Adults

The usual initial dose is 30 mg once daily, taken at breakfast. The dose may be increased to 60 mg, 90 mg, or 120 mg once daily, in successive steps, allowing at least a 1-month interval between each dose increment, except in patients whose blood glucose has not reduced after 2 weeks. The maximum recommended daily dose is 120 mg.

Elderly

The same dosing regimen as for adults is recommended, with careful titration and blood glucose monitoring. Initial dose 30 mg once daily.

Renal_impairment

In mild to moderate renal impairment (creatinine clearance 30-60 mL/min), the recommended initial dose is 30 mg once daily with careful monitoring. Severe renal impairment (creatinine clearance <30 mL/min): Not recommended.

Onset

Onset of action within 2-4 hours.

Excretion

Mainly excreted in urine as metabolites (60-70%) and approximately 10-20% in feces.

Half life

Approximately 10-12 hours for the modified-release formulation.

Absorption

Rapidly and completely absorbed from the gastrointestinal tract. Plasma concentrations increase progressively over the first 6 hours, reaching a plateau from the 6th to the 12th hour.

Metabolism

Extensively metabolized in the liver, primarily by CYP2C9, into inactive metabolites. Less than 1% of the unchanged drug is found in urine.

Miconazole (systemic, oral gel)

Potentiates the hypoglycemic effect, possibly leading to coma.

Danazol, Chlorpromazine (high doses), Glucocorticoids (systemic), Diuretics (e.g., thiazides), Barbiturates

May reduce the hypoglycemic effect, leading to elevated blood glucose levels.

Phenylbutazone, Alcohol, other antidiabetic agents (e.g., metformin, insulin), Beta-blockers, ACE inhibitors, Fluconazole, H2-receptor antagonists

May potentiate the hypoglycemic effect of gliclazide.