Gliclazide

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About gliclazide

Gliclazide is a medicine used to treat type 2 diabetes.

Type 2 diabetes is an illness where the body doesn't make enough insulin, or the insulin that is made doesn't work properly. This causes high blood sugar levels.

Gliclazide lowers your blood sugar by increasing the amount of insulin your body produces.

Gliclazide is available on prescription. It comes as tablets.

Key facts

Gliclazide works by increasing the amount of insulin that your body makes. Insulin is the hormone that controls the level of sugar in your blood.
If you take gliclazide once a day, it's best to take it in the morning with breakfast.
Gliclazide can sometimes make your blood sugar level too low (hypoglycaemia). Carry some sweets or fruit juice with you to help when this happens.
Gliclazide may make you put on weight.
Gliclazide may also be called by the brand names Bilxona, Dacadis, Diamicron, Laaglyda, Nazdol, Vamju, Vitile, Ziclaseg, and Zicron.

Who can and can't take gliclazide

Gliclazide is only for adults. Do not give this medicine to children under 18 years.

Gliclazide isn't suitable for some people. Tell your doctor before starting the medicine if you:

have had an allergic reaction to gliclazide or any other medicines in the past
have insulin-dependent diabetes (type 1)
have ketone bodies and sugar in your urine
have severe kidney or liver disease
have a rare illness called porphyria
are taking miconazole (a treatment for fungal infections)
are breastfeeding
have an illness called G6PD-deficiency
need to have surgery

How and when to take it

The dose of gliclazide can vary. Take this medicine as prescribed by your doctor.

Swallow your gliclazide tablets whole with a glass of water, do not chew them.

Different types of gliclazide tablets

Gliclazide comes as 2 different types of tablets - normal (standard-release) and long-acting (slow-release).

Standard-release tablets release gliclazide into your body quickly so you may need to take them several times a day depending on your dose.

Slow-release tablets dissolve slowly which means you don't have to take them as regularly as the standard ones. One dose in the morning is usually enough.

Your doctor or pharmacist will explain what type of gliclazide tablets you are on and how often to take them.

How much will I take?

For standard-release gliclazide, the maximum daily dose is 320mg (4 x 80mg tablets). If you need to take more than 160mg (2 x 80mg tablets) a day, take the tablets twice a day with your morning and evening meals.

For slow-release gliclazide, the maximum daily dose is 120mg. Take your dose once a day before breakfast.

Will my dose go up or down?

Your doctor will check your blood sugar levels regularly and may adjust your dose of gliclazide if necessary.

What if I forget to take it?

If you miss a dose of gliclazide, take the next dose at the usual time. Do not take a double dose to make up for a forgotten dose.

If you forget doses often, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.

What if I take too much?

If you take too many gliclazide tablets, contact your doctor straight away. An overdose of gliclazide can cause low blood sugar.

If you think you have low blood sugar, have some food or drink that quickly gets sugar into your bloodstream such as sugar cubes or fruit juice. This type of sugar will not last long in your blood so you may also need to eat a starchy carbohydrate, like a sandwich or a biscuit.

Side effects

Like all medicines, gliclazide can cause side effects although not everyone gets them. Side effects can be less likely if you take gliclazide tablets with a meal.

Common side effects

Talk to your doctor or pharmacist if these side effects bother you or don’t go away:

stomach ache
feeling sick (nausea)
being sick (vomiting)
indigestion
diarrhoea
constipation

Serious side effects

Serious side effects are rare.

Tell your doctor straight away if you get warning signs of a:

yellow skin or eyes - these can be signs of a liver problem
paleness, prolonged bleeding, bruising, sore throat and fever - these can be signs of a blood disorder
rash, redness, itching and hives, sudden swelling of eyelids, face, lips, mouth, tongue or throat that may make it hard to breathe - these can be signs of a skin disorder

Your eyesight may be affected for a short time, especially at the start of treatment because of changes in your blood sugar levels.

Low blood sugar

Gliclazide can sometimes cause your blood sugar to go too low. The name for this is hypoglycaemia - or a 'hypo'.

Early warning signs of low blood sugar include:

feeling hungry
trembling or shaking
sweating
confusion
difficulty concentrating

It's also possible for your blood sugar to go too low while you're asleep. If this happens, it can make you feel sweaty, tired and confused when you wake up.

