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Gliclazide tablets: Oral Antidiabetic drug, Uses & Side effects.
Chemical Structure:

Class of drug:
Sulfonylurea (Antidiabetic)
Drug action/mode of action:
Acts mainly by augmenting insulin secretion and is consequently effective only when some residual pancreatic beta-cell activity is present.

Medicinal forms:
Tablet, Modified-release tablet.
Some brands available:
Zicron, Diamicron, Bilxona, Dacadis, Laaglyda, Nazdol, Vitile.

Indications and dose:
Type 2 diabetes mellitus
By mouth using immediate-release medicines
Adult
Initially 40–80 mg daily, adjusted according to response, increased if necessary up to 160 mg once daily, dose to be taken with breakfast, doses higher than 160 mg to be given in divided doses; maximum 320 mg per day.
Child 12–17 years
Initially 20 mg once daily, adjusted according to response, increased if necessary up to 160 mg once daily (max. per dose 160 mg twice daily), dose to be taken with breakfast.
By mouth using modified-release medicines
Adult
Initially 30 mg daily, dose to be taken with breakfast, adjust dose according to response every 4 weeks (after 2 weeks if no decrease in blood glucose); maximum 120 mg per day.

Unlicensed use:
Not licensed for use in children.
Contra-indications:
Presence of ketoacidosis; Acute porphyria
Cautions:
Can encourage weight gain; Use with caution in G6PD deficiency
Interactions:
Chloramphenicol: increases the exposure to Gliclazide.
Rifampicin: decreases the exposure to Gliclazide.
Metreleptin: increases the risk of hypoglycaemia when given with Gliclazide.
Miconazole: increases the exposure to Gliclazide.
Clarithromycin: slightly increases the exposure to Gliclazide.
Fluconazole: increases the exposure to Gliclazide.
Side-effects of Gliclazide
• Abdominal pain
• Diarrhoea
• Hypoglycaemia
• Nausea
• Vomiting
Use of Gliclazide in Pregnancy
The use of sulfonylureas in pregnancy should generally be avoided because of the risk of neonatal hypoglycaemia.
Use of Gliclazide in Breast feeding mothers
Avoid use in breastfeeding due to the theoretical possibility of hypoglycaemia in the infant.
Hepatic impairment:
Manufacturers advice to avoid in severe impairment (increased risk of hypoglycaemia)
Renal impairment:
Gliclazide, which is principally metabolised in the liver, can be used in renal impairment but 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.
Patient and carer advice on the use of gliclazide: Drivers need to be particularly careful to avoid hypoglycemia and should be warned of the problems.
Other drugs in class:
• Glibenclamide
• Tolbutamide
• Glipizide• Glimepiride