Gliclazide

Gliclazide primarily lowers blood glucose by stimulating insulin release from pancreatic beta cells. It binds to sulfonylurea receptors on the beta-cell membrane, leading to the closure of ATP-sensitive potassium channels. This causes depolarization of the beta-cell membrane, opening voltage-gated calcium channels, and subsequent influx of calcium, which triggers insulin exocytosis. It may also have some extrapancreatic effects, including improved peripheral insulin sensitivity and reduction of hepatic glucose production.

Adult

Initial dose is typically 40-80 mg daily (conventional release) or 30 mg daily (modified release, MR), taken with breakfast. Dose can be titrated gradually based on blood glucose levels. Conventional release dose may range from 80-320 mg daily, given in 2 divided doses for doses >160 mg. Modified release (MR) dose may range from 30-120 mg once daily. For MR, the maximum single dose is 120 mg.

Pediatric

Not recommended for use in children due to lack of established safety and efficacy.

Renal adjustment

Mild to moderate renal impairment (eGFR 30-60 mL/min/1.73m2): Caution is advised, starting with a lower dose and careful monitoring of blood glucose to avoid hypoglycemia. Severe renal impairment (eGFR <30 mL/min/1.73m2): Contraindicated due to increased risk of hypoglycemia and drug accumulation. Insulin is generally preferred in such cases.…

Max dose

240 mg/day (doses >80 mg given in divided doses)

• Hypersensitivity to gliclazide or other sulfonylureas or sulfonamides
• Type 1 Diabetes Mellitus
• Diabetic ketoacidosis, diabetic precoma and coma
• Severe renal insufficiency or failure
• Severe hepatic insufficiency
• Pregnancy and lactation
• Concomitant treatment with miconazole
• pregnancy (change to insulin advised)
• nursing mothers
• liver dysfunction
• kidney dysfunction