Drugs Diamicron MRGeneric Name: Gliclazide Product Name: Diamicron MR • • • • • Indication of Diamicron MR Action of Diamicron MR Dose advice of Diamicron MR Schedule of Diamicron MR Common side effects of Diamicron MR Indication of Diamicron MR: Diamicron MR is used in the treatment of type II (non-insulin dependent) diabetes that cannot be controlled with diet and exercise. ^ top Action of Diamicron MR: Gliclazide is a blood glucose-lowering agent. Non-insulin dependent diabetes (NIDDM) is due to a decreased sensitivity of the body�s cells to insulin, but the pancreas still has the ability to produce insulin. Gliclazide stimulates the islet cells of the pancreas to secrete insulin, and also increases their sensitivity to their normal stimulus, glucose. These effects restore the (first-phase) insulin secretion that has become diminished in NIDDM patients. Gliclazide also has effects outside the pancreas, where it improves insulin-stimulated usage of glucose. This, combined with its continuing ability to stimulate insulin secretion, allow Gliclazide to have long-term blood glucose-lowering ability.Diamicron MR is a modified release tablet, meaning the blood concentrations of Gliclazide increase slowly. This produces steadier insulin release and more moderated diabetic control. ^ top Dose advice of Diamicron MR: Diamicron MR is for use in adults only. • • • • • • Dose may vary from 30-120mg, taken once daily Should be taken with food, preferably at breakfast time Tablets are modified release, therefore should not be broken or chewed Always titrate dose according to individual patient requirements, in steps of 30mg Daily dose should not exceed 120mg Diamicron MR can replace other Gliclazide 80mg tablets, one for one Do not use in patients with sulphonylurea intolerance. . Do not use in juvenile diabetes. INDICATIONS: Therapy of maturity onset Diabetes Mellitus (non-insulin. and 10-20% in the faeces as metabolites. In addition to this pancreatic action. It is due to an extension of the therapeutic effect. as safety in pregnancy has not been established. mature age onset) Diabetic Nephropathy PHARMACOLOGICAL CLASSIFICATION: A 21. and peak plasma concentrations occur (2-8) hours after administration.2 Oral Hypoglycaemics PHARMACOLOGICAL ACTION: Gliclazide stimulates the secretion of insulin by the beta cells of the pancreas.Other common adverse effects include: • • • • Weight gain constipation Epigastric discomfort/heartburn Skin itching ^ top Diseases treated by Diamicron MR: • • • Diabetes Mellitus Type 2 (non-insulin dependent. hepatic.^ top Schedule of Diamicron MR: S4 ^ top Common side effects of Diamicron MR: Hypoglycaemia is the most common and serious side effect of Diamicron. The elimination half-life of gliclazide is 10-12 hours. Gliclazide is (85-97%) bound to plasma proteins. Gliclazide is well absorbed. Do not use in the first trimester of pregnancy.dependent or Type II). Metabolism is extensive and all metabolites are devoid of hypoglycaemic activity. adrenal or thyroid dysfunction. Do not use in "brittle" or unstable diabetes. it has been demonstrated that gliclazide administration may improve the metabolic utilisation of glucose at a peripheral level. where dietary management alone has been insufficient. 60-70% of the dose is excreted in the urine. CONTRA-INDICATIONS: Do not use in the presence of keto-acidosis or severe renal. WARNING: The administration of oral hypoglycaemics may be associated with increased cardiovascular mortality as compared to treatment with diet alone or diet with insulin. and some may go away on their own over time. discuss the risks and benefits of this medication with your doctor. Adjustment of dosage of hypoglycaemic agents may be required in patients suffering from intercurrent infections. chloramphenicol. When major surgery is to be performed. ketoconazole. they could lead to serious problems if you do not seek medical attention. dicoumarol and cimetidine. Beta-blockers may mask symptoms of hypoglycaemia and may inhibit normal physiological response to hypoglycaemia.Most studies report no significant overall change in weight. temporary or permanent. Your pharmacist may be able to advise you on managing side effects. insulin therapy should be substituted for oral hypoglycaemics. IDE-EFFECTS AND SPECIAL PRECAUTIONS: Weight changes . The following side effects have been reported by at least 1% of people taking this medication. mono amine oxidase inhibitors. Contact your doctor if you experience these side effects and they are severe or bothersome. corticosteroids. cyclophosphamide. Drug interactions . If you are concerned about side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. betaadrenoreceptor blocking agents. oestrogens and adrenalin. Many of these side effects can be managed. Side effects can be mild or severe. Hypoglycaemic reactions may occur. Many medications can cause side effects. shock or after anaesthesia.A reduction in dosage may be necessary in patients with renal dysfunction.Potentiation of the hypoglycaemic action of the drug may occur with the concomitant administration of sulphonamides. Diminution of hypoglycaemic action of the drug may occur with the concomitant administration of thiazide diuretics. • • • • • • • • • • • • • changes in taste sensation changes in appetite (increased or decreased) constipation diarrhea difficulty focusing eyes dizziness frequent urination gas in stomach heartburn increased amounts of urine increased skin sensitivity to the sun nausea or vomiting stomach pain or discomfort Although most of the side effects listed below don't happen very often. . The side effects listed below are not experienced by everyone who takes this medication. traumas. phenylbutazone. clofibrate or halofenate. salicylates. miconazole. Check with your doctor as soon as possible if any of the following side effects occur: More common • • unusual weight gain symptoms caused by low blood sugar: o anxiousness o feeling drunk o