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All sulfonylureas should be used with caution in the elderly because of the greater likelihood of their missing meals and the more severe outcome of significant hypoglycemia.
Hypoglycemia may occur in some patients and may be severe and prolonged, requiring hospitalisation and blood sugar level monitoring for several days.
Careful monitoring of the dosage may be necessary for patients with adrenal insufficiency or hypopituarism, or are on beta-blockers.
Renal or hepatic insufficiency may alter the distribution of Gliclazide and increase the risk of hypoglycaemic reactions.
Blood and urine glucose levels should be monitored regularly.
The risk of hypoglycaemia, its symptoms and treatment, and the predisposing factors should be explained to the patient.
