Hypoglycemia gliclazide

In an open study in 57 patients acarbose and gliclazide had the same effects on HbAic, blood glucose, and lipids, but the ratio of HDL to LDL cholesterol increased with acarbose (19). Acarbose caused flatulence in 30% and diarrhea in 3% and gliclazide caused at least one mild attack of hypoglycemia in 10%. 

In a 2-year study in 507 patients, mean age 61 years, the incidence of symptoms suggestive of hypoglycemia was 4.8 per 100 patient years (56). Seven patients withdrew after 1 year because of adverse events, which were thought to be unrelated to the gliclazide. 

In a small study, gliclazide MR 30-120 mg/day had similar efficacy to 80-320 mg/day of the immediate-release formulation. The most commonly observed adverse events were arthralgia, arthritis, back pain, and bronchitis, which may not all have been directly related to the drug, as they also occurred with placebo. There was symptomatic hypoglycemia in about 5%. 

A once-daily modified-release formulation of gliclazide has been reviewed (157). It has a low tendency to cause hypoglycemia in all patients, including the elderly and patients with mild renal insufficiency. Arthralgia, arthritis, back pain, and bronchitis are its most commonly reported adverse effects, although it is not clear whether they are all related to gliclazide. 

Chlorpropamide produces the same interaction (192). The combination of gliclazide, fluconazole, and sulfamethoxazole can cause severe hypoglycemia (193). 

Drug overdose In a case of overdose with gliclazide there was severe hypoglycemia without adrenergic or autonomic responses [78" ]. 

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