, patients may become more sensitive to insulin, resulting in reduced Glimepiride requirements. To avoid hypoglycemia, dose reduction or discontinuation of therapy should be considered when necessary. Adjustments should also be made if there are significant changes in the patient’s weight or lifestyle, or if factors arise that increase the risk of hypoglycemia or hyperglycemia.

Transition from Other Oral Antidiabetic Medications to Glimepiride: There is no direct dose equivalence between Glimepiride and other oral hypoglycemic agents. When switching to Glimepiride, the initial dose should be 1 mg daily, even if the patient was previously taking the maximum dose of other oral antidiabetics. Dose increases should follow the titration steps outlined above. Be mindful of the potency and duration of action of the previous medication, and it may be necessary to temporarily interrupt treatment to prevent additive hypoglycemic effects.

Administration
Diaryl tablets should be taken with an adequate amount of liquid.

Interaction
Certain medications may enhance or reduce the effectiveness of Diaryl. Drugs that may potentiate the hypoglycemic effect of Diaryl include ACE inhibitors, anabolic steroids, chloramphenicol, and several other medications, such as fluoxetine, quinolones, and sulfonamide antibiotics. Conversely, drugs like corticosteroids, diuretics, and certain hormones may weaken the hypoglycemic effect. Specific interactions can also occur with alcohol, which may unpredictably alter the drug’s activity.

Contraindications
Glimepiride is contraindicated in patients with insulin-dependent (Type I) diabetes mellitus, diabetic ketoacidosis, diabetic coma, or hypersensitivity to Glimepiride or other sulfonylureas. It should also not be used in cases of severe hepatic dysfunction, severe renal impairment, or in dialysis patients.

Side Effects
Common side effects of Glimepiride include hypoglycemia, temporary vision impairment, nausea, vomiting, diarrhea, abdominal pain, urticaria, and a reduction in blood pressure.

Pregnancy & Lactation
Glimepiride is not recommended during pregnancy; patients should switch to insulin therapy. If a patient plans to become pregnant, they must consult their physician and consider switching to insulin. Glimepiride should not be used while breastfeeding, as it can pass into breast milk and harm the infant. A changeover or complete discontinuation of breastfeeding is necessary.

Precautions & Warnings
During the initial weeks of treatment, there may be an increased risk of hypoglycemia, which requires careful monitoring. If hypoglycemia occurs, it can typically be managed by consuming carbohydrates (glucose or sugar). Dose adjustments may be necessary based on the patient’s response.

Overdose Effects
Overdosing on Glimepiride may result in hypoglycemia. Mild symptoms should be treated with oral glucose and close monitoring. Severe hypoglycemic reactions, including coma or seizures, require immediate medical attention. If hypoglycemic coma is suspected, intravenous administration of concentrated glucose followed by a continuous infusion of diluted glucose is necessary. Close monitoring is required for 24-48 hours as hypoglycemia may recur.

Therapeutic Class
Sulfonylureas

Storage Conditions
Store below 30°C in a cool, dry place, away from light and out of reach of children.