Sulfonylureas- include- First generation - Acetohexamide, Chlorpropamide, Tolazamide, Tobutamide Second generation - Glipizide, Glyburide ( Glibenclamide ), GlimepIride,Gliclazide Refer Chlorpropamide 

Hypoglycaemia augumented by alcohol, sulphonamides, trimethoprim, salicylates, other NSAIDS and beta-blocking drugs(non-selective). Thiazide diuretics and betablockers counteract hypoglycaemic action. Food delays absorption.

FIXED DOSE COMBINATIONS APPROVED BY DCG(I)

Diabetes 

Sulfonylureas- include-

First generation - Acetohexamide, Chlorpropamide, Tolazamide, Tobutamide

Second generation - Glipizide, Glyburide ( Glibenclamide ), GlimepIride,Gliclazide Refer Chlorpropamide

Prolonged and severe hyploglycaemia in presence of renal/hepatic damage, alcohol and drugs. Hypoglycaemia, GI upsets, allergic skin reactions, leucopenia, leucocytipenia,agranulocytosis.

Pregnancy, stress, pre-coma,coma. Juvenille diabetes mellitus, impaired adreno-cortical function. Ketoacidosis.

Special precautions:

Hypoglycaemia, stress, secondary failure. Renal or hepatic disease, lactation.

Indications:

Diabetes

Dosage:

Give approximately 30 minutes before meals to acheive the greatest reduction in Post prandial hyperglycea.

Initial 5mg given 30 minutes before breakfast. Elderly patients may be started on 2.5mg. Maximum recommended daily dose once a day is 15mg.

Sulfonylureas- include- First generation - Acetohexamide, Chlorpropamide, Tolazamide, Tobutamide Second generation - Glipizide, Glyburide ( Glibenclamide ), GlimepIride,Gliclazide Refer Chlorpropamide 

1. Patients must receive full and complete instructions about the nature of diabetes.

2. Strict adherence to prescribed diet, an excercise program personal hygiene and avoidance of infection are essential

3. It is important to teach patients to self-monitor blood glucose

4. Do not discontinue medication except on advice of a physicain

5. May cause GI upset, may be taken with food. take glipizide  30 minutes before a meal to increse effectiveness.

6. Avoid alcohol (disulfram reaction and interference with blood sugar control ) and salicylates except on professional advice

7. Monitor urine for glcose and ketones as prescribed, monitor blood glucose as prescribed.

8. Notify physician if any of the following occurs- Hypoglycemia- fatigue, excessive thirst or urination, profuse sweating, numbness of extremities Hypoglycemia- excessive thirst or urination, urinary glucose or ketones Other- sore throat, rash, unusual bruising, or bleeding

Food delays absorption.