Gliclada

Gliclada - Pregnancy | Dosage | Effects

Gliclada modified release tablets is a drug that contains gliclazide (active substance of the drug) and belongs to a family of medicines that lower glucose levels in the blood, or more precisely it belongs to sulphonylurea derivatives. It is an oral anti-diabetic medicine and it reduces blood sugar levels because it stimulates production of insulin. It is used to treat diabetes mellitus type 2.

It also exerts positive effects on blood vessels, because it decreases the occurrence of thrombosis (it inhibits aggregation of platelets - the main mechanism responsible for occurrence of thrombosis).

Contraindications and special precautions

Gliclada is contraindicated in the following situations:

  • Hypersensitivity to gliclazide or other sulphonylurea derivatives
  • Diabetes type 1
  • Diabetic ketoacidosis
  • Diabetic coma
  • Severe kidney impairment
  • Severe liver impairment
  • Lactation
  • If you are taking medicine called miconazole (anti-fungal medication)

This drug should be used only when patients eat their meals regularly. It is very important to eat carbs regularly while taking Gliclazide in order to avoid hypoglycemia. Sometimes, during the use of this drug, severe hypoglycemia may occur and in that case, you need to go to the nearest hospital as soon as possible.

The risk of hypoglycemia is higher in elderly patients (due to the dementia), patients who don't eat their meals regularly, patients who exercise a lot but eat inadequate food and in patients who are taking other drugs that may lower your blood sugar.

Patients must be well familiar with hypoglycemia symptoms and in which situations they must go to the hospital.

Gliclada and pregnancy

One case of a 42-year old pregnant woman who took gliclazide (active component of Gliclada) in the dose of 30 mg per day has been reported. She gave a birth to a completely healthy child.1 However, this is only a single case and there is not enough data/research about the safety profile of this drug during pregnancy. Because of that, your doctor will probably prescribe you some other anti-diabetic medications during pregnancy.

Gliclada and breastfeeding

There is no data about Glicalada excretion in breast milk. Because of the possible risk of hypoglycemia in infants, this drug must not be used during breastfeeding.

Dosage

Glicalada extended-release tablets exist in a dose of 30 mg and 60 mg.

Glicalada immediate-release tablets exist in a dose of 80 mg.

Sometimes, your doctor may decide to replace immediate-release tablets with extended-release tablets due to their long-lasting effects. In that case, you should know that one immediate-release tablet in a dose of 80 mg is equivalent to one extended-release tablet in a dose of 30 mg.

The usual daily dose is 30 - 120 mg, depending on HbA1c concentration in the blood. At the beginning of the treatment, it is recommended to start with lower dose (30 mg/day) and to gradually increase it until an adequate effect is achieved.

Gliclada tablets should be taken with 1 cup of water during breakfast.

Dose adjustment is needed in patients with severe kidney or liver impairment.

Interactions

Drugs that increase risk of hypoglycemia if used concurrently with Gliclada include:

  • Miconazole (anti-fungal drug), including topical products intended for use on skin or mucosa (gel, cream and ointment)
  • Phenylbutazone - non-steroidal anti-rheumatic drug
  • ACE inhibitors, e.g. captopril and enalapril (drugs used to treat heart diseases)
  • Beta blockers (also drugs used to treat heart disease)
  • Ranitidine (a drug for the treatment of heartburn and ulcers)
  • Phenelzine, moclobemide and isocarboxazid

Alcoholic beverages also increase the effect of this drug and should never be taken concurrently with Gliclada.

Drugs that increase the risk of hyperglycemia if used concurrently with Gliclada include:

  • Phenothiazine antipsychotics (such as chlorpromazine)
  • Danazol - a drug used in the treatment of endometriosis and fibrocystic breast disorders
  • Anti-asthmatic drugs
  • Corticosteroids

Gliclada side effects

Side effects that occur in < 10 % of patients:

  • Hypoglycemia. If you notice symptoms of hypoglycemia (a strong sense of hunger, nausea, vomiting, sleep disorders and headache), visit your physician immediately. Always carry some candy or regular sugar cube so you can react immediately when you feel your blood sugar is low.

Side effects that occur in < 1 % of patients:

  • Gastrointestinal disorders. If taken with a meal as recommended, these side effects occur rarely.

Side effects that occur in < 0.1 %:

  • Anemia
  • Leukopenia
  • Thrombocytopenia
  • Allergic reaction
  • Jaundice
  • Short-term vision altering effects

References

  1. NCBI link 1