Chlorpropamide

CLINICAL USE

Diabetes mellitus Diabetes insipidus

DOSE IN NORMAL RENAL FUNCTION

Diabetes mellitus: initially 250 mg daily (elderly 100–125 mg, but avoid). Maximum 500 mg dailyDiabetes insipidus: 100–350 mg daily

PHARMACOKINETICS

Molecular weight :276.7

%Protein binding :88–96

%Excreted unchanged in urine : 47

Volume of distribution (L/kg) :0.09–0.27

half-life – normal/ESRD (hrs) :35/50–200

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : 50% of normal dose

10 to 20 : Avoid. See ‘Other Information’

<10 : Avoid. See ‘Other Information’

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Not dialysed. Avoid

HD :Not dialysed. Avoid

HDF/high flux :Unknown dialysability. Avoid

CAV/VVHD :Unknown dialysability. Avoid

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugsAnalgesics: effects enhanced by NSAIDs Antibacterials: effects enhanced by chloramphenicol, sulphonamides, and trimethoprim; effect reduced by rifamycinsAnticoagulants: effect possibly enhanced by coumarins; also possibly changes to INRAntifungals: concentration increased by fluconazole and miconazole and possibly voriconazoleSulfinpyrazone: enhanced effect of sulphonylureas

ADMINISTRATION

Reconstition

–

Route

Oral

Rate of Administration

–

Comments

Take with breakfast

OTHER INFORMATION

Chlorpropamide can enhance antidiuretic hormone and very rarely cause hyponatraemiaContraindicated in patients with serious impairment of hepatic, renal or thyroid function – severe risk of metabolic acidosis Prolonged hypoglycaemia can occur in azotaemic patients

See how to identify renal failure stages according to GFR calculation

See how to diagnose irreversible renal disease

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