Low blood sugar may happen if you:

take too much gliclazide
eat meals irregularly or skip meals
are fasting
don't eat a healthy diet with enough nutrients in
change what you eat
increase your physical activity without eating more to compensate
drink alcohol, especially after skipping a meal
take some other medicines or natural remedies at the same time
have a hormone disorder such as hypothyroidism
have kidney or liver problems

To prevent hypoglycaemia, it's important to have regular meals, including breakfast. Never miss or delay a meal.

If you're planning to exercise more than usual, make sure you eat carbohydrates (bread, pasta, cereals) before, during or afterwards.

Always carry a fast-acting carbohydrate with you, like sugar cubes, fruit juice, or some sweets in case your blood sugar level gets low. Artificial sweeteners won't help. You may also need to eat a starchy carbohydrate, like a sandwich or a biscuit, to maintain your blood sugar for longer.

If taking in sugar does not help or if the hypo symptoms come back, contact your doctor or the nearest hospital.

Make sure your friends and family know about your diabetes and the symptoms of low blood sugar level so they can recognize a hypo if it happens.

Serious allergic reaction

In rare cases, it’s possible to have a serious allergic reaction to gliclazide.

A serious allergic reaction is an emergency. Contact a doctor straight away if you think you or someone around you is having a serious allergic reaction.

The warning signs of a serious allergic reaction are:

getting a skin rash that may include itchy, red, swollen, blistered or peeling skin
wheezing
tightness in the chest or throat
having trouble breathing or talking
swelling of the mouth, face, lips, tongue, or throat

These are not all the side effects of gliclazide. For a full list see the leaflet inside your medicines packet.

You can report any suspected side effect to the UK safety scheme.

How to cope with side effects

What to do about:

feeling sick (nausea) - take your tablets with a meal - stick to simple meals and avoid rich or spicy food
being sick (vomiting) or diarrhoea - have small but frequent sips of water. Speak to a pharmacist if you have signs of dehydration, such as peeing less than usual or having dark, strong-smelling pee. Don't take any other medicines to treat diarrhoea or vomiting without speaking to a pharmacist or doctor.
constipation - eat more high-fibre foods such as fresh fruit and vegetables and cereals, and drink plenty of water. Also exercise more regularly, for example, by going for a daily walk or run.

Pregnancy and breastfeeding

Gliclazide is not generally recommended in pregnancy and while breastfeeding.

It's not clear whether gliclazide harms an unborn baby. For safety, your doctor will probably change your medicine to insulin before you become pregnant or as soon as you find out you're pregnant.

Gliclazide and breastfeeding

If you take gliclazide while breastfeeding there's a risk of your baby getting low blood sugar. Talk to your doctor if you want to breastfeed.

Tell your doctor if you're trying to get pregnant, are already pregnant or if you're breastfeeding.

Cautions with other medicines

There are some medicines that interfere with the way gliclazide works.

Tell your doctor if you are taking any of these medicines:

steroid tablets such as prednisolone
some medicines used to treat heart problems and high blood pressure
medicines to treat bacterial or fungal infections such as clarithromycin or fluconazole
painkillers such as ibuprofen and aspirin (but not paracetamol)
medicines used to treat asthma such as salbutamol
male and female hormones such as testosterone, oestrogen and progesterone
other diabetes medicines

Gliclazide may also increase the effects of medicines that thin your blood such as warfarin.

Some women might need a small adjustment in their gliclazide dose after starting contraceptive pills as in rare cases they can increase blood sugar levels.

Mixing gliclazide with herbal remedies and supplements

Do not take the herbal remedy for depression, St John's wort. It may change the way your body processes gliclazide.

Tell your doctor and pharmacist if you are taking any other medicines, including herbal remedies, vitamins or supplements.

Common questions

How does gliclazide work?

Gliclazide is a type of medicine known as a sulfonylurea. Sulfonylureas increase the amount of insulin that your pancreas makes. Insulin is the hormone that controls the level of sugar in your blood.

When will I feel better?

You may not have had any symptoms of diabetes so you won't necessarily feel any different when you take gliclazide. This doesn't mean that gliclazide isn't working and it's important to keep taking it.