blurred vision o cold sweats o confusion o difficulty concentrating o drowsiness o hunger o fast heart rate o headache o nausea o nervousness o nightmares o shakiness o slurred speech o unusual tiredness Less common • • • itching or rash peeling of skin reddening of skin Rare • • • • • • • • chest pain coughing up blood shortness of breath sore throat thinning of skin unusual bleeding or bruising unusual tiredness yellowing of eyes or skin Seek immediate medical attention if any of the following occur: • • • • back pain headache increased blood pressure respiratory infections . be sure to inform your doctor of any medical conditions or allergies you may have. nervousness. it should be stopped and another medication added. Weakness. Are there any other precautions or warnings for this medication? Before you begin using a medication. lack of energy. Alcohol use: Gliclazide MR can cause an unpleasant "intolerance reaction" to alcohol. Check with your doctor if you notice any symptom that worries you while you are taking this medication. whether you are pregnant or breast-feeding. and any other significant facts about your health. headache. Hypoglycemia (low blood sugar): As with other sulfonylurea medications like gliclazide MR. those with reduced liver or kidney function. The elderly. drowsiness. Worsening of condition: Over a period of time. and numbness or tingling have also been reported. Low blood sugar is more likely to occur when food intake is inadequate or after strenuous or prolonged physical exercise. the doctor may give consideration to stopping the medication and prescribing insulin until the situation improves. Proper diet: The use of gliclazide MR must be considered as treatment in addition to proper diet and not as a substitute for diet. . and those who are fragile or malnourished are more likely to have low blood sugar when they take these medications. any medications you are taking. To prevent this reaction. symptoms of hypoglycemia (low blood sugar) including dizziness. giddiness. These factors may affect how you should use this medication. Severe hypoglycemia can result from taking any of the sulfonylurea medications. Illness/stress: People on gliclazide MR therapy may experience loss of blood sugar control during illness or stressful situations. shakiness. nausea. gliclazide MR may become less effective because of the worsening of diabetes. Blood glucose should be monitored regularly and emergency glucose (and glucagon kit) kept available in case the need arises to increase blood sugar levels. Diabetes complications: The use of gliclazide MR (or any other medication used for diabetes) will not prevent the development of diabetes complications. and sweating have been observed. Under these conditions.• • • seizures unconsciousness urinary tract infections Some people may experience side effects other than those listed. the use of alcohol should be avoided. People taking gliclazide MR may experience flushing. such as trauma or surgery. If gliclazide MR no longer controls blood glucose to target levels. warmth. and possibly increased heart rate when they use alcohol. enalapril) diuretics (e.g. ranitidine. Children: The safety and effectiveness of using this medication have not been established for children. heparin) azole antifungal medications (e.. e. but it is not known whether gliclazide MR is one of them.. An interaction between two medications does not always mean that you must stop taking one of them. miconazole.g. propranolol) chlorpromazine corticosteroids (e. e. metformin) phenylbutazone probenecid salbutamol salicylates (e. prednisone) disopyramide fibrates (e. thiazides.g.....g. famotidine. Medications other than those listed above may interact with this medication.g. a decision should be made whether to discontinue breastfeeding or to discontinue the medication.g. your doctor may want you to: • • • • stop taking one of the medications. clofibrate) • • • • • • • • • • • H2 receptor antagonists (e. phenelzine) nicotinic acid nonsteroidal anti-inflammatory drugs (NSAIDs. or leave everything as is... Because the potential for low blood sugar in nursing infants may exist. furosemide) alcohol anticoagulants (e. Speak to your doctor about how any drug interactions are being managed or should be managed. selegiline.g.g. taking into account the importance of the medication to the mother. over-the-counter (non-prescription). naproxen) oral contraceptives other antidiabetes medications (e. change one of the medications to another.... insulin. Depending on your specific circumstances..g. Tell your doctor or prescriber about all prescription. thiopental) beta-blockers (e. cimetidine) monoamine oxidase inhibitors (MAOIs. ibuprofen.Pregnancy: Gliclazide MR should not be taken by pregnant women. ASA) terbutaline If you are taking any of these medications. warfarin.g. and herbal . speak with your doctor or pharmacist.g. phenobarbital. Breast-feeding: Some sulfonylurea medications like gliclazide MR are excreted in breast milk.g. clotrimazole) barbiturates (e.. change how you are taking one or both of the medications. What other drugs could interact with this medication? There may be an interaction between gliclazide MR and any of the following: • • • • • • • • • • • ACE inhibitors (e.g. metoprolol. Generic/rINN (Recommended International Nonproprietary Name) Doxofylline ATC (Anatomical Therapeutic Chemical Classification) R03DA11 CAS registry number (Chemical Abstracts Service) 69975-86-6 Chemical Name 7-(1. or street drugs can affect the action of many medications. Philippines Ansimar is NOT known to be marketed in the USA. the nicotine from cigarettes. Ansimar may be available in the countries listed above. Ansimar Found in: Italy.3-Dioxolan-2-ylmethyl)theophylline Chemical Formula C11-H14-N4-O4 Other Brand Names • • Axofin Puroxan . alcohol.medications you are taking. you should let your prescriber know if you use them. Also tell them about any supplements you take. Since caffeine.