Gliclazide

Generic Name: Gliclazide
Brand Name: Diamicron
Classification: Antidiabetics
Mode of Action: Lowers blood glucose by stimulating the release of insulin

from the pancreas and increasing sensitivity to insulin at receptor sites.
Dose and Route:

Actual Dose:
Recommended Dose: PO (Adults) Tablets– 80–320 mg/day, doses >160 mg/day

should be divided and given twice daily; modified-release tablets– 30 mg daily, may be ↑ in 30–mg
increments every 2 wk until blood sugar is controlled up to 120 mg/day.
Indication: Control of blood sugar in type 2 diabetes mellitus when control of diet and exercise fails or
when insulin is not an option. Requires some pancreatic function.
Contraindication:
 Hypersensitivity; cross sensitivity with other sulfonylureas may occur;
 Unstable diabetes, type 1 diabetes mellitus, diabetic ketoacidosis, diabetic coma
or pre-coma;
 Severe hepatic or renal impairment;
 Concurrent use of oral/oromucosal miconazole, alcohol or alcohol-containing
medications, or systemic phenylbutazone;
 OB: Should not be used during pregnancy, insulin is preferred;
 Lactation: Should not be used during lactation, insulin is perferred.
Side Effects/ Adverse Reactions:

Endo: hypoglycemia
GI: abdominal pain, diarrhea, dyspepsia, ↑ liver enzymes,
nausea, vomiting
Derm: photosensitivity, rash
Drug Interactions:
 Concurrent use of alcohol, angiotensin converting-enzyme inhibitors, antituberculars, azole

antifungals, beta-blockers, clarithromycin, clofibrate, disopyramide, H2–receptor antagonists, MAO
inhibitors, NSAIDs, phenylbutazone, salicylates, long-acting sulfonamides, warfarin , may ↑ risk of
hypoglycemia.
 ↑ risk of hypoglycemia with other antidiabetic agents including alpha glucosidase
inhibitors, biguanides, and insulin .
 Concurrent use of chlorpromazine, corticosteroids, danazol, diuretics, (including thiazides,
and furosemide), hormonal contraceptives ( estrogen and progestogen ), nicotinic
acid (pharmacologic doses), ritodrine, salbutamol, terbutaline, or tetracosactrin may ↑ risk of
hyperglycemia and lead to loss of diabetic control.
 May ↑ risk of bleeding with warfarin .
 Concurrent use with alcohol may result in a disulfiram-like reaction and should be avoided.
 Beta-blockers may ↓ some symptoms of hyperglycemia.
Nursing Responsibilities:
 Observe for signs and symptoms of hypoglycemia (hunger, weakness, sweating, dizziness,
tachycardia, anxiety).
 Assess patient for allergy to sulfonyureas.
 Monitor serum glucose and glycosylated hemoglobin periodically during therapy to evaluate
effectiveness of treatment.
 Monitor liver function periodically in patients with mild to moderate liver dysfunction. May
cause ↑ AST, ALT, alkaline phosphatase and LDH.
 Monitor renal function periodically in patients with mild to moderate renal dysfunction. May
cause ↑ creatinine and hyponatremia.
 Patients on a diabetic regimen exposed to stress, fever, infection, trauma, or surgery may
require administration of insulin.
 PO Administer with meals at the same time every day.
 Instruct patient to take gliclazides as directed at the same time every day.
 Explain to patient that this medication does not cure diabetes and must be used in conjunction
with a prescribed diet, exercise regimen, to prevent hypoglycemic and hyperglycemic events.
 Instruct patient on proper technique for home glucose monitoring. Monitor closely during
periods of stress or illness and health care professional notified if significant changes occur.
 Review signs of hypoglycemia and hyperglycemia with patient. If hypoglycemia occurs, advise
patient to drink a glass of orange juice or ingest 2–3 tsp of sugar, honey, or corn syrup dissolved in
water or an appropriate number of glucose tablets and notify health care professional.
 Encourage patient to follow prescribed diet, medication, and exercise regimen to prevent
hypoglycemic or hyperglycemic episodes.
 Concurrent use of alcohol may cause a disulfiram-like reaction (abdominal cramps, nausea,
flushing, headaches, and hypoglycemia).

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Gliclazide

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Generic Name: Gliclazide

Brand Name: Diamicron

Mode of Action: Lowers blood glucose by stimulating the release of insulin

Dose and Route:

Recommended Dose: PO (Adults) Tablets– 80–320 mg/day, doses >160 mg/day

Side Effects/ Adverse Reactions:

 Concurrent use of alcohol, angiotensin converting-enzyme inhibitors, antituberculars, azole

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