If you have type 2 diabetes, your doctor might suggest Amaryl as a treatment option for you. It’s a prescription drug used to treat type 2 diabetes in adults.

The active ingredient in Amaryl is glimepiride. (The active ingredient is what makes the drug work.)

Amaryl comes as a tablet that you swallow. It’s often taken together with other diabetes medications.

You’ll usually take Amaryl long term. For more information about this drug, including details about its uses, see this in-depth article.

Like other drugs, Amaryl can cause mild to serious side effects. One of the more common side effects is hypoglycemia (low blood sugar). Keep reading to learn more.

Some people experience mild to serious side effects during Amaryl treatment. But most of Amaryl’s side effects are mild. Commonly reported side effects include:

* To learn more about this side effect, see the “Side effects explained” section below.

These are just a few of the side effects Amaryl may cause. But not everyone who takes this drug will have side effects.

Amaryl causes mild side effects in some people. But people who have these mild side effects can usually treat them while taking Amaryl. Examples of mild side effects that have been reported with Amaryl include:

* To learn more about this side effect, see the “Side effects explained” section below.

In most cases, these side effects should be temporary. And some may be easily managed. But if you have symptoms that are ongoing or bother you, talk with your doctor or pharmacist. And do not stop taking Amaryl unless your doctor recommends it.

Amaryl may cause mild side effects other than the ones listed above. See Amaryl’s prescribing information for details.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with Amaryl, visit MedWatch.

Serious side effects from Amaryl are rare. And they’re more likely to occur in people who have had kidney problems or are taking other diabetes medications. Let your doctor know right away if you have a serious side effect, as this may be a medical emergency.

Serious side effects that have been reported with Amaryl include:

If you develop serious side effects while taking Amaryl, call your doctor right away. If the side effects seem life threatening or if you think you’re having a medical emergency, immediately call 911 or your local emergency number.

* To learn more about this side effect, see the “Side effects explained” section below.

Find answers to some common questions about Amaryl’s side effects.

Does Amaryl have any negative effects on the kidneys?

No, Amaryl doesn’t harm your kidneys. But if you have kidney problems, using this drug may increase your risk of hypoglycemia (low blood sugar). Adults ages 65 and older and people with low kidney function were more likely to have low blood sugar in studies of Amaryl.

If you have kidney problems, your doctor will likely start you on a low dose of the drug. The lowest dose of Amaryl is 1 milligram (mg) daily. Because you’re more likely to have low blood sugar, your doctor will increase your dose very slowly. They won’t increase it more often than every 1 to 2 weeks.

Talk with your doctor about how to monitor your blood sugar while you’re taking Amaryl.

Can the Amaryl 2-mg tablet increase my risk of side effects compared with the 1-mg tablet?

Yes, the 2-milligram (mg) tablet may increase your risk of hypoglycemia (low blood sugar) more than the 1-mg tablet. But low blood sugar wasn’t a common side effect in Amaryl studies.

You can avoid this side effect by monitoring your blood sugar carefully. If you have questions about how to do this or the risk of side effects with your specific dose, talk with your doctor.

Will low blood sugar make it hard for me to concentrate?

Yes, hypoglycemia (low blood sugar) makes it difficult to concentrate. If you have difficulty thinking clearly, check your blood sugar level.

In studies of Amaryl, doctors observed that some people were accidentally injured. But it wasn’t clear if this was due to low blood sugar making them less alert.

Be sure to avoid driving and other activities that require you to be alert until you know how Amaryl affects you. Talk with your doctor about symptoms of low blood sugar to watch out for.

Can Amaryl be used in children?

No, doctors do not usually prescribe Amaryl for children. Studies of Amaryl in children showed side effects of weight gain and hypoglycemia (low blood sugar). These side effects were not considered safe.

Talk with a doctor about safe and effective medications for your child.

Learn more about some of the side effects Amaryl may cause.

Weight gain

Weight gain was commonly reported in studies of Amaryl, but it was slight. The average weight gain in people who took Amaryl in these studies was about 1.8 kilograms (kg).*

This side effect happened more often in people who took a higher dose of Amaryl. The higher doses are 4 milligrams (mg) or 8 mg daily. The lower doses are 1 mg or 2 mg daily.

* 1 kg equals about 2.2 pounds (lbs.)

