Chlorpropamide

Sulphonylurea acting primarily by stimulating the release of insulin & inhibit the release of glucose by the liver & increase sensitivity of peripheral tissues to insulin.

Indications

In the treatment of Diabetes unresponsive to diet.

Dosage

Initially 100-250 mg once daily after breakfast. Increase or decrease by 50-125 m daily every 3-5 days. Max 500 mg daily.

Contra-Indications

Hepatic insufficiency (hepatitis, cirrhosis, steatosis). Serum creatine more than 12 mg% and urea greater than 40 mg%. Cardiovascular disease predisposing to tissue hypoxia. Alcohol intoxication. Diuretics & anti-hypertensive agents affect renal function adversely. Pregnancy, surgery, stress, infections.

Special Precautions

Alcohol even in moderation. renal dysfunction. Congestive heart failure, respiratory failure, Liver disease, pancreatitis. Ischaemic vascular disease. Paediatrics: Not recommended. Pregnancy & Lactation: Contraindicated. Elderly: Reduced dose may be necessary.

Side Effects

G.I. upset, leucopenia, thrombo- cytopenia, jaundice. Rashes, skin eruptions. Anaemia.

Drug Interactions

alicylates, NSAIDs, sulphonamides, chloramphenicol, probenecid, coumarins, MAOIs and betablockers potentiates the action and may cause hypoglycaemia. Oral contraceptives antagonise unsulin action. Thiazide diuretics reduce insulin release. Ca++ channel blockers decreases the action of chlorpropamide and may cause hyperglycaemia. Barbiturates may produce disulfiram like action.