Gliclazide

Question 1

What class of drug is gliclizide?

Answer 1

Sulfonylurea

Question 2

What is the mechanism of action of gliclazide?

Answer 2

Gliclazide binds to the sulfonylurea receptors on the beta cell membrane.

This blocks the K+ channels on the cell membrane, reducing efflux of potassium - this depolarises the cell and causes secretion of insulin

Question 3

What are the indications for gliclazide?

Answer 3

Type 2 diabetes - for those whose diabetes is not adequately controlled on metformin

Question 4

How is gliclazide given?

Answer 4

By mouth using an immediate release, or modified release tablets. Gliclazide is taken with food (breakfast in the morning)

Question 5

What are the common side effects of gliclazide?

Answer 5

Weight gain
GI disturbance

Question 6

What are the important side effects of gliclazide?

Answer 6

Hypoglycaemia
Hyponatraemia
Hepatotoxicity
Hypersensitivity

Question 7

What are the cautions for gliclazide?

Answer 7

Elderly
G6PD deficiency
Overweight/obese patients
Renal impairment

Question 8

What are the contraindications to gliclazide?

Answer 8

Ketoacidosis
Acute porphyrias
Pregnancy and breastfeeding

Question 9

What does gliclazide interact with?

Answer 9

Warfarin (increased hypoglycaemic effect)
Antifungals (increased hypoglycaemic effect)
Alcohol - increased hypoglycaemic effect
Beta blockers
MAOIs - increase hypoglycaemic effect

Question 10

How should gliclazide be monitored?

Answer 10

Blood glucose levels and HbA1c should be checked to determine efficacy

Question 11

What information should patients taking gliclazide be given?

Answer 11

Patients should be warned of the risks of hypoglycaemia, particularly around driving. Advise patients to take some form of sugar e.g orange juice, jelly babies if this arises