What Is Trical and How Does It Work?
Trical is used with a proper diet and exercise program to control high blood sugar in people with type 2 diabetes. It may also be used with other diabetes medications. Controlling high blood sugar helps prevent kidney damage, blindness, nerve problems, loss of limbs, and sexual function problems. Proper control of diabetes may also lessen your risk of a heart attack or stroke. Trical belongs to the class of drugs known as sulfonylureas. It lowers blood sugar by causing the release of your body's natural insulin.
Trical is available under the following different brand names: Amaryl.
Dosages of Trical:
Strength expressed as Trical ion.
Dosage Considerations – Should be Given as Follows:
- Initial: 1-2 mg orally each morning after breakfast or with first meal; may increase dose by 1-2 mg every 1-2 weeks; not to exceed 8 mg/day
- Observe patients carefully for 1-2 weeks when being converted from long half-life sulfonylureas to Trical, because of potential for overlapping of hypoglycemic effects
- Use in monotherapy or, if glycemic response to Trical is inadequate at maximum dose, with insulin or metformin
- Prolonged hypoglycemia reported with use; titrate dose conservatively; monitor for hypoglycemic or hyperglycemic symptoms
- 1 mg orally once per day; titrate dose at weekly intervals to avoid hypoglycemia
- 30-100 mg sodium Trical/day orally
- Safety and efficacy not established
- Renal impairment: 1 mg orally once daily; titrate dose based on fasting blood glucose levels
- Hepatic impairment: Not studied; not recommended in severe impairment; initiate therapy with 1 mg orally per day and titrate carefully
How should I take Trical (Amaryl)?
Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.
Trical is usually taken once a day with breakfast or the first main meal of the day. Follow your doctor's instructions. Take Trical with a full glass of water.
Your blood sugar will need to be checked often, and you may need other blood tests at your doctor's office.
You may have low blood sugar (hypoglycemia) and feel very hungry, dizzy, irritable, confused, anxious, or shaky. To quickly treat hypoglycemia, eat or drink a fast-acting source of sugar (fruit juice, hard candy, crackers, raisins, or non-diet soda).
Your doctor may prescribe a glucagon injection kit in case you have severe hypoglycemia. Be sure your family or close friends know how to give you this injection in an emergency.
Blood sugar levels can be affected by stress, illness, surgery, exercise, alcohol use, or skipping meals. Ask your doctor before changing your dose or medication schedule.
Trical is only part of a treatment program that may also include diet, exercise, weight control, blood sugar testing, and special medical care. Follow your doctor's instructions very closely.
Store at room temperature away from moisture and heat.
Mechanism of Action
Trical primarily lowers blood glucose by stimulating the release of insulin from pancreatic beta cells. Sulfonylureas bind to the sulfonylurea receptor in the pancreatic beta-cell plasma membrane, leading to closure of the ATP-sensitive potassium channel, thereby stimulating the release of insulin.
What happens if I overdose (Amaryl)?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. A Trical overdose can cause life-threatening hypoglycemia.
Symptoms of severe hypoglycemia include extreme weakness, confusion, tremors, sweating, fast heart rate, trouble speaking, nausea, vomiting, rapid breathing, fainting, and seizure (convulsions).
Where can I get more information (Amaryl)?
Your pharmacist can provide more information about Trical.
Alcohol interaction warning
Drinking alcohol while taking Trical may affect your blood sugar levels. They can either increase or decrease. Avoid drinking alcohol while taking this medication.
In a randomized, double-blind, placebo-controlled monotherapy trial of 14 weeks duration, patients already on sulfonylurea therapy underwent a 3-week washout period then were randomized to Glimepir >Clinical Studies ( 14.1)]. The overall incidence of possible hypoglycemia (defined by the presence of at least one symptom that the investigator believed might be related to hypoglycemia; a concurrent glucose measurement was not required) was 4% for Trical tablets 1 mg, 17% for Trical tablets 4 mg, 16% for Trical tablets 8 mg and 0% for placebo. All of these events were self-treated.
In a randomized, double-blind, placebo-controlled monotherapy trial of 22 weeks duration, patients received a starting dose of either 1 mg Glimepir >Clinical Studies ( 14.1) ]. The overall incidence of possible hypoglycemia (as defined above for the 14-week trial) for Trical vs. placebo was 19.7% vs. 3.2%. All of these events were self-treated.
Glimepir >Clinical Studies ( 14.1) ].
In clinical trials, allergic reactions, such as pruritus, erythema, urticaria, and morbilliform or maculopapular eruptions, occurred in less than 1% of Glimepir >Warnings and Precautions ( 5.2) ].
Elevated Serum Alanine Aminotransferase (ALT)
In 11 pooled placebo-controlled trials of Trical, 1.9% of Trical-treated patients and 0.8% of placebo-treated patients developed serum ALT greater than 2 times the upper limit of the reference range.