HEALTHY LIFESTYLE




Gliclazide
Gliclazide.JPG

Gliclazide

CLINICAL USE

Non-insulin dependent diabetes mellitus

DOSE IN NORMAL RENAL FUNCTION

Initially: 40–80 mg daily, with breakfast, adjusted according to response up to 160 mg as a single dose; higher doses should be divided; maximum 320 mg daily

PHARMACOKINETICS

  • Molecular weight                           :323.4
  • %Protein binding                           :Approx 95
  • %Excreted unchanged in urine     : <5
  • Volume of distribution (L/kg)       :0.24
  • half-life – normal/ESRD (hrs)      :10–12 (MR: 12–20)/Prolonged

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

  • 20 to 50     : Initially 20–40 mg daily. Use with caution and monitor
  • 10 to 20     : Initially 20–40 mg daily. Use with caution and monitor
  • <10           : Initially 20–40 mg daily. Use with caution and monitor closely

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD                :Unlikely to be dialysed. Dose as in GFR <10 mL/min
  • HD                     :Unlikely to be dialysed. Dose as in GFR <10 mL/min
  • HDF/high flux   :Unlikely to be dialysed. Dose as in GFR <10 mL/min
  • CAV/VVHD      :Unlikely to be dialysed. Dose as in GFR 10 to 20 mL/min

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugs
  • Analgesics: effects enhanced by NSAIDs
  • Antibacterials: effects enhanced by chloramphenicol, sulphonamides, and trimethoprim; effect reduced by rifamycins
  • Anticoagulants: effect possibly enhanced by coumarins; also possibly changes to INR
  • Antifungals: concentration increased by fluconazole and miconazole and possibly voriconazole – avoid with miconazoleSulfinpyrazone: enhanced effect of sulphonylureas

    ADMINISTRATION

    Reconstition

    Route

    Oral

    Rate of Administration

    Comments

    OTHER INFORMATION

    Care should be exercised in patients with hepatic and/or renal impairment, and a small starting dose should be used with careful patient monitoringCompany contraindicates prescribing of Diamicron in severe renal impairment, which they define as creatinine clearance below 40 mL/min.
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