eiiiiF 452Glibenclamide
lINDICATIONS AND DOSE
Type 2 diabetes mellitus
▶BY MOUTH
▶Child 12–17 years:Initially 2. 5 mg daily, adjusted
according to response, dose to be taken with or
immediately after breakfast; maximum 15 mg per day
Maturity-onset diabetes of the young (specialist use only)
▶BY MOUTH
▶Child 12–17 years:Initially 2. 5 mg daily, adjusted
according to response, dose to be taken with or
immediately after breakfast; maximum 15 mg per daylUNLICENSED USENot licensed for use in breast feeding
women with pre-existing diabetes. Not licensed for use in
gestational diabetes.
Not licensed for use in children.
lCONTRA-INDICATIONSAvoid where possible in Acute
porphyrias p. 603
lINTERACTIONS→Appendix 1 : sulfonylureas
lSIDE-EFFECTSAppetite decreased.SIADH.taste metallic
lPREGNANCYThe use of sulfonylureas in pregnancy should
generally be avoided because of the risk of neonatal
hypoglycaemia; however, glibenclamide can be used
during the second and third trimesters of pregnancy in
women with gestational diabetes.
lBREAST FEEDINGGlibenclamide can be used during
breast-feeding in women with pre-existing diabetes.
lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug. Forms available from special-order
manufacturers include: oral suspension, oral solution
Tablet
▶Glibenclamide (Non-proprietary)
Glibenclamide 2.5 mgGlibenclamide 2. 5 mg tablets|
28 tabletP£ 11. 78 DT = £ 10. 49
Glibenclamide 5 mgGlibenclamide 5 mg tablets| 28 tabletP
£ 14. 72 DT = £ 3. 16
eiiiiF 452Gliclazide
lINDICATIONS AND DOSE
Type 2 diabetes mellitus
▶BY MOUTH USING IMMEDIATE-RELEASE MEDICINES
▶Child 12–17 years:Initially 20 mg once daily, adjusted
according to response, increased if necessary up to
160 mg once daily (max. per dose 160 mg twice daily),
dose to be taken with breakfast
Maturity-onset diabetes of the young (specialist use only)
▶BY MOUTH USING IMMEDIATE-RELEASE MEDICINES
▶Child 12–17 years:Initially 20 mg once daily, adjusted
according to response, increased if necessary up to
160 mg once daily (max. per dose 160 mg twice daily),
dose to be taken with breakfastlUNLICENSED USENot licensed for use in children.
lCONTRA-INDICATIONSAvoid where possible in Acute
porphyrias p. 603
lINTERACTIONS→Appendix 1 : sulfonylureas
lSIDE-EFFECTSAnaemia.angioedema.dyspepsia.
hypersensitivity vasculitis.hyponatraemia.severe
cutaneous adverse reactions (SCARs).skin reactions
lPREGNANCYThe use of sulfonylureas in pregnancy should
generally be avoided because of the risk of neonatal
hypoglycaemia.
lBREAST FEEDINGAvoid—theoretical possibility of
hypoglycaemia in the infant.
lRENAL IMPAIRMENTIf necessary, gliclazide which is
principally metabolised in the liver, can be used in renal
impairment but careful monitoring of blood-glucose
concentration is essential.lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug. Forms available from special-order
manufacturers include: oral suspension
Tablet
▶Gliclazide (Non-proprietary)
Gliclazide 40 mgGliclazide 40 mg tablets| 28 tabletP£ 3. 19 DT
=£ 3. 04
Gliclazide 80 mgGliclazide 80 mg tablets| 28 tabletP£ 7. 22 DT
=£ 0. 92 | 60 tabletP£ 0. 81 – £ 9. 32
▶Diamicron(Servier Laboratories Ltd)
Gliclazide 80 mgDiamicron 80 mg tablets| 60 tabletP£ 4. 38
▶Zicron(Bristol Laboratories Ltd)
Gliclazide 40 mgZicron 40 mg tablets| 28 tabletP£ 3. 36 DT =
£ 3. 04eiiiiF 452Tolbutamide
lINDICATIONS AND DOSE
Type 2 diabetes mellitus
▶BY MOUTH
▶Child 12–17 years (specialist use only): 0. 5 – 1. 5 g daily in
divided doses, dose to be taken with or immediately
after meals, alternatively 0. 5 – 1. 5 g once daily, dose to
be taken with or immediately after breakfast;
maximum 2 g per daylUNLICENSED USENot licensed for use in children.
lCONTRA-INDICATIONSAvoid where possible in Acute
porphyrias p. 603
lINTERACTIONS→Appendix 1 : sulfonylureas
lSIDE-EFFECTS
▶Rare or very rareAplastic anaemia.blood disorder
▶Frequency not knownAlcohol intolerance.appetite
abnormal.erythema multiforme (usually in thefirst
6 – 8 weeks of therapy).exfoliative dermatitis (usually in
thefirst 6–8 weeks of therapy).fever (usually in thefirst
6 – 8 weeks of therapy).headache.hypersensitivity
(usually in thefirst 6–8 weeks of therapy).paraesthesia.
photosensitivity reaction.tinnitus.weight increased
lPREGNANCYThe use of sulfonylureas in pregnancy should
generally be avoided because of the risk of neonatal
hypoglycaemia.
lBREAST FEEDINGThe use of sulfonylureas in breast-
feeding should be avoided because there is a theoretical
possibility of hypoglycaemia in the infant.
lRENAL IMPAIRMENTIf necessary, the short-acting drug
tolbutamide can be used in renal impairment but careful
monitoring of blood-glucose concentration is essential.lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug. Forms available from special-order
manufacturers include: oral suspension
Tablet
▶Tolbutamide (Non-proprietary)
Tolbutamide 500 mgTolbutamide 500 mg tablets| 28 tabletP
£ 34. 88 DT = £ 4. 56 | 112 tabletP£ 17. 60 – £ 18. 24BNFC 2018 – 2019 Diabetes mellitus 453
Endocrine system6