Maintenance: Oral, 80 to 320 mg a day with meals. Pharmaceutical, Inc. February, 2011. Zilly W, Breimer DD, Richter E. Induction of drug metabolism in man after rifampicin treatment measured by increased hexobarbital and tolbutamide clearance.
Other than the above information, there is no additional information relating to its proper use, precautions, or side effects for this use. Closely monitoring for at least 3 to 5 days patients who develop hypoglycemia during use of chlorpropamide. Kubacka RT, Antal EJ, Juhl RP. The paradoxical effects of cimetidine and ranitidine on glibenclamide pharmacokinetics and pharmacodynamics. Br J Clin Pharmacol 1987; 23: 743-51. Balant L. Clinical pharmacokinetics of sulphonylurea hypoglycemic drugs. Clin Pharmacokinet 1981; 6: 215-41. It may be harder to control your when your body is stressed such as due to fever, infection, injury, or surgery. benefits of phenergan
Take this medication on an empty stomach, 30 minutes before meals. Briggs GG, Freeman RK, Yaffe SJ. A reference guide to fetal and neonatal risk. Drugs in pregnancy and lactation. Secondary failure may be treated by using insulin in combination with glimepiride. Chlorpropamide is also indicated as secondary therapy in selected patients to treat partial central diabetes insipidus. Used as an antidiuretic, chlorpropamide has successfully reduced polyuria in about 50% of such treated patients. Chlorpropamide may be used alone or in combination with another agent such as carbamazepine or clofibrate so that the dose of both can be reduced and side effects minimized. Desmopressin is considered the primary treatment for diabetes insipidus. trandate
If an elderly patient tends toward hypoglycemia during the first twenty-four hours after an initial dose of 250 mg at breakfast, the dose should be reduced or the medication discontinued. Kadowaki T, Hagura R, Kajinuma H, et al. Chlorpropamide-induced hyponatremia incidence and risk factors. Diabetes Care 1983; 6: 468. Riddle MC, Hart JS, Bouma DJ, et al. Efficacy of bedtime NPH insulin with daytime sulfonylurea for subpopulation of type II diabetic subjects. Diabetes Care 1989 Oct; 129: 623-9.
FDA Pregnancy Category C DiaBeta. Brunova E, Slabachova Z, Platiliva H, et al. Interaction of tolbutamide and chloramphenicol in diabetic patients. Beta-adrenergic blocking agents may increase the chance that high or low blood sugar can occur. Also, they can hide symptoms of low blood sugar such as fast heartbeat. When these two medicines are taken together, rifamycins may cause your body to process your diabetes medicine more quickly. Store at room temperature away from light and moisture. not store in the bathroom. Keep all away from children and pets. Zaman R, Kendall MJ, Biggs PI. The effect of acebutalol and propranolol on the hypoglycaemic action of glibenclamide. Br J Clin Pharmacol 1982; 13: 507-12. Basler A, Baumann M, Rohrborn G. In vitro testing of chlorpropamide with human lymphocyte cultures in the presence of liver microsome fraction S9 mix of rats. Arzneimittelforschung 1982; 327: 724-6. Maintenance: Oral, 250 to 2000 mg a day as single morning or divided doses. Thonnard-Neumann E. Phenothiazines and diabetes in hospitalized women. Am J Psychiat 1968 Jun; 124: 978-82. Maintenance: Oral, 250 to 1000 mg once a day before breakfast or 1000 to 1500 mg divided into two doses taken before breakfast and evening meals. Bacterial and in vivo mutagenicity testing showed no evidence of mutagenicity. When patients are transferred to tolazamide from another sulfonylurea antidiabetic medication with the exception of chlorpropamide no transition period is required. When transferring patients from chlorpropamide, caution should be exercised during the first 1 to 2 weeks because of the prolonged retention of chlorpropamide in the body. Ferrari C, Frezzati S, Testori GP, et al. Potentiation of hypoglycaemic response to intravenous tolbutamide by clofibrate. N Engl J Med 1976 May 20; 29421: 1184. Levaquin levofloxacin US prescribing information. Along with their needed effects, sulfonylureas may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. When patients are transferred to acetohexamide from another sulfonylurea antidiabetic medication with the exception of chlorpropamide no transition period is required. When transferring patients from chlorpropamide, caution should be exercised during the first 1 to 2 weeks because of the prolonged retention of chlorpropamide in the body.
