DiamicronPatient <65 yr Initially 1 tab daily. Adjust dose depending on the blood glucose response & in steps of 1 tab at a time (at least 14 days should separate successive steps in the dose). Maintenance: 1-3 tab daily, or rarely 4 tab daily. Usual dose: 2 tab daily. Patient at particular risk (eg, >65 yr) Initially ½ tab once daily, can progressively increase until blood glucose is satisfactorily controlled, while keeping to steps of at least 14 days between successive levels, & w/ close monitoring of blood glucose. Diamicron MR 60 Initially 30 mg daily (½ tab), may be increased to 60, 90 or 120 mg daily, in successive steps. Interval between each dose increment should be at least 1 mth except in patients whose blood glucose has not been reduced after 2 wk of treatment. Dose may be increased at the end of the 2nd wk of treatment in such cases. Max: 120 mg/day. Switching from Gliclazide 80 mg tab to Gliclazide 60 mg MR tab: 1 tab Gliclazide (Diamicron) 80 mg tab is comparable to 30 mg MR formulation (eg, ½ tab of Diamicron MR 60 mg). Consequently, the switch can be performed w/ careful blood monitoring. Switching from another oral antidiabetic agent to Gliclazide 60 mg MR tab: Initially 30 mg/day, followed by a stepwise increase in dose, depending on the metabolic response. Patients at risk of hypoglycemia Min starting dose of 30 mg daily.
Diamicron Should be taken with food: Take w/ meals to minimize GI disturbances. Diamicron MR 60 May be taken with or without food..
Contraindications
Hypersensitivity to gliclazide, other sulfonylureas, or sulfonamides. Type 1 diabetes; diabetic pre-coma & coma, diabetic ketoacidosis. Concomitant use w/ miconazole. Severe renal or hepatic insufficiency. Lactation.
Increased risk of hypoglycemia due to low-calorie diet, following major or prolonged exercises, following ingestion of alcohol or in combination w/ other hypoglycemic agents; patient refuses or is unable to cooperate (particularly in elderly); malnutrition, irregular mealtimes, skipping meals, periods of fasting or dietary changes; imbalance between physical exercise & carbohydrate intake; overdosage; thyroid disorders, hypopituitarism & adrenal insufficiency. St. John's wort prep, fever, injury, infection, or surgery may affect blood glucose control. Dysglycemia (concomitant use w/ fluoroquinolones, especially in elderly). Monitor blood glucose levels regularly. G6PD-deficiency. Galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption. May affect ability to drive or operate machinery. Avoid use during pregnancy. Childn & adolescents. Elderly.
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