Zoryl (glimepiride) is used to treat type 2 diabetes. The medication promotes insulin production by the pancreas, thereby lowering blood sugar and slowing or halting the progression of the disease. It can be used on its own or with other antidiabetic medications; both situations are normal.

With doctor involvement and dosage modifications, Zoryl can be used in children.

The medication will not provide benefit in type 1 diabetes, as the pancreas in this condition is unable to produce insulin.

Zoryl is a sulfonylurea medication. Though cross-reactivity with patients who have a history of hypersensitivity to sulfa medications is debatable, these patients should use the medication with caution until effects are known, or seek an alternative treatment.

Dosage & Administration

Treatment is best individualized according to each patient's needs. A doctor is best equipped to do so, and can not only determine dosage but also recommend lifestyle changes according to individual circumstances.

General treatment guidelines are:

• Adults typically start with 1 or 2 mg taken once per day.
• After one or two weeks, dosage may be increased if needed.
• Do not exceed 8 mg per day.
• Doctors sometimes advise doses above 4 mg be divided into multiple daily doses.
• Each dose should be taken with a meal and a full glass of fluid.
• Blood sugar must be checked frequently when treatment begins or dosage is increased.

Tablets should not be crushed, chewed, dissolved, or otherwise damaged; they should be swallowed whole.

In most cases doses are taken once per day, usually in the morning with breakfast. Taking with a meal and a beverage is always recommended.

It takes one or two weeks for maximum benefit to be seen, which is why the wait before increasing dosage.

Zoryl can be taken for as long as it provides benefit, assuming no serious adverse reactions develop.

Modifying Lifestyle

The vast majority of patients prescribed Zoryl will also be advised to make lifestyle changes. A doctor should provide individualized recommendations, according to a patient's particular lifestyle and location. While recommended changes can be quite varied, there are some factors universal to all:

• Reach and maintain a healthy weight
• Get regular exercise
• Control blood sugar
• Control blood cholesterol
• Quit smoking

There are numerous other factors with can also influence blood sugar, such as prolonged stress or other medical conditions. Doctor advice should be complied with as much as possible; in the vast majority of cases, it is only lifestyle changes that can minimize or eliminate dependency on medications to slow or halt the progression of type 2 diabetes. If sufficient changes are made and maintained---difficult though they may be at first---many patients will no longer need to buy and take medications and can enjoy a longer, healthier, independent life.

A minority of patients are already living well, or made recommended changes, and find it makes little difference in type 2 diabetes. These patients---as well as those disinclined to make such changes---will likely need to take Zoryl or similar medications for the remainder of life.

Controversy

As mentioned above, Zoryl is a sulfonylurea medication. All sulfonylurea medications are subject to controversy regarding long-term use and pancreatic damage, which includes pancreatic cancer. It is controversial because some claim---and some studies indicate---that risk for some pancreatic conditions is increased when sulfonylurea medications are taken, while others---both people and studies---indicate no such association at all.

It is impossible at this point in time to determine the truth here. Tens of millions of patients around the globe take sulfonylurea medications with no serious side effects, though that's likely little consolation for those who do develop severe pancreatic conditions.

Patients concerned about this issue can find plenty of information online.

Low Blood Sugar

All patients taking Zoryl---or any sulfonylurea medication---are at increased risk of hypoglycemia, or low blood sugar. Too-high doses of Zoryl can cause the pancreas to produce too much insulin, thus lowering blood sugar to detrimental or even dangerous levels.

The risk is greatest when treatment begins, when dosage is increased, or when radical changes to diet or exercise are made. All patients should be aware of this risk, be alert for symptoms, and monitor blood sugar closely when treatment begins or dosage is increased, and it should be monitored regularly throughout treatment.

Symptoms of low blood sugar include:

• Pale skin
• Hunger
• Shakiness
• Sweating
• Weakness
• Confusion
• Seizures
• Loss of consciousness

A quick fix is to consume a readily-available sugar, such as fruit juice or glucose tablets. Patients may also be given a glucagon injection kit for emergencies. If experienced, hypoglycemia may require emergency medical attention, or if mild it may be manageable by the patient. In both cases the prescribing doctor should be consulted, as dosage may need to be lowered.

Hypersensitivity

Another common risk is hypersensitivity, even without any association of sulfa allergies. This condition can also range from mild to severe; in some cases it may be life-threatening, while in others it may be mild and intermittent. Again, all patients should be aware of and alert for symptoms.

Symptoms of hypersensitivity include:

• Hives
• Rashes
• Itching
• Swelling of face, tongue, or throat
• Rapid or erratic heart beat
• Confusion
• Difficulty breathing

As with hypoglycemia, severity is important when determining whether to deal with the situation on one's own or to seek emergency medical attention. Be aware that in severe cases symptoms can progress very rapidly, and while some patients do experience hypersensitivity symptoms during the first few doses, others may take the medication for years without problems.

Again, even if emergency medical attention was sought, the prescribing doctor should be consulted if any hypersensitivity symptoms are experienced. There are alternative treatments available that may be more suitable for a given individual.

Drug Interactions

Zoryl is known to interact with a wide range of other drugs, including other medications used to treat type 2 diabetes, non-prescription drugs, and recreational drugs like alcohol. Sometimes the interactions are considered worth the risk---such as with antidiabetic treatments---but other times not, and one of the medications should stop.

Always be sure the prescribing doctor is aware of all other medications being taken throughout treatment, and, if using recreational drugs, do not use any to excess.