Gliclazide

Gliclazide is an oral hypoglycemic sulfonylurea drug used to treat type 2 diabetes mellitus. This drug helps control blood glucose levels by stimulating the pancreas to produce insulin. Gliclazide is effective for patients who have not achieved adequate glycemic control through diet, exercise, or other medications.

Gliclazide works by stimulating the beta cells of the pancreas to produce more insulin. Insulin is needed to help the body's cells absorb glucose from the blood and use it as energy, which ultimately lowers blood glucose levels.

Indications Gliclazide

Type 2 diabetes mellitus: The drug may be prescribed as monotherapy or in combination with other hypoglycemic agents such as metformin or insulin to achieve optimal control of blood glucose levels.

Release form

Gliclazide is usually available in tablet form to be taken orally. Tablets may have different dosages depending on the doctor's prescription and the patient's needs.

Pharmacodynamics

1. Stimulation of insulin release: Gliclazide acts on the beta cells of the pancreas, stimulating them to release insulin. This occurs by blocking potassium channels in beta cells, which leads to cell depolarization and subsequent release of insulin.
2. Improving tissue sensitivity to insulin: Gliclazide may also increase the sensitivity of peripheral tissues to insulin, which means that tissues respond better to insulin, increasing its action and reducing blood sugar.
3. Reducing blood pressure: Some studies show that gliclazide may have an antihypertensive effect, that is, help lower blood pressure in patients with diabetes. This is due to its ability to dilate blood vessels and improve blood flow.
4. Anti-inflammatory effects: Some studies also suggest that gliclazide may have anti-inflammatory properties, which may be useful in preventing or reducing inflammation associated with diabetes.

Pharmacokinetics

1. Absorption: Gliclazide is usually well absorbed from the gastrointestinal tract after oral administration. Peak plasma concentrations are usually achieved 4-6 hours after administration.
2. Metabolism: The drug is metabolized in the liver to form active and inactive metabolites. The main active metabolite of gliclazide is M1, which also has a hypoglycemic effect.
3. Elimination: Gliclazide and its metabolites are eliminated primarily through the kidneys. Half-life from the body is approximately 6-12 hours.
4. Interactions: Gliclazide may interact with other drugs, including anticoagulants, beta blockers and some antibiotics. Some medications may increase or decrease the hypoglycemic effect of gliclazide, so it is important to tell your doctor about all medications you are taking.

Dosing and administration

The dosage and route of administration of Gliclazide may vary depending on the doctor's recommendations, the patient's health condition and other factors. Gliclazide is usually taken orally during or immediately after meals to reduce the risk of hypoglycemia (low blood sugar).

The dosage is usually selected individually by the doctor, depending on the level of glucose in the blood and other factors. The usual starting dose for adults is 30 to 120 mg once or twice daily. The maximum daily dose can be up to 320 mg, but be sure to follow your doctor's recommendations.

Use Gliclazide during pregnancy

The use of gliclazide during pregnancy is generally not recommended. Gliclazide is a sulfonylurea drug used to treat type 2 diabetes mellitus, and its effects on pregnancy and the fetus have not been fully studied. During pregnancy, monitoring blood glucose levels is extremely important, but other methods and drugs are usually preferred due to concerns about the safety of gliclazide and other oral hypoglycemic agents.

Risks of using gliclazide during pregnancy:

1. Hypoglycemia: Gliclazide can cause hypoglycemia, which is dangerous for both the mother and the developing fetus.
2. Effects on the fetus: Like other sulfonylureas, gliclazide can cross the placenta, which could theoretically affect the fetus, although specific research in this area is limited.

Recommendations for pregnant women:

• Alternative treatments: During pregnancy, the use of insulin is usually recommended to control blood glucose levels because it does not cross the placenta and is considered safe for the fetus.
• Careful Monitoring: Women with type 2 diabetes who are planning pregnancy or are already pregnant should monitor their blood glucose levels carefully under the guidance of a doctor. Your doctor may adjust your treatment to ensure optimal control of your diabetes during pregnancy.
• Consult Your Doctor: Before changing or stopping any medications during pregnancy, you should consult your doctor.

Contraindications

1. Type 1 diabetes: Gliclazide is not effective for treating type 1 diabetes because in this type of diabetes the pancreas does not produce enough insulin. Its use may be contraindicated in such patients.
2. Hypoglycemia: Gliclazide may lower blood sugar levels, which can cause hypoglycemia (severely low blood sugar). Patients at increased risk of hypoglycemia, such as the elderly or those with poor nutritional status, should use gliclazide with caution.
3. Renal impairment: The use of gliclazide may be contraindicated in patients with severe renal impairment as its metabolism and elimination from the body may be impaired.
4. Liver failure: The liver plays an important role in the metabolism of gliclazide. Therefore, in patients with severe hepatic impairment, its use may be contraindicated or require dosage adjustment.
5. Pregnancy and breastfeeding: The use of gliclazide during pregnancy and breastfeeding requires special caution and consultation with a doctor.
6. Cardiovascular disease: Gliclazide may affect the cardiovascular system and its use may be contraindicated in patients with or at risk of developing cardiovascular disease.
7. Allergic reaction: People with a known allergy to gliclazide or other sulfonylureas should avoid its use.

Side effects Gliclazide

1. Hypoglycemia: This is the most serious side effect of gliclazide. Hypoglycemia can be caused by an excessive decrease in blood sugar levels. Symptoms of hypoglycemia include dizziness, hunger, tremors, sweating, weakness, irregular heartbeat and even loss of consciousness.
2. Digestive disorders: May include nausea, vomiting, diarrhea, constipation, or abdominal discomfort.
3. Allergic reactions: Some people may be allergic to gliclazide and experience skin rash, itching, swelling of the throat or face, difficulty breathing, and other signs of an allergy.
4. Possible changes in liver or kidney function tests: In some cases, changes in blood tests may occur that indicate liver or kidney problems.
5. Rare: Other side effects may occur, such as headache, fatigue, drowsiness, irritability, or changes in blood pressure.

Overdose

1. Hypoglycemia: This is the most serious and common complication of gliclazide overdose. Overdose causes blood glucose levels to drop excessively, which can cause dizziness, weakness, hunger, loss of consciousness, and serious heart symptoms such as arrhythmias.
2. Cardiac arrhythmias: An overdose of gliclazide can cause various heart rhythm disturbances such as tachycardia, bradycardia or atrial fibrillation.
3. Hypotension: Excessive action of the drug can lead to a decrease in blood pressure, which can cause dizziness, fainting, or even collapse.
4. Other symptoms: Overdose may also cause nausea, vomiting, stomach upset, drowsiness, headache and other undesirable effects.

Interactions with other drugs

1. Hypoglycemic drugs: Use of gliclazide with other hypoglycemic drugs, such as sulfonylureas or insulin, may enhance the hypoglycemic effect and increase the risk of hypoglycemia.
2. Beta blockers: Beta blockers may mask symptoms of hypoglycemia, such as increased heart rate or sweating, which may make it difficult to diagnose hypoglycemia in patients taking gliclazide.
3. Anticoagulants: Gliclazide may increase the effect of anticoagulants such as warfarin, which may lead to an increased risk of bleeding. Constant monitoring of prothrombin time levels is necessary.
4. Antibiotics: Some antibiotics may change blood glucose levels, which may require dose adjustment of gliclazide.
5. Antifungal drugs: Antifungal drugs such as fluconazole may increase blood levels of gliclazide, requiring caution and possible dosage adjustment.