chlorpropamide, Diabinese (cont.)

PRESCRIBED FOR: It is believed that strict glucose control in diabetics reduces the chances of eye, kidney, and nerve damage. The first generation sulfonylureas are used in type II diabetes to help lower and control blood glucose that is not controlled by diet and exercise. They are usually tried before turning to insulin for therapy.

SIDE EFFECTS: The most common side effects of the first generation sulfonylureas are:

  • nausea,
  • vomiting,
  • heartburn,
  • diarrhea and,
  • headache.

These symptoms usually are avoided if the drug is ingested with a meal.

Hypoglycemia may occur during first generation sulfonylurea therapy. Symptoms and signs include:

  • hunger,
  • nausea,
  • tiredness,
  • perspiration,
  • headache,
  • heart
  • palpitations,
  • numbness around the mouth,
  • tingling of the fingers,
  • tremors,
  • muscle weakness,
  • blurred vision,
  • sensation of cold,
  • excessive yawning,
  • irritability,
  • confusion or loss of consciousness.

Other important side effects of first generation sulfonylureas include:

  • weight gain,
  • sun sensitivity (skin rash), and
  • allergic-type skin-reactions such as itching and hives.

Rarely, blood disorders occur, for example, low white cell counts or low red cell counts. Jaundice, hepatitis and a low blood sodium concentration, which can lead to retention of fluid and swelling of the body, rarely occur.

GENERIC AVAILABLE: yes

PRESCRIPTION: yes

PREPARATIONS: Tablets: Acetohexamide, 250 or 500 mg; chlorpropamide (Diabinese), 100 or 250 mg; (Tolinase), 100, 250 or 500 mg; and tolbutamide (Orinase), 500 mg.

STORAGE: All sulfonylureas should be stored at room temperature, 15-30°C(59-86°F) in an air-tight container.

DOSING: Like other medications used to manage diabetes, the dose of the first generation sulfonylureas should be individualized using periodic measurements of blood glucose. Any of the first generation sulfonylureas may be taken with food, although tolbutamide is more effective if taken 30 minutes before a meal.

All sulfonylureas can lower glucose levels to the point of causing symptoms and signs (hypoglycemia). Therefore, these agents must be used carefully with patients who have other physical or medical factors that may lower their blood glucose. These factors include kidney or liver disease, poor food intake, alcohol use, or participation in heavy exercise.

Medically Reviewed by a Doctor on 12/18/2014


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