Gliclazide

Gliclazide is a sulfonylurea — oral antidiabetic for type 2 diabetes medicine available in Bangladesh under many brand names. Below are its uses, side effects and precautions — and every brand with its current price.

Gliclazide is used for:

• Type 2 diabetes mellitus in adults — when blood sugar cannot be controlled by diet, exercise and weight reduction alone.
• Combination therapy — together with metformin or other antidiabetic medicines when single-drug treatment is insufficient, as judged by the doctor.

It is not used in type 1 diabetes or diabetic ketoacidosis, where insulin injections are essential. Your doctor will consider your kidney and liver function, age, meal pattern and hypoglycaemia risk before choosing gliclazide and its release form (standard or MR).

Side effects of Gliclazide may include:

• Hypoglycaemia — the key risk: sweating, shakiness, intense hunger, palpitations, dizziness, irritability, blurred vision or confusion; severe cases may cause unconsciousness. Take sugar or glucose immediately, then a meal.
• Digestive upset — nausea, indigestion, abdominal pain, constipation or diarrhoea; taking the tablet with breakfast reduces this.
• Mild weight gain in some patients.
• Skin reactions — rash, itching; stop and consult a doctor if severe.
• Rarely, liver enzyme changes or blood-cell disturbances, which reverse after stopping — periodic blood tests may be advised.

Important precautions with Gliclazide:

• Regular, carbohydrate-containing meals are essential — skipped or delayed meals, unusual exertion or alcohol can trigger hypoglycaemia.
• Keep glucose or sweets within reach and make sure family members recognise low-sugar symptoms.
• Take care when driving or using machines, particularly at the start of treatment or after dose changes.
• Elderly patients and those with kidney or liver impairment need lower doses and closer monitoring.
• Illness, fever, vomiting, surgery or major stress can destabilise sugar control — your doctor may switch you temporarily to insulin.
• Before fasting (e.g. Ramadan), consult your doctor for dose and timing adjustment.
• Continue routine glucose and HbA1c monitoring.

Tell your doctor about all medicines you take with Gliclazide:

• Increase low-sugar risk — other antidiabetics and insulin, miconazole and fluconazole (antifungals), phenylbutazone, NSAIDs and aspirin, sulfonamide antibiotics (co-trimoxazole), some antidepressants and ACE inhibitors.
• Reduce sugar control — corticosteroids, danazol, chlorpromazine in high doses, thiazide diuretics and some hormone preparations.
• Beta-blockers — may mask the early warning signs of hypoglycaemia.
• Warfarin — anticoagulant effect may be altered; INR monitoring needed.
• Alcohol — can provoke severe, prolonged hypoglycaemia; avoid it.

Gliclazide must not be used in:

• Type 1 diabetes.
• Diabetic ketoacidosis, diabetic pre-coma or coma — these need emergency insulin treatment.
• Severe kidney or liver failure — insulin is recommended instead.
• Allergy to gliclazide, other sulfonylureas or sulfonamides.
• Concurrent miconazole therapy.
• Breastfeeding, and generally in pregnancy, where insulin is the standard choice.

Pregnancy: Gliclazide is generally avoided in pregnancy. If you are planning a baby or find out you are pregnant, inform your doctor immediately — control is usually switched to insulin, which is the safest established option for the baby. Do not stop the tablet abruptly without a replacement plan, because uncontrolled sugar itself is harmful in pregnancy.

Breastfeeding: It is not known with certainty how much gliclazide passes into breast milk, and there is a theoretical risk of low blood sugar in the infant, so the medicine is contraindicated while breastfeeding. Your doctor will arrange insulin or another suitable alternative during this time.

Store Gliclazide in a cool, dry place below 30°C, away from direct sunlight and moisture. Keep tablets in the original strip until you take them, and store all medicines out of the reach and sight of children. Never use the medicine after its expiry date; hand expired stock to a pharmacy for safe disposal instead of discarding it with household waste.