DIAMICRON (Gliclazide)

Diamicron Information
Diamicron is an hypoglycemic agent of the sulfonylurea group and is related to insulin secretion improvement from the functioning beta cells of the pancreas. It potentiates the insulin release and improves the dynamics of insulin. Diamicron is rapidly absorbed from the gastrointestinal tract and the plasma peak of gliclazide occurs between 4 and 6 hours. In man it is highly bound to plasma proteins, about 94.

Diamicron Warnings
The use of Diamicron will not prevent the development of complications peculiar to diabetes mellitus and it should be considered as treatment in addition to proper dietary routine and not as substitute for diet. Patients over a period of time, may become progressively less responsive to therapy with oral hypoglycemic agents because of worsening of their diabetic state. If a loss of adequate blood glucose-lowering response to Diamicron is detected, the drug should be discontinued. Since the effects of oral hypoglycemic agents on the vascular changes and other long-term sequelae of diabetes mellitus are not fully known, patients receiving such drugs must be closely observed for both short- and long-term complications. Periodic assessment of cardiovascular, ophthalmic, renal and hepatic status is advisable.

Drug Interactions: As a result of drug interaction, hypoglycemia may be potentiated when a sulfonylurea is used concurrently with agents such as: long-acting sulfonamides, tuberculostatics, phenylbutazone, clofibrate, MAO inhibitors, coumarin derivatives, salicylates, probenecid, propranolol, miconazole, cimetidine, disopyramide and angiotensin converting enzyme inhibitors. Certain drugs tend to induce hyperglycemia and may lead to loss of control of blood sugar control. These include diuretics (thiazides, furosemide), corticosteroids, oral contraceptives (estrogen plus progestogen) and nicotinic acid in pharmacologic doses. Barbiturates should be used with caution in patients receiving an oral hypoglycemic agent since they may reduce the hypoglycemic effect. Some sulfonylurea drugs are excreted in human milk although it is not known whether gliclazide is one of them. Safety and effectiveness in children have not been established. Contra-Indications include : - Known hypersensitivity or allergy to gliclazide. - Unstable and/or insulin dependent diabetes mellitus, ketoacidosis, coma. - During stress conditions such as serious infection, trauma or surgery.

Diamicron Side Effects
Diamicron side effects include manifestations of hypoglycemia including dizziness, lack of energy, drowsiness, headache and sweating have been observed apart from Weakness, nervousness, shakiness and paresthesia. Gastrointestinal side effects include nausea, vomiting, diarrhea, epigastric fullness and gastric irritation can be observed. . Allergic reactions such as pruritus, erythema, urticaria and morbiliform or maculopapular rash have been reported. Cases of hepatic porphyria and disulfiram-like reactions have been described with sulfonylurea drugs. A decrease in the uptake of radioactive iodine by the thyroid gland has been reported with other sulfonylurea drugs.

Diamicron Overdose
Diamicron overdose may result in hypoglycemia but it should be noted that the dosage which causes such hypoglycemia varies widely and may be within the accepted therapeutic range in sensitive individuals. The symptoms of hypoglycemia include sweating, flushing or pallor, numbness, chilliness, hunger, trembling, headache, dizziness, increased pulse rate, palpitations, increased blood pressure and apprehensiveness in mild cases. In more severe cases, coma appears. Some sulfonylurea-induced hypoglycemias may be refractory to treatment and susceptible to relapse especially in elderly or malnourished patients.

Diamicron Usage guidelines
Determination of the proper dosage for Diamicron for each patient should be made on the basis of frequent determinations of blood glucose during dose titration and throughout maintenance. The recommended daily dosage is 80 to 320 mg. Dosage of 160 mg and above should be divided into 2 equal parts for twice a day administration. Diamicron should be taken preferentially with meals.