What might help

If you gain weight while taking Amaryl, there are ways you can reduce this side effect.

You can make changes to your diet and exercise routines. A balanced, nutritious diet and regular exercise will also help you manage your diabetes symptoms.

Talk with a doctor if you need help setting and reaching diet and exercise goals.

Liver damage

Elevated levels of a liver enzyme called alanine aminotransferase were reported in Amaryl studies. This is sometimes a sign of liver damage. You won’t notice symptoms of mildly elevated liver enzymes, but your doctor may notice higher levels of these enzymes on a blood test. (See “What might help” just below.)

Amaryl studies did not identify liver damage, but it was reported by people who took the drug after it became available on the market. It’s not clear whether Amaryl was the direct cause. The following types of liver damage were reported:

What might help

Your doctor will monitor your blood while you’re taking Amaryl. One of the blood tests will be a liver function test. But be sure to talk with your doctor about symptoms to watch for if your liver isn’t working well.

Hypoglycemia (low blood sugar)

Low blood sugar was a common side effect in studies of Amaryl. When you have type 2 diabetes, your blood sugar level is too high. Amaryl helps lower your blood sugar to a level that is healthy for you, but sometimes it can get too low. All diabetes medications can cause this side effect.

Symptoms of low blood sugar include:

Symptoms of very low blood sugar include seizure or loss of consciousness. In extreme cases, very low blood sugar can be life threatening or cause permanent damage.

What might help

You can help prevent low blood sugar by checking your levels as often as your doctor recommends. You can increase your blood sugar safely by eating or drinking 15 grams (g) of sugar in the form of glucose tablets, juice, or non-diet soda. You should then check your blood sugar again after 15 minutes to see if it’s at a healthy level for you. If not, you can repeat this process. Then you can either eat a snack or a meal if it’s time for your next one.

Talk with your doctor about how to track your blood sugar levels and how to avoid low blood sugar levels while you’re sleeping.

Hemolytic anemia

Amaryl studies didn’t show hemolytic anemia (damage to red blood cells that carry oxygen). But there have been reports of this side effect since the drug came on the market. These reports were from people with a genetic condition called glucose-6-phosphate dehydrogenase (G6PD) deficiency and also from some without it.

Hemolytic anemia is a problem with your red blood cells. Your bone marrow makes red blood cells. If it’s not making new red blood cells as fast as your body is removing old ones, your body tissues do not receive enough oxygen.

Symptoms of hemolytic anemia include the following:

What might help?

Hemolytic anemia is a serious condition that needs treatment at a healthcare facility. You might need a red blood cell transfusion or surgery. If you have this side effect from taking Amaryl, your doctor will likely choose a different treatment option for your type 2 diabetes.

Talk with your doctor about G6PD testing and your risk of hemolytic anemia.

Allergic reaction

Like most drugs, Amaryl can cause an allergic reaction in some people. Allergic reaction was not seen during studies of Amaryl, but there have been reports of this side effect in people taking this drug. But it’s unclear how often this has happened or if Amaryl was the cause.

Symptoms can be mild to serious and can include:

  • skin rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)
  • swelling under your skin, usually in your eyelids, lips, hands, or feet
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

There are also rare reports of people developing Stevens-Johnson syndrome when taking Amaryl. This is a serious skin reaction that requires immediate medical treatment, as it can be life threatening. Symptoms can include:

  • flu-like symptoms or feeling generally unwell
  • red or purple skin rash that peels, blisters, or ruptures
  • body aches and pains that get worse as time goes on

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest an over-the-counter oral antihistamine, such as Benadryl (diphenhydramine), or a topical product, such as hydrocortisone cream, to manage your symptoms.

If your doctor confirms you’ve had a mild allergic reaction to Amaryl, they’ll decide if you should continue taking it.

If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you’ve had a serious allergic reaction to Amaryl, they may have you switch to a different treatment.

Keeping track of side effects

During your Amaryl treatment, consider taking notes on any side effects you’re having. You can then share this information with your doctor. This is especially helpful when you first start taking new drugs or using a combination of treatments.

Your side effect notes can include things such as:

  • what dose of the drug you were taking when you had the side effect
  • how soon you had the side effect after starting that dose
  • what your symptoms were
  • how it affected your daily activities
  • what other medications you were taking
  • any other information you feel is important

Keeping notes and sharing them with your doctor will help them learn more about how Amaryl affects you. They can then use this information to adjust your treatment plan if needed.

