Gliclazide

Introduction: Gliclazide is a medicine used to treat type 2 diabetes mellitus in adults. It belongs to a group of medicines called sulfonylureas and helps control blood sugar levels in people with diabetes.

How it works: 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.

Important Information: Take with food. Take it regularly at the same time each day. Do not stop without consulting your doctor. Regular blood sugar monitoring is recommended.

• Type 2 diabetes mellitus

Sulfonylureas

Sulfonylurea antidiabetic

Gliclazide is a second generation sulfonylurea drug that has hypoglycaemic and potentially useful hematological properties. It stimulates the release of insulin from pancreatic β-cells by facilitating Ca+2 transport across the β-cell membranes and decreases hepatic glucose output.

Gliclazide increases insulin secretion from the pancreas and reduces liver glucose production to lower blood sugar levels.

Film-coated tablet:

• Initial dose: 40-80 mg daily
• Can be increased up to 320 mg daily in divided doses when needed
• Take before meal

Modified release preparation:

• Initial: 30 mg once daily
• Increase in increments of 30 mg up to max 120 mg daily
• Interval between doses should be at least 1 month

Children: Not used (contraindicated in juvenile-onset diabetes)

* Use as directed by the registered physician

Oral tablet. Take with food (with breakfast or first main meal). Swallow whole, do not chew or crush.

If a meal is skipped, skip the dose, and add a dose if you eat an extra meal.

Common Side Effects:

• Upset stomach
• Indigestion
• Hypoglycemia (low blood sugar)

Other Side Effects:

• Abdominal pain, nausea, vomiting, diarrhea, constipation
• Skin reactions (rash, redness, itching)
• Increased liver enzymes (rare)

Precautions:

• Risk of hypoglycemia may be increased in the first few weeks of treatment.
• Irregular meals, skipping meals or fasting may cause hypoglycemia.
• Avoid alcohol (increases hypoglycemia risk).
• Regular blood sugar and HbA1c monitoring required.
• Caution in severe kidney or liver disease.

Contraindications:

• Type 1 diabetes mellitus
• Diabetic ketoacidosis (with or without coma)
• Severe kidney or liver disease
• Pregnancy and lactation
• Hypersensitivity to gliclazide or sulfonylureas

Drug Interactions:

• May increase hypoglycemic effect with other antidiabetics, beta-blockers, ACE inhibitors, MAOIs, sulfonamides, clarithromycin, miconazole
• May decrease hypoglycemic effect with chlorpromazine, corticosteroids, danazol, St. John's Wort
• May increase anticoagulant effect of warfarin

Food Interactions:

• Unsafe to consume alcohol with Gliclazide.

Use in Pregnancy: Not recommended during pregnancy. If pregnant or planning pregnancy, consult your doctor.

Use in Lactation: Should not be used during breastfeeding.

Pediatric Use: Not recommended for use in children due to lack of data (contraindicated in juvenile-onset diabetes).

Geriatric Use: Elderly patients should be dosed carefully. Symptoms of hypoglycemia may be less obvious.

Renal Impairment: Use with caution in severe kidney disease. Very low blood sugar may occur which may take a long time to return to normal.

Hepatic Impairment: Use with caution in severe liver disease.

Overdose: Symptoms of hypoglycemia (headache, intense hunger, nausea, vomiting, weariness, sweating, anxiety). Take sugar or sweet drinks. Unconscious patients must not be given food or drink. Seek emergency medical attention.

Storage: Store below 30°C. Keep out of reach of children.

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