Gliclazide

Indications

Gliclazide is used for: Type 2 DM

Adult Dose

Oral Type 2 diabetes mellitus Adult: Initially, 40-80 mg daily gradually increased to 320 mg daily if necessary. Doses >160 mg daily are given in 2 divided doses. Modified-release tab: Initially, 30 mg once daily, may increase in increments of 30 mg up to max 120 mg daily. Interval between doses should be at least 1 mth. For non-respondent patients, dose may be increased after 2 wk.

Child Dose

Renal Dose

Administration

Should be taken 30 mintues before meal or with meal.

Contra Indications

Type 1 DM, diabetes complicated with ketoacidosis; hypersensitivity; severe renal and hepatic impairment. Pregnancy and lactation.

Precautions

Monitor blood glucose concentration. May require insulin during metabolic stress. Care when transferring from combination therapy. Increased risk of severe hypoglycaemia in elderly, debilitated patients, patients with hepatic or renal impairment. Risk of hypogylcaemia when caloric intake is deficient, after strenuous exercise, when taken with ethanol or when >1 antidiabetic drug is used.

Pregnancy-Lactation

Interactions

May increase hypoglycaemic effect w/ phenylbutazone. Potentiation of blood glucose lowering effect w/ other antidiabetics (e.g. acarbose, insulins, metformin), beta-blockers, ACE inhibitors, H2-receptor antagonists, MAOIs, sulfonamides, clarithromycin and NSAIDs. Chlorpromazine, glucocorticoids, ritodrine, salbutamol and terbutaline may cause increases in blood glucose levels. May diminish hypoglycaemic effect w/ danazol. May increase anticoagulant effect of warfarin. Potentially Fatal: Increased hypoglycaemic effect w/ miconazole

Adverse Effects

Side effects of Gliclazide : GI disturbances, skin reaction, leucopenia, thrombocytopenia, agranulocytosis, haemolytic anaemia, cholestatic jaundice, vomiting, diarrhoea, gastritis, increased transaminases.

Mechanism of Action

Gliclazide stimulates insulin secretion from pancreatic beta-cells, reduces insulin uptake and glucose output by the liver, and increases insulin sensitivity at peripheral target sites. It decreases microthrombosis by partial inhibition of platelet aggregation and adhesion, and by restoring fibrinolysis w/ an increase in tissue plasminogen activator (t-PA) activity.