Product Information: Amaryl, glimepiride. Hoechst Marion Roussel, Kansas City, MO, USA. Chlorpropamide or tolbutamide causes some patients to retain keep more body water than usual. Have a glucagon kit and a syringe and needle available in case severe low blood sugar occurs. Check and replace any expired kits regularly. Diabetes Res Clin Prac 1985; Suppl 1: S522. Luntz GRWN, Smith SG. Effect of isoniazid on carbohydrate metabolism in controls and diabetics. BMJ 1953; 1: 296-99. Palatnick W, Meatherall RC, Tenenbein M. Clinical spectrum of sulfonylurea overdose and experience with diazoxide therapy. Arch Intern Med 1991 Sep; 151: 1859-62. rosuvastatin
Chlorpropamide may also be used for other conditions as determined by your doctor. Davies RR, Miller M, Turner SJ, et al. Effects of somatostatin analogue SMS 201-995 in normal man. Clin Endocrinol 1986; 24: 665-74. Know what to do if symptoms of low blood sugar occur. Eating some form of quick-acting sugar when symptoms of low blood sugar first appear will usually prevent them from getting worse. You may sometimes notice what looks like a tablet in your stool. Do not worry. After you swallow the tablet, the medicine in the tablet is absorbed inside your body. Then the tablet passes into your stool without changing its shape. The medicine has entered your body and will work properly. Do not use chocolate because its fat slows down the sugar entering the bloodstream. Monitoring vital signs, arterial blood gases, blood glucose, and serum electrolytes especially calcium, potassium, and sodium as required. Initially, blood glucose concentrations should be monitored as frequently as every 1 to 3 hours. Blood urea nitrogen and serum creatinine concentrations should also be obtained. McCaleb ML, Maloff BL, Nowak SM, et al. Sulfonylurea effects on target tissues for insulin. Diabetes Care 1984; 7 Suppl 1: 42-6. Using some quinolone antibiotics with your diabetes medicine may make your blood sugar too low. Other supportive measures should also be employed as needed. Initial: Oral, 1 to 2 mg once a day with breakfast or the first main meal. Ferriere M, Lachkar H, Richard JL, et al. Captopril and insulin sensitivity. Ann Intern Med 1985; 102: 134-5. generic ciprofloxacin reviews message board ciprofloxacin
Studies in male and female rats given 75 times the maximum human dose showed no evidence of impaired fertility. Young DS, editor. Effects of drugs on clinical laboratory tests. 1991 supplement to the third edition. Washington: AACC Press; 1991. Miners JO, Foenander T, Wanwimolruk S, Gallus AS, et al. The effect of sulphinpyrazone on oxidative drug metabolism in man: inhibition of tolbutamide elimination. Eur J Clin Pharmacol 1982: 224: 321-6. In general, no overall difference in safety or efficacy was apparent in persons over 65 years of age when compared to persons younger than 65 years of age taking sulfonylureas for type 2 diabetes. Lower doses are used initially because of possible increased sensitivity to these agents due to age-related metabolism and excretion changes; the steady state concentration of extended-release glipizide has been delayed for 1 or 2 days in elderly patients. The risk of adverse reactions is relatively low when other factors for toxicity, including liver and kidney disease and known drug interactions, are considered. Special counseling with emphasis on hydration, diet, and exercise may be necessary because of the greater risk of hypoglycemia in this age group. Special instruction to recognize hypoglycemia may be needed because early warning adrenergic symptoms of hypoglycemia such as sweating, weakness, tachycardia, and nervousness are absent in many patients. Hypoglycemia manifests as neurological symptoms such as headache, irritability, mental confusion, unusual tiredness, and drowsiness and may be more prolonged and severe in the elderly. Combining antidiabetic agents sulfonylureas with metformin or insulin or using long-acting sulfonylureas, such as chlorpropamide and glyburide, is most often associated with hypoglycemia in elderly patients and is not generally recommended; shorter-acting sulfonylureas cause fewer problems. Also, instructions may be needed to help the patient monitor urine or blood glucose if visual problems are present. Klein W. Sulfonylurea-metformin-combination versus sulfonylurea-insulin-combination in secondary failures of sulfonylurea monotherapy. Results of a prospective randomized study in 50 patients. Diabete Metab 1991 May; 17 1 Pt 2: 235-40. Groop LC. Sulfonylureas in NIDDM. Diabetes Care 1992; 156: 737-54. Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor. Br J Clin Pharmacol 1986; 22: 43-8. Totterman KJ, Groop LC. No effect of propranolol and metoprolol on the tolbutamide-stimulated insulin-secretion in hypertensive diabetic and non-diabetic patients. Ann Clin Res 1982; 14: 190-3. Holt RJ, Gaskins JD. Hyperglycemia associated with propranolol and chlorpropamide administration. Shah GF, Ghandi TP, Patel PR, et al. The effect of cimetidine on the hypoglycaemic activity of four commonly used sulphonylurea drugs. Indian Drugs 1985; 22: 570-2. In contrast, glyburide micronized has an AB rating, denoting that bioequivalence for many state formularies has been resolved; however, some state formularies have deemed the AB-rated generic nonsubstitutable if a scored tablet is divided. State formularies should be checked before substitution is made with this type of product. Kemball ML, McIver C, Milner RDG, et al. Neonatal hypoglycemia in infants of diabetic mothers given sulphonylurea drugs in pregnancy. Arch Dis Child 1970; 45: 696-701. Dukes MNG, Aronson JK, editors. Side effects of drugs annual 16. Amsterdam: Excerpta Medica; 1993. p. 292, 484, 490-2.
If you don't have these reliable forms of glucose, rapidly raise your by eating a quick source of sugar such as table sugar, honey, or candy, or drink fruit juice or non-diet soda. Tell your doctor right away about the reaction and the use of this product. No evidence of teratogenicity was found in rats following oral administration of glimepiride at doses approximately 4000 times the maximum recommended human dose based on body surface area, or in rabbits following administration of glimepiride at doses approximately 60 times the maximum recommended human dose based on body surface area. Keep some kind of quick-acting sugar handy to treat low blood sugar. Micronized glyburide has an AB rating. However, some state formularies may not consider certain generic products bioequivalent when scored tablets are divided; state formularies should be checked before substituting one product for another. Some elderly patients may be more sensitive than younger adults to the effects of sulfonylureas, especially when more than one antidiabetic medicine is being taken or if other medicines that affect blood sugar are also being taken. This may increase your chance of developing low blood sugar during treatment. Furthermore, the first signs of low or high blood sugar are not easily seen or do not occur at all in older patients. This may increase the chance of low blood sugar developing during treatment. Rett K, Wicklmayr M, Dietz GJ. Hypoglycemia in hypertensive diabetic patients treated with sulfonylurea, biguanides, and captopril. N Engl J Med 1988; 319: 1609. At first, 250 milligrams mg once a day. Some elderly people may need a lower dose of 100 to 125 mg a day at first. Then, your doctor may change your dose a little at a time if needed. The dose is usually not more than 750 mg a day. cardizem canada otc cardizem
Controlling high helps prevent damage, blindness, nerve problems, loss of limbs, and sexual function problems. Keep all regular medical and laboratory appointments. Warren SE. False-positive urine ketone test with captopril. N Engl J Med 1980; 30317: 1003-4. For a listing of dosage forms and brand names by country availability, see Dosage Forms sections. Gregorio F, Ambrosi F, Cristallini S, et al. Therapeutical concentrations of tolbutamide, glibenclamide, gliclazide, and gliquidone at different glucose levels: in vitro effects on pancreatic A- and B-cell function. Diabetes Res Clin Pract; 18: 197-206. Using an in vitro method and whole embryo mouse culture, one study compared growth differences between untreated embryos and those bathed in hypoglycemic and euglycemic chlorpropamide-treated rat serums. The teratologic evaluation of the treated early somite mouse embryos showed malformations and growth retardation at doses similar to human therapeutic concentrations, which suggested that the teratogenicity was due to chlorpropamide and not to hypoglycemia; untreated mouse embryos showed normal development. However, the advice about hypoglycemia low blood sugar does apply to you. Call your doctor right away if you feel any of the symptoms described. Although similar in appearance to a conventional tablet, Glucotrol XL actually is a specially formulated gastrointestinal system GITS consisting of a semipermeable membrane surrounding an osmotically active drug core, which is designed to release glipizide at a constant rate over twenty-four hours; following drug release, the system is eliminated in the feces as an insoluble shell. Many people with type 2 diabetes can control their blood sugar level with diet or diet and exercise alone. Following a diabetes diet plan and exercising will always be