Description
Therapeutic action
– Sulphonyl urea hypoglycaemic which stimulates secretion of pancreatic insulin
Indications
– Adult-onset diabetes, insulin-independent and not controlled by well followed diet
Measurement of blood glucose levels is essential in establishing diagnosis and control of the disease
process.
Presentation
– 2.5 mg and 5 mg tablets
Also comes in 1.25 mg tablet.
Dosage
– Adult: initially, 2.5 to 5 mg once daily in the morning
Adjust dosage until diabetic control is obtained; maximum dose: 15 mg/day.
Adjust dosage gradually and very cautiously for elderly patients.
Duration
– According to clinical response and laboratory tests
Contra-indications, adverse effects, precautions
– Do not administer if:
- insulin-dependent diabetes, juvenile diabetes mellitus;
– May cause:
- severe renal or hepatic function impairment; allergy to sulphonamides.
- hypoglycaemia due to excessive doses, especially in elderly patients; insufficient intake of sugar;
hepatic or renal failure. Treat mild hypoglycaemia with intake of oral sugar and IV injection of hypertonic glucose solution if severe; adjust dosage;
- allergic reactions.
– Avoid combination with: co-trimoxazole, aspirin and other anti-inflammatory drugs, beta-blockers (risk
of hypoglycaemia), barbiturates, glucocorticoids, oral contraceptives (antagonise hypoglycaemic effect),
etc.
– Avoid combination with alcohol: antabuse reaction.
–Pregnancy: contra -indicated during the third trimester
–Breast-feeding: contra-indicated
Remarks
– Use only when diabetes cannot be controlled with diet alone, and monitor blood-glucose levels
regularly.
– Use of oral antidiabetics does not mean dietetic measures should be cancelled.
– Insulin may be required in patients having surgery.
– Chlorpropamide is a long-acting sulphonylurea hypoglycaemic used at doses of 125 to 250 mg once
daily. Risk of hypoglycaemia is higher than with other antidiabetic.
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