Indications

Glicron (Gliclazide) is an oral antidiabetic medicine (sulfonylurea group) used for the treatment of Type 2 Diabetes Mellitus in adults when diet, exercise, and weight loss alone are not adequate for maintaining correct blood sugar levels.

Pharmacology

Gliclazide is a second-generation sulfonylurea drug. It works by:

1. Stimulating the release of insulin from the pancreatic β-cells by facilitating Ca2+ transport across the β-cell membranes.
2. Decreasing hepatic glucose output (glucose production by the liver).

Dosage & Administration

• Film-coated Tablet (Immediate Release):
  • Initial Dose: 40 to 80 mg daily.
  • Maximum Dose: Up to 320 mg daily in divided doses, if needed.
  • Timing: Should be taken before a meal.
• Modified Release (MR) Preparation (Maximum 120 mg):
  • Dose: One to four tablets (maximum 120 mg) in a single intake at breakfast time.
  • Administration: Swallow the whole tablet(s) with water at breakfast time; do not chew or crush. You must always eat a meal after taking the tablet(s).
• Children: Not used/contraindicated in juvenile-onset diabetes.
• Overdose: Signs are those of low blood sugar (hypoglycemia). Consume sugar (4-6 lumps) or sugary drinks immediately, followed by a substantial snack or meal. Seek immediate medical attention if severe, prolonged, or if the patient is unconscious.

Contraindications

Do not take Glicron if you have:

• Allergy to gliclazide, other sulfonylureas, or related sulfonamides.
• Insulin-dependent diabetes (Type 1).
• Diabetic ketoacidosis, diabetic pre-coma, or coma (ketone bodies and sugar in the urine).
• Severe kidney or liver disease.
• If you are taking medicines to treat fungal infections (e.g., miconazole, fluconazole).
• If you are breastfeeding.

Interaction

Increased Hypoglycemic Effect (Increased risk of low blood sugar) with:

• Other antidiabetics (oral antidiabetics, insulin, GLP-1 receptor agonists).
• Antibiotics (sulphonamides, clarithromycin, fluoroquinolones - especially in the elderly).
• Blood pressure/heart failure medicines (beta-blockers, ACE-inhibitors like captopril or enalapril).
• Medicines for fungal infections (miconazole, fluconazole).
• Painkillers/antirheumatics (phenylbutazone, ibuprofen).
• Medicines containing alcohol.
• Medicines to treat ulcers (H2​ receptor antagonists).
• Antidepressants (monoamine oxidase inhibitors).

Weakened Hypoglycemic Effect (Increased risk of high blood sugar) with:

• Medicines reducing inflammation (corticosteroids).
• Medicines for asthma/labour (intravenous salbutamol, ritodrine, terbutaline).
• Medicines to treat breast disorders/endometriosis (danazol).
• St John's Wort preparations.
• Medicines for CNS disorders (chlorpromazine).

Other Interactions: Glicron may increase the effect of medicines that reduce blood clotting (warfarin).

Side Effects

The most common side effect is low blood sugar (hypoglycemia), which can progress to coma if left untreated.

• Digestive Disorders: Abdominal pain, nausea, vomiting, indigestion, diarrhea, and constipation (reduced when taken with a meal).
• Liver Disorders (Isolated Reports): Abnormal liver function, jaundice (yellowing of skin/eyes).
• Skin Disorders: Rash, redness, itching, hives, blisters, angioedema (rapid swelling).
• Blood Disorders: Decrease in blood cells (platelets, red/white blood cells) leading to paleness, prolonged bleeding, or fever.
• Eye Disorders: Temporary blurred vision, especially at the start of treatment, due to changing blood sugar levels.

Pregnancy & Lactation

Gliclazide is not recommended for use during pregnancy. You must not take Glicron while you are breastfeeding.

Precautions & Warnings

• Regular monitoring of blood sugar, urine sugar, and HbA1c​ is essential.
• The risk of hypoglycemia is increased in the first few weeks of treatment, with irregular/skipped meals, increased physical activity without adequate carbohydrate intake, alcohol consumption, and decreased kidney or liver function.
• Always carry a source of sugar (glucose tablets, sugar cubes) to treat symptoms of low blood sugar (headache, intense hunger, confusion, tremor, fast heartbeat). Artificial sweeteners are ineffective.
• If you are in stressful situations (e.g., surgery, fever), your doctor may temporarily switch you to insulin therapy.
• Gliclazide should not be used in children due to lack of data.

Therapeutic Class

Sulfonylureas.

Storage Conditions

Store below 30∘C, protected from light. Keep out of the reach and sight of children. Do not use after the expiry date.