Sulphonylureas gliclazide

Several studies have demonstrated that treatment of diabetic patients with the sulphonylurea, gliclazide, is associated with a fall in lipid peroxidation, protein fluorescence and beneficial effects on platelet function (Florkowski et al., 1988 Jennings et al., 1992). These changes were seen to be independent of changes in giycaemic control. 

At least for some sulphonylureas (gliclazide and glipizide), intra- and inter-individual variations in absorption are pronounced, perhaps explaining the large variations observed in their responses (Hartling et al., 1987). 

Sulphonylureas Chlorpropamide, glibenclamideb, gliclazide, glimepiride, glipizide, gliquidone, tolazamide, tolbutamide Stimulate insulin secretion (typically 6-24 h) Oral... 

Rosiglitazone is a thiazolidinedione that can be used in combination with metformin or a sulphonylurea such as gliclazide. Rosiglitazone should be administered with caution in patients with cardiovascular disease. 

Gliclazide is a sulphonylurea. In general, diabetic patients are switched over to insulin during pregnancy. Sulphonylureas should be stopped at least 2 days... 

Gliclazide is a corrunonly used second generation sulphonylurea. If more than 80 mg is prescribed, the drug should be taken twice daily before meals. 

Absorption of both first- and second-generation sulphonylureas is rapid and complete except for gliclazide and tolazamide, which are absorbed more slowly. The maximal plasma concentrations are usually reached within 2-4 h. The kinetics of absorption depend on the formulation and crystalline structure of the drug. Absorption of chlorpropamide may also depend on pH and therefore on food intake, which appears not to be true for the other sulphonylureas (Sartor et al., 1980). The absorption of glibenclamide, although rapid and almost complete, can be improved by an appropriate formulation (Haupt et al., 1984) which leads to a reduction in the daily dosage required. 

The inactivation and disappearance of sulphonylureas is dominated by their metabolism. An enterohepatic recirculation is postulated for gliclazide from animal experiments but seems to be absent in humans (Benakis and Glasson, 1980). 

On the whole cimetidine and ranitidine do not appear to significantly alter diabetic control with sulphonylureas, although cases of adverse effects have been seen when glibenclamide was given with ranitidine, and when gliclazide or glipizide were given with cimetidine. 

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