Glurenorm Special Precautions

Treatment of diabetes requires regular medical attention. Caution should be exercised, particularly during the dose titration phase or upon transfer from another preparation (see Effects on ability to drive and use machines as follows).
Although only about 5% of GLURENORM is excreted by the kidneys and GLURENORM is thus generally well tolerated by patients with renal impairment, in the presence of severe renal impairment particularly careful medical control is necessary. Should signs of hypoglycaemia such as fever, skin rashes, or nausea occur during treatment, the physician should be consulted without delay. Should a patient become pregnant during treatment, GLURENORM should be discontinued and medical advice sought immediately.
Oral antidiabetic therapy should not be used to replace dietetic therapy, since in diabetes the diet is designed primarily to control the patient's weight and is independent of any drug treatment which the physician may prescribe. The omission of a meal or non-adherence to the physician's dosage recommendations may considerably reduce the blood sugar level and possibly lead to loss of consciousness e.g. if the tablet is taken before a meal instead at starting the meal, the effect on blood glucose is usually more prominent increasing the risk of hypoglycaemia.
Should clinical signs of hypoglycaemia occur, the immediate oral intake of sugar containing foods is the appropriate action. If the hypoglycaemic state persists, immediate intensified treatment and monitoring is necessary.
Physical exertion may intensify the hypoglycaemic effects.
Alcohol or stress may enhance or reduce the blood glucose lowering effect of sulfonylureas.
Treatment of patients suffering from glucose-6-phosphate-dehydrogenase deficiency with sulfonylureas may lead to haemolytic anaemia. As GLURENORM belongs to the class of sulfonylureas, it should be used with caution in patients with glucose-6-phosphate-dehydrogenase deficiency and an alternative therapy should be considered.
Special care should be observed in concomitant use of GLURENORM with many other medications especially those which increase the blood glucose lowering of GLURENORM (see Interactions).
One tablet of 30 mg contains 134.6 mg lactose, resulting in 538.4 mg lactose per maximum recommended daily dose. Patients with the rare hereditary conditions of galactose intolerance e.g. galactosaemia, the Lapp lactase deficiency or glucose-galactose malabsorption should not take this medicine.
Effects on ability to drive and use machines: No studies on the effects on the ability to drive and use machines have been performed. However, patients should be advised that they may experience somnolence, dizzinesss and accomodation disorders or other clinical signs of hypoglycaemia during treatment with GLURENROM. Therefore, caution should be recommended when driving a car or operate machinery. If patients experience hypoglycaemic effects they should avoid potentially hazardous tasks such as driving or operate machinery.