Amaryl may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before starting Amaryl. Below are some factors to consider.

Kidney problems. Your kidneys remove Amaryl from your body. So if you have kidney problems, Amaryl can stay in your body for a longer time. This means you’re at an increased risk of side effects such as hypoglycemia (low blood sugar).

Talk with your doctor about your dose of Amaryl. Due to the risk of side effects, they may prescribe a lower dose.

Older adults. Amaryl can take longer to leave your body if you’re ages 65 years and older. Your doctor may still prescribe Amaryl but at a lower dose. Talk with them about the best dose for you.

Taking certain medications. If you’re already taking certain drugs to treat type 2 diabetes, Amaryl may not be the best treatment option for you. Medications for diabetes, such as insulin, may lower blood sugar. Amaryl also lowers blood sugar. If taken together, you may be at increased risk of this side effect.

Drugs you take for other conditions may also affect how well Amaryl works. Talk with your doctor about all the medications you take before starting Amaryl.

G6PD deficiency. If you have a genetic condition called glucose-6-phosphate dehydrogenase (G6PD) deficiency, your doctor may choose a different medication for you.

People with G6PD deficiency are at risk of hemolytic anemia if they take any sulfonylurea, including Amaryl. With hemolytic anemia, the red blood cells in your body get damaged. Talk with your doctor about your other treatment options if you have this condition.

Allergic reaction. If you’ve had an allergic reaction to Amaryl or any of its ingredients, your doctor will likely not prescribe it for you. If you have a sulfa allergy, you may also be allergic to Amaryl. Ask your doctor about other treatments that are better options for you.

While not seen in studies, there have been reports of people having serious allergic reactions, called hypersensitivity reactions, to Amaryl. These reactions were rare, but they are medical emergencies and include:

* For more information on this syndrome, see “Allergic reaction” under “Side effects explained” above.

Alcohol and Amaryl

Alcohol may affect how well Amaryl works. Drinking alcohol may also increase your risk of hypoglycemia (low blood sugar). If you drink alcohol, talk with your doctor about how much, if any, is safe to drink while taking Amaryl.

Pregnancy and breastfeeding while taking Amaryl

If you take Amaryl while pregnant, it is important to monitor your blood sugar levels to ensure they don’t get too low. Studies of Amaryl showed that hypoglycemia (low blood sugar) caused fetal harm, especially in the 2 weeks before birth. The manufacturer of Amaryl recommends stopping the drug at least 2 weeks before the expected birth date.

If your doctor prescribes Amaryl for you while you’re breastfeeding, they may also talk with you about signs of low blood sugar in an infant.

Talk with your doctor about pregnancy and breastfeeding while you’re taking Amaryl. Due to the risks of low blood sugar, your doctor may monitor you closely or choose a different treatment for your type 2 diabetes.

Amaryl is usually a long-term treatment for type 2 diabetes, so you may have questions for your doctor about side effects. This drug has several common side effects that your doctor can help you manage. If you’re considering Amaryl, here are a few questions to ask them:

  • How likely am I to develop hypoglycemia (low blood sugar) as a side effect of Amaryl?
  • Does Amaryl interact with any of the other drugs I’m taking for type 2 diabetes?
  • How can I manage a mild Amaryl side effect, such as nausea?
  • Are there ways I can avoid weight gain while taking Amaryl?

For tips on managing your condition, sign up for the Healinggeeks type 2 diabetes newsletter. And if you’re looking for a supportive online community of people living with the same condition, consider joining Bezzy T2D.


I think I have a sulfa allergy. Is it safe for me to take Amaryl?



Amaryl is in a drug class called sulfonylureas, which means it contains sulfa as an ingredient. Some people with a sulfa allergy will react negatively to Amaryl.

Amaryl is contraindicated in people who have had an allergic reaction to a sulfa-containing drug. A contraindication is a factor or condition that could prevent your doctor from prescribing a drug due to the risk of harm.

If you have a sulfa allergy, talk with your doctor about whether a different type 2 diabetes treatment is better for you.

The Healinggeeks Pharmacist TeamAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

Disclaimer: Healinggeeks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.