Clorpropamida L.CH. Dosage
There is no fixed dosage regimen for the management of type 2 diabetes with Clorpropamida L.CH. (Clorpropamida L.CH.) or any other hypoglycemic agent. The patient's blood glucose must be monitored periodically to determine the minimum effective dose for the patient; to detect primary failure, i.e., inadequate lowering of blood glucose at the maximum recommended dose of medication; and to detect secondary failure, i.e., loss of an adequate blood glucose lowering response after an initial period of effectiveness. Glycosylated hemoglobin levels may also be of value in monitoring the patient's response to therapy.
Short-term administration of Clorpropamida L.CH. (Clorpropamida L.CH.) may be sufficient during periods of transient loss of control in patients usually controlled well on diet.
The total daily dosage is generally taken at a single time each morning with breakfast. Occasionally cases of gastrointestinal intolerance may be relieved by dividing the daily dosage. A LOADING OR PRIMING DOSE IS NOT NECESSARY AND SHOULD NOT BE USED.
Many mild to moderately severe, middle-aged, stable type 2 diabetes patients receiving insulin can be placed directly on the oral drug and their insulin abruptly discontinued. For patients requiring more than 40 units of insulin daily, therapy with Clorpropamida L.CH. (Clorpropamida L.CH.) may be initiated with a 50 per cent reduction in insulin for the first few days, with subsequent further reductions dependent upon the response.
During the initial period of therapy with Clorpropamida L.CH., hypoglycemic reactions may occasionally occur, particularly during the transition from insulin to the oral drug. Hypoglycemia within 24 hours after withdrawal of the intermediate or long-acting types of insulin will usually prove to be the result of insulin carry-over and not primarily due to the effect of Clorpropamida L.CH..
During the insulin withdrawal period, the patient should self-monitor glucose levels at least three times daily. If they are abnormal, the physician should be notified immediately. In some cases, it may be advisable to consider hospitalization during the transition period.
Five to seven days after the initial therapy, the blood level of Clorpropamida L.CH. reaches a plateau. Dosage may subsequently be adjusted upward or downward by increments of not more than 50 to 125 mg at intervals of three to five days to obtain optimal control. More frequent adjustments are usually undesirable.
Most moderately severe, middle-aged, stable type 2 diabetes patients are controlled by approximately 250 mg daily. Many investigators have found that some milder diabetics do well on daily doses of 100 mg or less. Many of the more severe diabetics may require 500 mg daily for adequate control. PATIENTS WHO DO NOT RESPOND COMPLETELY TO 500 MG DAILY WILL USUALLY NOT RESPOND TO HIGHER DOSES. MAINTENANCE DOSES ABOVE 750 mg DAILY SHOULD BE AVOIDED.
|Strength||Tablet Description||Tablet Code||NDC||Package Size|
|Clorpropamida L.CH. (Clorpropamida L.CH.) 100 mg||Blue, D- shaped, scored||393||0069-3930-66||100's|
|Clorpropamida L.CH. (Clorpropamida L.CH.) 250 mg||Blue, D- shaped, scored||394|| 0069-3940-66 |
| 100's |
RECOMMENDED STORAGE: Store below 86°F (30°C).
Distributed by: Pfizer Labs, Division of Pfizer Inc, NY, NY, 10017
You may be more likely to have hyperglycemia (high blood sugar) if you are taking Clorpropamida L.CH. with other drugs that raise blood sugar, such as:
You may be more likely to have hypoglycemia (low blood sugar) if you are taking Clorpropamida L.CH. with other drugs that lower blood sugar, such as:
This list is not complete and other drugs may interact with Clorpropamida L.CH.. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.
The following products can lead to hypoglycemia:
The hypoglycemic action of sulfonylurea may be potentiated by certain drugs including nonsteroidal anti-inflammatory agents and other drugs that are highly protein bound, salicylates, sulfonamides, chloramphenicol, probenecid, coumarins, monoamine oxidase inhibitors, and beta adrenergic blocking agents. When such drugs are administered to a patient receiving Clorpropamida L.CH. (Clorpropamida L.CH.), the patient should be observed closely for hypoglycemia. When such drugs are withdrawn from a patient receiving Clorpropamida L.CH. (Clorpropamida L.CH.), the patient should be observed closely for loss of control.
Miconazole: A potential interaction between oral miconazole and oral hypoglycemic agents leading to severe hypoglycemia has been reported. Whether this interaction also occurs with intravenous, topical, or vaginal preparations of miconazole is not known.
Alcohol: In some patients, a disulfiram-like reaction may be produced by the ingestion of alcohol. Moderate to large amounts of alcohol may increase the risk of hypoglycemia (ref.l), (ref. 2).
The following products can lead to hyperglycemia:
Certain drugs tend to produce hyperglycemia and may lead to loss of control. These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blocking drugs, and isoniazid.
When such drugs are administered to a patient receiving Clorpropamida L.CH. (Clorpropamida L.CH.), the patient should be closely observed for loss of control. When such drugs are withdrawn from a patient receiving Clorpropamida L.CH. (Clorpropamida L.CH.), the patient should be observed closely for hypoglycemia.
Since animal studies suggest that the action of barbiturates may be prolonged by therapy with Clorpropamida L.CH., barbiturates should be employed with caution.
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Information checked by Dr. Sachin Kumar, MD Pharmacology