Patient leaflet - GLICLAZIDE ACCORD-UK 60 MG PROLONGED-RELEASE TABLETS
Gliclazide Accord-UK 30mg and 60mg Prolonged-release Tablets
Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.
- Keep this leaflet. You may need to read it again.
- If you have any further questions, ask your doctor or pharmacist.
- This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.
- If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.
What is in this leaflet
^Iwhat Gliclazide is and what it is used for
z^What you need to know before you take Gliclazide
3MHow to take Gliclazide
^Mpossible side effects
5j|How to store Gliclazide
^BContents of the pack and other information
^Hwhat Gliclazide is and what it is used for
Gliclazide is a medicine that reduces blood sugar levels (oral anti-diabetic medicine belonging to the sulfonylurea group).
Gliclazide is used in a certain form of diabetes (type 2 diabetes mellitus) in adults, when diet, exercise and weight loss alone do not have an adequate effect on keeping blood sugar at the correct level.
^Hwhat you need to know before you take Gliclazide
Do not take Gliclazide if you:
- are allergic to gliclazide or any of the other ingredients in this medicine (listed in section 6), or to other medicines in the same group (sulfonylureas), or to other related medicines (hypoglycaemic sulfonamides)
- have insulin-dependent diabetes (type 1)
- have ketone bodies and sugar in your urine (this may mean you have diabetic ketoacidosis), a diabetic pre-coma or coma
- have severe kidney or liver disease
- are taking medicines to treat fungal infections (miconazole, see section ‘Other medicines and Gliclazide’)
- are breast-feeding (see section ‘Pregnancy and breast-feeding’).
In most cases the symptoms of low blood sugar vanish very quickly when you consume some form of sugar, e.g. glucose tablets, sugar cubes, sweet juice, sweetened tea. You should therefore always carry some form of sugar with you (glucose tablets, sugar cubes). Remember that artificial sweeteners are not effective.
Please contact your doctor or the nearest hospital if taking sugar does not help or if the symptoms recur.
Symptoms of low blood sugar may be absent, less obvious or develop very slowly or you are not aware in time that your blood sugar level has dropped. This may happen if you are an elderly patient taking certain medicines (e.g. those acting on the central nervous system and beta blockers).
If you are in stress-situations (e.g. accidents, surgical operations, fever etc.) your doctor may temporarily switch you to insulin therapy.
Symptoms of high blood sugar (hyperglycaemia) may occur when gliclazide has not yet sufficiently reduced the blood sugar, when you have not complied with the treatment plan prescribed by your doctor, if you take St. John’s Wort (Hypericum perforatum ) preparations (see section ‘Other medicines and Gliclazide), or in special stress situations. These may include thirst, frequent urination, dry mouth, dry itchy skin, skin infections and reduced performance.
If these symptoms occur, you must contact your doctor or pharmacist.
Blood glucose disturbance (low blood sugar and high blood sugar) can occur when gliclazide is prescribed at the same time than medicines belonging to a class of antibiotics called fluoroquinolones, especially in elderly patients. In this case, your doctor will remind you the importance of monitoring your blood glucose.
If you have a family history of or know you have the hereditary condition glucose-6-phosphate dehydrogenase (G6PD) deficiency (abnormality of red blood cells), lowering of the haemoglobin level and breakdown of red blood cells (haemolytic anaemia) can occur. Contact your doctor before taking this medicinal product.
Cases of acute porphyria have been described with some other sulfonylurea drugs, in patients who have porphyria (inherited genetic disorders with accumulation in the body of porphyrins or porphyrin precursors).
Warnings and precautions
Talk to your doctor or pharmacist before taking Gliclazide.
You should observe the treatment plan prescribed by your doctor to achieve proper blood sugar levels. This means, apart from regular tablet intake, you observe the dietary regimen, have physical exercise and where necessary, reduce weight.
During gliclazide treatment regular monitoring of your blood (and possibly urine) sugar level and also your glycated haemoglobin (HbA1c) is necessary.
In the first few weeks of treatment the risk of having reduced blood sugar levels (hypoglycaemia) may be increased. So particularly close medical monitoring is necessary.
Low blood sugar (hypoglycaemia) may occur:
- if you take meals irregularly or skip meals altogether
- if you are fasting
- if you are malnourished
- if you change your diet
- if you increase your physical activity and carbohydrate intake does not match this increase
- ifyou drink alcohol, especially in combination with skipped meals
- if you take other medicines or natural remedies at the same time
- if you take too high a dose of gliclazide
- if you suffer from particular hormone-induced disorders (functional disorders of the thyroid gland, of the pituitary gland or adrenal cortex)
- if your kidney function or liver function is severely decreased.
