Zide
Generic Name
Gliclazide
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| zide 80 mg tablet | ৳ 6.00 | N/A |
Description
Overview of the medicine
Gliclazide is an oral antidiabetic drug (sulfonylurea class) used to lower blood glucose levels in patients with type 2 diabetes mellitus.
Uses & Indications
Dosage
Adults
Initial dose: 40-80 mg once daily, preferably with breakfast. Maintenance dose: 80-320 mg daily, given as a single dose or in two divided doses. Doses above 160 mg/day should be divided.
Elderly
Start with a lower dose (e.g., 40 mg daily) and titrate carefully, due to increased risk of hypoglycemia and altered renal function.
Renal_impairment
In mild to moderate renal impairment, dose adjustment may not be required. In severe renal impairment, dose reduction or alternative agents should be considered. Gliclazide MR 30 mg or 60 mg is generally preferred for ease of use in such cases.
How to Take
Take orally, usually with breakfast or the main meal of the day. Swallow the tablet whole with water. Do not chew or crush.
Mechanism of Action
Gliclazide primarily acts by stimulating insulin release from the pancreatic beta cells. It binds to the sulfonylurea receptor (SUR1) on beta cells, leading to closure of ATP-sensitive potassium channels, depolarization, calcium influx, and subsequent insulin secretion.
Pharmacokinetics
Onset
Approximately 1 hour
Excretion
Primarily renal excretion of metabolites (60-70%), with a smaller amount excreted in feces (10-20%).
Half life
10-12 hours
Absorption
Well absorbed orally. Peak plasma concentration reached within 2-6 hours.
Metabolism
Extensively metabolized in the liver (primarily via CYP2C9) to inactive metabolites.
Side Effects
Contraindications
- Type 1 Diabetes Mellitus
- Diabetic ketoacidosis (with or without coma)
- Severe renal or hepatic impairment
- Hypersensitivity to gliclazide, other sulfonylureas, or sulfonamides
- Pregnancy and lactation
- Concomitant use with miconazole
Drug Interactions
Alcohol
Can enhance the hypoglycemic effect, leading to severe hypoglycemia.
Miconazole
Potentiates the hypoglycemic effect, potentially leading to severe hypoglycemia. Concomitant use is contraindicated.
Phenylbutazone, other NSAIDs
Enhance the hypoglycemic effect.
Beta-blockers, ACE inhibitors
May mask symptoms of hypoglycemia and potentiate the effect.
Corticosteroids, Diuretics, Danazol
May increase blood glucose levels, reducing the efficacy of gliclazide.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include severe hypoglycemia, which may be accompanied by headache, nausea, vomiting, lethargy, confusion, agitation, unconsciousness, and seizures. Management involves immediate correction of hypoglycemia with oral glucose if conscious, or intravenous glucose/glucagon if unconscious. Continuous monitoring of blood glucose is necessary for at least 24-48 hours.
Pregnancy & Lactation
Gliclazide is contraindicated during pregnancy and lactation. Insulin is generally preferred for glycemic control in pregnant women with diabetes. It is unknown whether gliclazide is excreted in human milk.
Side Effects
Contraindications
- Type 1 Diabetes Mellitus
- Diabetic ketoacidosis (with or without coma)
- Severe renal or hepatic impairment
- Hypersensitivity to gliclazide, other sulfonylureas, or sulfonamides
- Pregnancy and lactation
- Concomitant use with miconazole
Drug Interactions
Alcohol
Can enhance the hypoglycemic effect, leading to severe hypoglycemia.
Miconazole
Potentiates the hypoglycemic effect, potentially leading to severe hypoglycemia. Concomitant use is contraindicated.
Phenylbutazone, other NSAIDs
Enhance the hypoglycemic effect.
Beta-blockers, ACE inhibitors
May mask symptoms of hypoglycemia and potentiate the effect.
Corticosteroids, Diuretics, Danazol
May increase blood glucose levels, reducing the efficacy of gliclazide.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include severe hypoglycemia, which may be accompanied by headache, nausea, vomiting, lethargy, confusion, agitation, unconsciousness, and seizures. Management involves immediate correction of hypoglycemia with oral glucose if conscious, or intravenous glucose/glucagon if unconscious. Continuous monitoring of blood glucose is necessary for at least 24-48 hours.
Pregnancy & Lactation
Gliclazide is contraindicated during pregnancy and lactation. Insulin is generally preferred for glycemic control in pregnant women with diabetes. It is unknown whether gliclazide is excreted in human milk.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
36 months from manufacturing date.
Availability
Pharmacies nationwide
Approval Status
Approved by DGDA
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Gliclazide has been extensively studied in numerous clinical trials establishing its efficacy and safety in managing type 2 diabetes. ADVANCE trial (Action in Diabetes and Vascular Disease: Preterax and Diamicron MR Controlled Evaluation) is one of the notable trials.
Lab Monitoring
- Blood glucose levels (fasting and post-prandial) regularly
- HbA1c levels every 3-6 months
- Renal and hepatic function tests periodically
- Complete Blood Count (CBC) occasionally
Doctor Notes
- Educate patients thoroughly on hypoglycemia symptoms, prevention, and emergency management.
- Emphasize the importance of adherence to diet, exercise, and regular blood glucose monitoring alongside medication.
- Assess renal and hepatic function periodically, especially in elderly patients.
- Caution against concomitant use with medications that can potentiate or attenuate gliclazide's effect.
Patient Guidelines
- Take the medicine exactly as prescribed by your doctor.
- Monitor your blood glucose levels regularly as advised.
- Be aware of the symptoms of hypoglycemia (e.g., sweating, trembling, confusion) and carry a source of sugar (e.g., glucose tablets, juice) to treat it immediately.
- Follow your diet and exercise plan diligently.
Missed Dose Advice
If a dose is missed, take it as soon as you remember, unless it is almost time for your next dose. Do not take a double dose to make up for a forgotten dose.
Driving Precautions
This medicine may cause hypoglycemia, which can impair your ability to concentrate and react. Caution should be exercised when driving or operating machinery, especially at the beginning of treatment or if you frequently experience hypoglycemia.
Lifestyle Advice
- Maintain a balanced diet suitable for diabetes management.
- Engage in regular physical activity as recommended by your doctor.
- Maintain a healthy body weight.
- Avoid or limit alcohol consumption.
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