Gliclazide will help keep your blood sugar level stable and reduce your chances of diabetes-related problems in the future.

How long will I take gliclazide for?

Treatment for diabetes is usually for life. Don't stop taking your gliclazide tablets without talking to your doctor.

Can I take gliclazide for a long time?

Gliclazide is safe to take for a long time. There's no evidence it harms your pancreas or your general health.

However, gliclazide may stop working properly after a while. Your doctor may then want to stop it or add a different medicine to help keep your blood sugar level stable.

What will happen if I come off gliclazide?

Don't stop taking gliclazide without talking to your doctor.

If you stop taking gliclazide suddenly your diabetes may get worse.

Will I put on weight?

Gliclazide can make you hungrier and retain water so it can be quite challenging to avoid putting on weight while you're taking it. Try to eat a healthy balanced diet without increasing your portion sizes so you don't gain too much weight. Regular exercise will also help to keep your weight stable.

Can I get diabetes medicines for free?

If you have diabetes, you're entitled to free prescriptions for all of your medicines (not just your diabetes ones).

To claim your free prescriptions you'll need to have a medical exemption certificate.

The application form for the medical exemption certificate is called FP92A. You can get this from your doctor's surgery. You will need to fill in the form, then your doctor will sign it and send it off.

Are other diabetes medicines better?

There are other groups of medicines that can lower blood sugar levels:

metformin
pioglitazone
DPP-4 inhibitors such as saxagliptin
SGLT2 inhibitors such as dapagliflozin
GLP-1 agonists such as exenatide
insulin

Gliclazide can be prescribed on its own or in combination with the above medicines.

It's usually prescribed if you can't take metformin, or if metformin is no longer keeping your blood sugar level under control when used by itself.

Gliclazide is a sulfonylurea. There are 4 other sulfonylureas available:

glibenclamide
glimepiride
glipizide
tolbutamide

These all work in the same way – by increasing the amount of insulin your body produces.

Can I take painkillers with gliclazide?

It's safe to take paracetamol with gliclazide.

Don't take aspirin or ibuprofen - these painkillers can interfere with gliclazide and lower your blood sugar levels too much.

Can I drive or ride a bike?

If your blood sugar levels are stable, your ability to drive, cycle or use machines or tools shouldn't be affected by gliclazie. However, if your blood sugar levels become too low, this can reduce your concentration. If this happens to you, don't drive, cycle, or use machines or tools, until you feel better.

Do not drive or use machines or tools if you start to feel the symptoms of low blood sugar.

Will it affect my fertility?

Gliclazide does not affect male or female fertility.

Will it affect my contraception?

Gliclazide doesn't interfere with any type of contraception.

Some women might need their gliclazide dose adjusting if they start taking the contraceptive pill. This is because contraceptive pills can occasionally increase blood sugar levels.

Can I drink alcohol with it?

Yes, you can drink alcohol while taking gliclazide but it's best for men and women to drink no more than 2 units per day. Drinking more than this can increase the risk of low blood sugar.

Usually, a standard glass of wine or a can of beer is 2 units.

Is there any food or drink I need to avoid?

It's a good idea to cut down on foods with added sugar. Check the nutrition labels as many foods and drinks are high in sugar, such as:

sweets
cakes
biscuits
chocolate
some fizzy drinks
juice drinks

Karela (also called bitter gourd) is used to flavour foods such as curries such as bitter gourd masala. It has a bitter taste and is also made into juice and tea.

Be careful eating food and drink containing karela because it can lower your blood sugar levels and mean your diabetes isn't controlled as well as it should be.

Can I take gliclazide before surgery?

If you're going to have an operation, tell the doctor you are taking gliclazide.

This is because gliclazide increases your risk of low blood sugar during the operation. Low blood sugar can be difficult to detect when a general anaesthetic (that puts you to sleep) is used.

For a few days around the time of your operation, your doctor may temporarily switch you to insulin instead.

Can lifestyle changes help my diabetes?

There are some lifestyle changes you can make to help control the symptoms of diabetes.

These include:

eating a healthy diet
losing any excess weight
not smoking
not drinking too much alcohol - no more than 2 units a day
exercising regularly - up to 30 minutes a day, 5 times a week is ideal