Diamicron MR Gliclazide
How does it work?
Gliclazide (Diamicron) is categorized under the therapeutic class of Sulfonylureas that work by stimulating the release of insulin in the pancreas to control excess blood glucose in the body.
Store this medication in a cool and dry place. Specifically, temperatures between 15-30 degrees Celsius (59-86 °F), away from heat, exposure to light, and moisture. Keep this medication out of reach of children and pets. Once a blister pack is opened, take it immediately or keep it in a vacuum-sealed container if you’re going to save it for later.
Dosage and Dosages Available
Gliclazide (Diamicron) comes in two types of tablets:
- Normal or Standard Release – the active ingredient of Diamicron is released immediately.
- Modified Release (MR) – the active ingredient of Diamicron is progressively released within 24 hours.
Dosages available in the market:
Diamicron comes in dosages of 30mg, 40mg, 60mg and 80mg.
When is Diamicron Used? How is it Used?
Gliclazide (Diamicron) tablet is used when blood glucose levels cannot be controlled with diet and lifestyle modification alone. Diamicron is a sulfonylurea and since its mechanism is to lower blood glucose (sugar) levels in the body by insulin stimulation, the best time to take the medication is at least 30 minutes before a meal or after meals in the morning to prevent hypoglycemia. Hypoglycemia is a condition where blood sugar levels go below the normal and symptoms such as irregular heartbeat, fatigue, pale skin, tremors, and extreme hunger rise.
Taking Diamicron tablets depend on the patient’s blood glucose level. The initial dose of Gliclazide (Diamicron) tablets start with 40-80mg per day then slowly increased to 320mg if there is a need. Doses above 160 mg are taken in 2 divided doses.
For Modified Release tablets, initially, a single dose of 30mg daily and will increase up to 120mg if necessary.
The usual interval before a dose increase would take a month, but for unresponsive patients, it would take a minimum of 2 weeks.
In case a dose is missed, skip the missed dose and continue with your regular regimen. Never take double doses of Gliclazide to make up for the missed one. If you’re unsure on what to do, call your pharmacist or physician on possible interventions they might add.
Common side-effects associated with Diamicron:
- Indigestion or stomach discomfort
- Diarrhea or Constipation
Less common but more serious side-effects include:
- Skin turning yellow
- Prolonged bleeding and bruising
- Redness, rash, or hives
If experienced, contact your physician immediately to intervene or change the course of therapy.
Warnings & Precautions
Low Blood Sugar (Hypoglycemia)
The main mechanism of Gliclazide (Diamicron) is to lower blood sugar. This could result to arrhythmias, fatigue, pale skin, tremors, and extreme hunger.
How to Avoid Hypoglycemia:
- Taking more than the dose prescribed or overdosing.
- Skipping meals while on medication/Taking the medication on an empty stomach.
- Taking the medication while on a fast.
- Going on a strict diet while on medication
- Taking herbal medicines concomitantly with Diamicron
- Pre-existing kidney or liver damage
- Drinking alcohol while on medication
Pregnancy and Lactation
Gliclazide (Diamicron) is under Pregnancy Category C where it had shown adverse effects on the fetus and there are no sufficient and well-controlled studies in humans yet. Therefore, Diamicron is generally not recommended to be taken while pregnant and breastfeeding because it could also affect the baby’s health.
Medications that cannot be taken while on Gliclazide (Diamicron) and could lead hypoglycemic shock:
- Miconazole – known as a medication used to treat skin infections associated with fungus.
- Phenylbutazone – is known as a non-steroidal anti-inflammatory drug (NSAID) which is often used for pain relief.
- Alcohol – a well-known recreational drug and generally an inhibitor.
- Other common anti-diabetic agents like insulin preparations, acarbose, dipeptidyl peptidase-4 inhibitors, metformin, thiazolidinediones, and GLP-1 receptor agonists.
- Beta-blockers – also known as beta-adrenergic blocking agents, medications that are used for the treatment of hypertension. (e.g., Propranolol)
- Fluconazole – a medication used to treat fungal and yeast infections.
- Captopril and Enalapril – medications classified under Angiotensin-Converting Enzyme Inhibitors (ACEIs) that are generally used to treat hypertension.
- H2-receptor antagonists – medications used to treat hyper gastric secretions in the stomach. (e.g., Ranitidine)
- Monoamine oxidase inhibitors (MAOIs)
- Sulfonamides – an antibacterial which includes sulfadiazine and sulfamethazine that is used to treat various infections.
- Clarithromycin – an antibacterial classified under macrolides that is used to treat various infections.
- Non-steroidal anti-inflammatory agents (NSAIDs) – medications widely used for pain (e.g., Ibuprofen, Celecoxib)
- Steroid-containing preparations such as prednisolone.
- Contraceptive Pills – should be used in small doses to avoid enhanced hyperglycemia.
Medications taken in conjunction with Gliclazide (Diamicron) that can antagonize its effect by increasing blood sugar levels instead of controlling it:
- Danazol – a medication that is used to treat endometriosis and fibrocystic breast disease. Often used alone or with other medications.
- Chlorpromazine – a medication used for psychiatric disorders like schizophrenia or manic-depression.
- Glucocorticoids – medications that are classified under steroid hormones where they are used to fight off inflammation.
- Ritodrine – a medication that could inhibit or stop premature labor.
- Salbutamol – a short-acting beta 2 adrenergic receptor agonist used as a treatment for asthma and COPD.
- Terbutaline – used as a treatment for bronchospasm correlated to asthma, bronchitis, and emphysema.
- Hypericum perforatum(St John’s Wort) – is a medicinal plant used for an array of conditions like depression, menopausal symptoms, and ADHD.
Medications that should be avoided in general to avoid further complications:
- Fluoroquinolones – antimicrobials that may lead to dysglycemia. Dysglycemia is a term used for blood glucose instability which may cause either hyperglycemia or hypoglycemia.
- Anticoagulant Therapy – could increase the chances of enhancing the anticoagulation effect of the medication. An example is Warfarin.
Gliclazide (Diamicron) is contraindicated in the following:
- May cause hypersensitivity to the following excipients
- Calcium Hydrogen Phosphate Dihydrate
- Magnesium Stearate
- Anhydrous Colloidal Silica
- Insulin-dependent Diabetes Mellitus (Type 1 DM)
- Diabetic Ketoacidosis – develops when there the body has insufficient insulin to allow blood glucose into the cells to use as energy in turn, the liver breaks down fat as fuel and produces acids known as ketones. When ketones are produced too quickly, they can add up as toxins in the body.
- Diabetic Coma/Pre-coma
- Severe renal or hepatic insufficiency. In this case, insulin preparations are recommended.