Indication
Gliclazide is?ÿindicated for the treatment of non insulin dependent diabetes mellitus (NIDDM) of patients who require oral antidiabetic treatment.
Pharmacology
Gliclazide is a second generation sulfonylurea drug that has hypoglycaemic and potentially useful haemobiological properties. It stimulates the release of insulin from pancreatic ??-cells by facilitating Ca2+ transport across the ??-cell membranes and decreases hepatic glucose output.
Dosage
Oral route: The usual initial dose is 40 to 80 mg daily. The dose can be increased upto 320 mg daily in divided doses when needed. The drug should be taken before meal. For children Gliclazide is not used because it is contraindicated in juvenile- onset diabetes.
Interaction
The hypoglycaemic effects of Gliclazide may be increased by Aspirin, NSAIDs, Phenylbutazone, Clofibrate, Sulfonamides, Cimetidine, Imidazole antifungal agents and Monoamine Oxidase inhibitors. The hypoglycaemic effect of Gliclazide some times may be reduced by Rifampin, Barbiturates, Phenytoin, Thiazide diuretics, Diazoxide, Glucocorticoids, Estrogens, Sympathomimectic drugs and occasionally Alcohol.
Contradiction
Gliclazide should not be used in-
Juvenile-onset (type-I) diabetes
Diabetes associated with Ketosis
Diabetic patients undergoing surgery, after severe injury or during infection
Patients having hypersensitivity for sulfonylurea group of drugs
Pregnant women and breast-feeding mother
Hepatic insufficiency
Side Effect
There may be hypoglycaemia in concurrent conditions such as hepatic and renal disease, malnutrition, alcohol intoxication. Sometimes headache, gastrointestinal upsets, nausea, dizziness, skin reactions including rash, pruritus, erythema may occur.
Pregnancy
Gliclazide is contraindicated in pregnant women. It should not be used in breast feeding mother.
Precaution
Gliclazide should be used carefully in patients with hepatic impairment. If there is definite hepatic disease then gliclazide should not be used. Gliclazide can be used safely in patients with renal insufficiency as it is extensively metabolized. Gliclazide has less sudden hypoglycaemic episode than other sulfonylurea group of drugs.
Overdose
Storage
Keep in a dry place away from light and heat. Keep out of the reach of children.