If you have low blood sugar you may have the following symptoms: headache, intense hunger, nausea, vomiting, weariness, sleep disorders, restlessness, aggressiveness, poor concentration, reduced alertness and reaction time, depression, confusion, speech or visual disorders, tremor, sensory disturbances, dizziness and helplessness.
The following signs and symptoms may also occur: sweating, clammy skin, anxiety, fast or irregular heartbeat, high blood pressure, sudden strong pain in the chest that may radiate into nearby areas (angina pectoris).
If blood sugar levels continue to drop you may suffer from considerable confusion (delirium), develop convulsions, lose self control, your breathing may be shallow and your heart beat slowed down, you may become unconscious.
Children and adolescents
Gliclazide is not recommended for use in children and adolescents due to a lack of data.
Other medicines and Gliclazide
Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines.
The blood sugar lowering effect of gliclazide may be strengthened and signs of low blood sugar levels may occur when one of the following medicines is taken:
- Other medicines used to treat high blood sugar (oral anti-diabetics, GLP-1 receptor inhibitors or insulin)
- Antibiotics (e.g. sulfonamides or clarithromycin)
- Medicines to treat high blood pressure or heart failure (beta blockers, ACE-inhibitors such as captopril or enalpril)
- Medicines to treat fungal infections (e.g. miconazole, fluconazole)
- Medicines to treat ulcers in the stomach or duodenum (H2 receptor antagonists)
- Medicines to treat depression (monamine oxidase inhibitors)
- Painkillers or antirheumatics (phenylbutazone, ibuprofen)
- Medicines containing alcohol.
The blood glucose lowering effect of gliclazide may be weakened and raised blood sugar levels may occur when one of the following medicines is taken:
- Medicines to treat disorders of the central nervous system (chlorpromazine)
- Medicines reducing inflammation (corticosteroids or tetracosactrin)
- Medicines to treat asthma or used during labour (intravenous salbutamol, ritodrine and terbutaline)
- Medicines to treat breast disorders, heavy menstrual bleeding and endometriosis (danazol)
- St. John’s Wort (Hypericum perforatum) preparations.
Blood glucose disturbance (low blood sugar and high blood sugar) can occur when a medicine belonging to a class of antibiotics called fluoroquinolones is taken at the same time as Gliclazide, especially in elderly patients.
Gliclazide may increase the effects of medicines which reduce blood clotting (e.g. warfarin).
Consult your doctor before you start taking another medicinal product. Ifyou go into hospital tell the medical staff you are taking Gliclazide.
Gliclazide with food, drink and alcohol Gliclazide can be taken with food and nonalcoholic drinks.
Drinking alcohol is not recommended as it can alter the control of your diabetes in an unpredictable manner.
Pregnancy and breast-feeding Pregnancy
Gliclazide is not recommended for use during pregnancy. If you are pregnant or breastfeeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.
Breast-feeding
You must not take Gliclazide while you are breast-feeding.
Driving and using machines
Your ability to concentrate or react may be impaired if your blood sugar is too low (hypoglycaemia) or too high (hyperglycaemia) or if you develop visual problems as a result of such conditions. Bear in mind that you could endanger yourself or others (e.g. when driving a car or using machines).
Please ask your doctor whether you can drive a car if you:
- have frequent episodes of low blood sugar (hypoglycaemia)
- have few or no warning signals of low blood sugar (hypoglycaemia).
Gliclazide contains lactose
If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product.
^Bhow to take Gliclazide
Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.
Dose
The dose is determined by the doctor, depending on your blood and possibly urine sugar levels.
Change in external factors (e.g. weight reduction, change in life style, stress) or improvements in the blood sugar control may require changed gliclazide doses.
The recommended starting dose is 30mg.
For 30mg tablets: The recommended daily dose is one to four tablets (maximum 120mg) in a single intake at breakfast time. This depends on the response to treatment.
For 60mg tablets: The tablet can be divided into equal doses. The recommended daily dose is half to two tablets (maximum 120mg) in a single intake at breakfast time. This depends on the response to treatment.
If a combination therapy of Gliclazide with metformin, an alpha glucosidase inhibitor, a thiazolidinedione, a dipeptidyl peptidase-4 inhibitor, a GLP-1 receptor agonist or insulin is initiated your doctor will determine the proper dose of each medicine individually for you.
If you notice that your blood sugar levels are high although you are taking the medicine as prescribed, you should contact your doctor or pharmacist.
For 30mg tablets: Swallow your whole tablet(s) in one piece.
For 60mg tablets: Swallow your half tablet or whole tablet(s) in one piece.
Take your tablet(s) with a glass of water at breakfast time (and preferably at the same time each day). Do not chew them. You must always eat a meal after taking your tablet(s).
