Formulary
Gliclazide: Indications, Dosing, Side Effects and Interactions
The sulfonylureas act mainly by augmenting insulin secretion and consequently are effective only when some residual pancreatic beta-cell activity is present;...
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Gliclazide: Indications, Dosing, Side Effects and Interactions
The sulfonylureas act mainly by augmenting insulin secretion and consequently are effective only when some residual pancreatic beta-cell activity is present;...
Drug action
The sulfonylureas act mainly by augmenting insulin secretion and consequently are effective only when some residual pancreatic beta-cell activity is present; during long-term administration they also have an extrapancreatic action.
Indications and dose
**Type 2 diabetes mellitus**
- **Adult** (By Mouth Using Immediate-Release Medicines): Initially 40-80 mg once daily, dose to be taken with breakfast, increased if necessary up to 160 mg 1-2 times a day, dose to be adjusted according to response.
- **Adult** (By Mouth Using Modified-Release Medicines): Initially 30 mg once daily, dose to be taken with breakfast, increased if necessary up to 120 mg once daily, dose to be taken with breakfast, dose to be adjusted according to response every 4 weeks (after 2 weeks if no decrease in blood glucose).
**Type 2 diabetes mellitus for gliclazide**
- **Child 12-17 years** (By mouth using immediate-release medicines): Initially 20 mg once daily, dose to be taken with breakfast, increased if necessary up to 160 mg 1-2 times a day, dose to be adjusted according to response.
**Maturity-onset diabetes of the young (specialist use only) for gliclazide**
- **Child 12-17 years** (By mouth using immediate-release medicines): Initially 20 mg once daily, dose to be taken with breakfast, increased if necessary up to 160 mg 1-2 times a day, dose to be adjusted according to response.
Cautions
Can encourage weight gain; elderly; G6PD deficiency Cautions, further information Elderly Screening Tool of Older Persons' potentially inappropriate Prescriptions (STOPP) criteria to aid medication reviews (see Prescribing in the elderly for information): potentially inappropriate if prescribed a long-acting sulfonylurea (e.g. glibenclamide, chlorpropamide, glimepiride) in type 2 diabetes mellitus (risk of prolonged hypoglycaemia).
Contraindications
Presence of ketoacidosis Contra-indications For gliclazide Avoid where possible in Acute porphyrias
Side effects
Common or very common Abdominal pain; diarrhoea; hypoglycaemia; nausea Uncommon Hepatic disorders; vomiting Rare or very rare Agranulocytosis; erythropenia; granulocytopenia; haemolytic anaemia; leucopenia; pancytopenia; thrombocytopenia Frequency not known Allergic dermatitis (usually in the first 6-8 weeks of therapy); constipation; photosensitivity reaction; skin reactions; visual impairment Side-effects For gliclazide Frequency not known Anaemia; angioedema; dyspepsia; gastrointestinal disorder; hypersensitivity vasculitis; hyponatraemia; severe cutaneous adverse reactions (SCARs)
Interactions
**Other interactions (16):**
- The following products are likely to increase the risk of hypoglycaemia Contra-indicated combination Miconazole (systemic route, oromucosal gel): increases the hypoglycaemic effect with possible...
- Where necessary, adjust the dose during and after treatment with the anti-inflammatory agent.
- Avoid alcohol or medicines containing alcohol.
- Combinations requiring precautions for use Potentiation of the blood glucose lowering effect and thus, in some instances, hypoglycaemia may occur when one of the following drugs is taken: Other...
- The following products may cause an increase in blood glucose levels Combination which is not recommended Danazol : diabetogenic effect of danazol.
- If the use of this active substance cannot be avoided, warn the patient and emphasise the importance of urine and blood glucose monitoring.
Pregnancy
The use of sulfonylureas in pregnancy should generally be avoided because of the risk of neonatal hypoglycaemia.
Breast feeding
Avoid-theoretical possibility of hypoglycaemia in the infant.
Hepatic impairment
In general, manufacturers advise avoid in severe impairment (increased risk of hypoglycaemia).
Renal impairment
Sulfonylureas should be used with care in those with mild to moderate renal impairment, because of the hazard of hypoglycaemia. Care is required to use the lowest dose that adequately controls blood glucose. Avoid where possible in severe renal impairment. Renal impairment For gliclazide If necessary, gliclazide which is principally metabolised in the liver, can be used in renal impairment but careful monitoring of blood-glucose concentration is essential.
Medicinal forms
Suspension,Tablet,Tablet
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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