Leicestershire Health Community Medicines Formulary
6 Endocrine system
Sulfonylureas act on the pancreatic beta cells to stimulate insulin release
Hypoglycaemia is the main risk associated with sulphonylureas. Inform patients about recognition and management
Elderly patients are particularly vulnerable to hypoglycaemia and this may be fatal. Chlorpropamide and glibenclamide should not be used in this group of patients.
Weight gain is associated with sulfonylurea therapy, but tends to plateau after a mean gain of 4kg.
With the exception of tolbutamide the sulfonylureas are similarly effective in maximum doses and there is no justification for changing drugs within this class if control deteriorates unless compliance is an issue when a decreased tablet count may be helpful.
Tablets should be taken before meals
Mainly metabolised by the liver.
Gliclazide MR Diamicron® MR
May be used if hypoglycaemia is a problem as associated with less hypoglycaemia than standard release gliclazide.