If you take more Gliclazide than you should If you take too many tablets, contact your doctor or the nearest hospital Accident & Emergency department immediately. The signs of overdose are those of low blood sugar (hypoglycaemia) described in section 2. The symptoms can be helped by taking sugar (4 to 6 lumps) or sugary drinks straight away, followed by a substantial snack or meal. If the patient is unconscious, immediately inform a doctor and call the emergency services.
The same should be done if somebody, e.g. a child, has taken the product unintentionally. Unconscious patients must not be given food or drink.
It should be ensured that there is always a preinformed person that can call a doctor in case of emergency.
If you forget to take Gliclazide
It is important to take your medicine every day as regular treatment works better. However, if you forget to take 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 stop taking Gliclazide
As the treatment for diabetes is usually life long, you should discuss with your doctor before stopping this medicinal product. Stopping could cause high blood sugar (hyperglycaemia) which increases the risk of developing complications of diabetes.
If you have any further questions on the use of this medicine, ask your doctor or pharmacist.
4^Possible side effects
Like all medicines, this medicine can cause side effects, although not everybody gets them.
The most commonly observed side effect is low blood sugar (hypoglycaemia). For symptoms and signs see ‘Warnings and precautions’ in section 2.
If left untreated these symptoms could progress to drowsiness, loss of consciousness or possibly coma. If an episode of low blood sugar is severe or prolonged, even if it is temporarily controlled by eating sugar, you should seek immediate medical attention.
Blood disorders
Decrease in the number of cells in the blood has been reported (e.g. platelets, red and white blood cells). This may cause paleness, prolonged bleeding, bruising, sore throat and fever. These symptoms usually vanish when the treatment is discontinued.
Liver disorders
There have been isolated reports of abnormal liver function, which can cause yellow skin and eyes. If you get this, see your doctor immediately. The symptoms generally disappear if the medicine is stopped. Your doctor will decide whether to stop your treatment.
Skin disorders
Skin reactions have been reported such as: rash, redness, itching, hives, angioedema (rapid swelling of tissues such as eyelids, face, lips, mouth, tongue or throat that may result in breathing difficulty). The rash may progress to widespread blistering or peeling of the skin. Exceptionally, signs of severe hypersensitivity reactions (DRESS) have been reported; initially as flu-like symptoms and a rash on the face, then an extended rash with a high temperature.
Digestive disorders
Stomach pain or discomfort, feeling or being sick, indigestion, diarrhoea and constipation. These effects are reduced when Gliclazide is taken with a meal as recommended, see section 3 ‘How to take Gliclazide’.
Eye disorders
Your vision may be affected for a short time, especially at the start of treatment. This effect is due to changes in blood sugar levels.
As for other sulfonylureas, the following adverse events have been observed: cases of severe changes in the number of blood cells and allergic inflammation of the wall of blood vessels; reduction in blood sodium (hyponatraemia); and symptoms of liver impairment (e.g. jaundice), which in most cases disappeared after withdrawal of the sulfonylurea, but may lead to life threatening liver failure in isolated cases.
Reporting of side effects
If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme Website: or search for MHRA Yellow Card in the Google Play or Apple App Store.
By reporting side effects you can help provide more information on the safety of this medicine.
5^How to store Gliclazide
Keep this medicine out ofthe sight and reach of children.
Do not store above 30°C
Do not take this medicine after the expiry date which is stated on the tablet carton and blister strip after ‘EXP:’. The expiry date refers to the last day of that month.
Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.
sBcontents of the pack and other information
What Gliclazide contains
- The active substance is gliclazide. One tablet contains either 30mg or 60mg of gliclazide in a prolonged-release formulation.
- The other ingredients are: lactose monohydrate, hypromellose, microcrystalline cellulose, colloidal anhydrous silica, magnesium stearate.
What Gliclazide looks like and contents of the pack
Gliclazide Accord-UK 30mg Prolonged-release Tablets are white, oval, biconvex 5 × 11 mm tablets marked “G” on one side.
Gliclazide Accord-UK 60mg Prolonged-release Tablets are white, oval, biconvex 7 × 15 mm tablets scored on both sides, marked with “G” on one side of the score and “60” on the other side of the score.
Pack sizes:
Blisters: 28 and 56 Prolonged-release Tablets.
Marketing Authorisation Holder
Accord, Barnstaple, EX32 8NS, UK
Manufacturer
Balkanpharma-Dupnitsa AD
3 Samokovsko Shosse Str., Dupnitsa 2600 Bulgaria
This leaflet was last revised in January 2021.
If you would like a leaflet with larger text, please contact 01271 385257.
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