important with any type of diabetes. To work properly, the amount of sulfonylurea you use must be balanced against the amount and type of food you eat and the amount of exercise you do. If you change your diet, your exercise, or both, you will want to test your blood sugar level so that it does not drop too low hypoglycemia or rise too high hyperglycemia. Your health care professional will teach you what to do if this happens. Pugh JA, Wagner ML, Sawyer J, et al. Is combination sulfonylurea and insulin therapy useful in NIDDM patients? During conversion from insulin therapy to acetohexamide therapy, no gradual dosage adjustment usually is required for patients using less than 20 USP Units of insulin daily. For patients using 20 or more USP Units daily, a 25 to 30% reduction in insulin every day or every second day with gradual dosage adjustment is advisable. Hospitalization for some patients on a higher insulin dosage may be required for uneventful conversion. Also indicated in the treatment of central diabetes insipidus. Studies in rats given doses of tolbutamide that were 25 to 100 times greater than the human dose have shown teratogenic effects, such as ocular and bone abnormalities, and increased mortality in the offspring. Repeat studies in rabbits showed no teratogenic effects. Maintenance: Oral, 250 to 500 mg a day with breakfast or the first main meal; some patients may need less 100 mg a day or more up to 1000 mg a day. Doses greater than 500 mg should be divided and given two times a day with meals. order flomax south africa
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Hanson RL, Nelson RG, McCance DR, et al. Comparison of screening tests for non-insulin-dependent diabetes mellitus. Arch Intern Med 1993 Sep; 153: 2133-40. Salicylates, in large doses these medications have intrinsic hypoglycemic activity in both diabetic and nondiabetic patients, possibly severe with quinine, quinidine, or salicylates in high doses but unlikely with low doses of salicylates. Also, salicylates may interfere with chlorpropamide's renal excretion. Absorption of chlorpropamide or glipizide may be delayed if the medication is ingested with food; glipizide should be taken 30 minutes before a meal. Gliclazide may be taken 30 minutes before a meal or with a meal but not after a meal. Glimepiride should be taken with breakfast or the first main meal. Nonmicronized glyburide should not be taken with a diet high in fat; nonmicronized glyburide does not have any other dietary restrictions. memus.info rosuvastatin
Studies in female rats and the first generation offspring of treated male and female rats showed no evidence of impaired fertility. Ask your doctor what kind of exercise to do, the best time to do it, and how much you should do each day. Jain AK, Ryan JR, McMahon FG. Potentiation of hypoglycemic effect of sulphonylureas by clofibrate. N Engl J Med 1976; 29411: 613. The United States pharmacopeia. The national formulary. USP 23rd revision January 1, 1995. NF 18th ed January 1, 1995. Rockville, MD: The United States Pharmacopeial Convention, Inc; 1995 Sixth supplement, 1997. p. 3679. Noroxin norfloxacin US prescribing information.
The use of sulfonylurea antidiabetic agents has been reported, but not proven in all studies, to increase the risk of death from heart and blood vessel disease. Patients with diabetes are already more likely to have these problems if they do not control their blood sugar. Some sulfonylureas, such as glyburide and gliclazide, can have a positive effect on heart and blood vessel disease. It is important to know that problems can occur, but it is also not known if other sulfonylureas, particularly tolbutamide, help to cause these problems. It is known that if blood sugar is not controlled, such problems can occur. lasix
Studies in rats and rabbits given 500 times the human dose have not shown evidence of impaired fertility. Sandostatin Sandoz. In: PDR Physicians' desk reference. 48th ed. 1994. Montvale, NJ: Medical Economics Data Production Company; 1994. p. 2077-8. At first, 100 to 250 milligrams mg once a day in the morning. Then, your doctor may change your dose a little at a time if needed. The dose is usually not more than 1 gram a day. If your dose is 500 mg or more, the dose is usually divided into two doses. These doses are taken with the morning and evening meals. Symptoms of high blood sugar appear more slowly than those of low blood sugar. Symptoms can include: blurred vision; drowsiness; dry mouth; flushed and dry skin; fruit-like breath odor; increased urination; loss of appetite; stomachache, nausea, or vomiting; tiredness; troubled breathing rapid and deep; and unusual thirst. antabuse