gliclazide gliclazide gliclazide, sold under the brand name diamicron among others, is a sulfonylurea type of anti-diabetic medication, used to treat type 2 diabetes. it is used when dietary changes, exercise, and weight loss are not enough. it is taken by mouth. not to be confused with glipizide or glyburide. gliclazideclinical datatrade namesdiamicron, diaprel, azukon, othersahfs/drugs.commicromedex detailed consumer informationpregnancycategory au: c routes ofadministrationby mouthatc codea10bb09 (who) legal statuslegal status au: s4 (prescription only) uk: pom (prescription only) pharmacokinetic dataelimination half-life10.4 hoursidentifiers iupac name n-(hexahydrocyclopentapyrrol-2(1h)-ylcarbamoyl)-4-methylbenzenesulfonamide cas number21187-98-4 ypubchem cid3475drugbankdb01120 ychemspider3356 yuniig4px8c4hkvkeggd01599 ychebichebi:31654 ychemblchembl427216 ycomptox dashboard (epa)dtxsid9023095 echa infocard100.040.221 chemical and physical dataformulac15h21n3o3smolar mass323.41 g·mol−13d model (jsmol)interactive imagemelting point180 to 182 °c (356 to 360 °f) smiles o=s(=o)(c1ccc(cc1)c)nc(=o)nn3cc2cccc2c3 inchi inchi=1s/c15h21n3o3s/c1-11-5-7-14(8-6-11)22(20,21)17-15(19)16-18-9-12-3-2-4-13(12)10-18/h5-8,12-13h,2-4,9-10h2,1h3,(h2,16,17,19) ykey:bovgtqgaoionjv-uhfffaoysa-n y (verify) side effect may include low blood sugar, vomiting, abdominal pain, rash, and liver problems. use by those with significant kidney problems or liver problems or who are pregnant is not recommended. gliclazide is in the sulfonylurea family of medications. it works mostly by increasing the release of insulin. gliclazide was patented in 1966 and approved for medical use in 1972. it is on the world health organization's list of essential medicines. it is not available for sale in the united states. medical uses gliclazide is used for control of hyperglycemia in gliclazide-responsive diabetes mellitus of stable, mild, non-ketosis prone, type 2 diabetes. it is used when diabetes cannot be controlled by proper dietary management and exercise or when insulin therapy is not appropriate. national kidney foundation (2012 update) claims that gliclazide does not require dosage uptitration even in end stage kidney disease. contraindications type 1 diabetes hypersensitivity to sulfonylureas severe renal or hepatic failure (but relatively useful in mild renal impairment e.g. ckd stage 3) pregnancy and lactation adverse effects hypoglycemia - while it was shown to have the same efficacy as glimepiride, one of the newer sulfonylureas, the european guide study has shown that it has approximately 50% less hypoglycaemic confirmed episodes in comparison with glimepiride. interactions hyperglycemic action may be caused by danazol, chlorpromazine, glucocorticoids, progestogens, or β-2 agonists. its hypoglycemic action may be potentiated by phenylbutazone, alcohol, fluconazole, β-blockers, and possibly ace inhibitors. it has been found that rifampin increases gliclazide metabolism in humans in vivo. overdose gliclazide overdose may cause severe hypoglycemia, requiring urgent administration of glucose by iv and monitoring. mechanism of action gliclazide selectively binds to sulfonylurea receptors (sur-1) on the surface of the pancreatic beta-cells. it was shown to provide cardiovascular protection as it does not bind to sulfonylurea receptors (sur-2a) in the heart. this binding effectively closes these k+ ion channels. this decreases the efflux of potassium from the cell which leads to the depolarization of the cell. this causes voltage dependent ca2+ ion channels to open increasing the ca2+ influx. the calcium can then bind to and activate calmodulin which in turn leads to exocytosis of insulin vesicles leading to insulin release. the mouse model of maturity-onset diabetes of the young (mody) diabetes suggested that the reduced gliclazide clearance stands behind their therapeutic success in human mody patients, but urbanova et al. found that human mody patients respond differently and that there was no consistent decrease in gliclazide clearance in randomly selected hnf1a-mody and hnf4a-mody patients. its classification has been ambiguous, as literature uses it as both a first-generation and second-generation sulfonylurea. properties according to the biopharmaceutical classification system (bcs), gliclazide falls under the bcs class ii drug, which is poorly soluble and highly permeable. water solubility = 0.027 mg/l hypoglycemic sulfonylurea, restoring first peak of insulin secretion, increasing insulin sensitivity. glycemia-independent hemovascular effects, antioxidant effect. no active circulating metabolites. metabolism gliclazide undergoes extensive metabolism to several inactive metabolites in human beings, mainly methylhydroxygliclazide and carboxygliclazide. cyp2c9 is involved in the formation of hydroxygliclazide in human liver microsomes and in a panel of recombinant human p450s in vitro. but the pharmacokinetics of gliclazide mr are affected mainly by cyp2c19 genetic polymorphism instead of cyp2c9 genetic polymorphism.