Chlorpropamide

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Chlorpropamide is a sulphonylurea drug and is an oral antidiabetics. Chlorpropamide is used to treat Type 2 (non-insulin dependent) diabetes mellitus and is used in conjunction with a diet and an exercise program. Sulphonylureas are considered for patients who are not overweight, or in whom metformin is contra-indicated (inadvisable or undesirable) or not tolerated.

Insulin is made naturally in the pancreas. It regulates the level of sugar in the blood. If the body does not make enough insulin to meet its needs, or does not properly use the insulin it makes, this results in the condition called (maturity onset) diabetes mellitus. Chlorpropamide works by increasing the amount of insulin the pancreas secretes lowering blood sugar levels and by promoting the uptake of sugar into body cells.

Chlorpropamide is considered the longest lasting of the oral diabetic drugs and needs to be taken once daily. This medication can also be given to patients for mild form of diabetes insipidus its action is to reduce the volume of urine produced by the kidneys, it does this by reabsorption.

Chlorpropamide would be given to elderly patient with caution. Dosage should generally be substantially lower than for younger patients and it is common to start with about 50% of the adult dose. Some drugs (e.g. long-acting antidiabetic drugs such as glibenclamide and chlorpropamide) should be avoided altogether. Chlorpropamide and glibenclamide are associated with a greater risk of hypoglycaemia; for this reason they should be avoided in the elderly and shorter-acting alternatives, such as gliclazide or tolbutamide, should be used instead.

Quick Guide

• Oral antidiabetic medication with overdose danger – HIGH.
• Dependency is said to be – LOW.
• Prescription only drug – YES.
• Available as generic – YES. (generic drugs, short: generics) is a drug which is produced and distributed without patent protection.
• Alcohol avoidance – YES.
• Alcohol may upset diabetic control and react adversely with chlorpropamide.

Side Effects

You may if you are taking chlorpropamide suffer one or more of these side effects, in the initial stages. However, you may find you do not suffer any at all, as it does not follow that being on this medication will cause unwanted side effects.

Common: confusion, Feeling sick, loss of appetite, Sweating, Pins and Needles, Stomach Pain, tremor, weakness.
Rare: Headaches, fever (high temperature), Skin Rash, itching, Diarrhoea, Nausea and Vomiting.

If you suffer difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives. seek immediate medical assistance.

The side effects listed here are the most common and rare problems reported by patients using chlorpropamide It does not include all of the side effects reported by the drug’s manufacturer. If common side effects persist you need to inform your doctor. Notify your doctor if you suffer any of the rare or some other side effects not listed here. For total peace of mind, seek information from your doctor or chemist.

Prolonged Use

There would be no problems expected. However, if you are taking this drug for diabetes mellitus, regular monitoring of your urine or blood sugar is required.

Driving, Hazardous Work & Alcohol

If you have warning signs of low blood sugar levels you should avoid these activities. Hypoglycaemia is likely to occur if you miss a meal, if you exercise more than usual, if you cannot eat because of sickness or if you drink a lot of alcohol. Alcohol may upset diabetic control and react adversely with chlorpropamide.

Pregnancy and Breast-Feeding

Would not usually be prescribed. Insulin would be used in pregnancy because it offers better diabetic control. Because the drug passes into the breast milk this may cause low blood pressure in the baby. You should discuss both of these issues with your doctor.

Chlorpropamide is classified as a Pregnancy Category C Medicine, By the US Food and Drug Administration (FDA). Category C… Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.

Surgery

You will need to tell your doctor/dentist if you are taking chlorpropamide. Insulin treatment may need to be substituted as surgery and general anaesthetics may reduce the response to this drug. If you find you need to take painkillers following a tooth extration do not use Aspirin choose another type (eg. paracetamol). This is because Aspirin is used to thin the blood and this would interfere with the body’s natural clotting ability.

Tell Your Doctor or Pharmacist

You should tell your doctor if you have a current health problem. For example: heart disease, kidney problems, if you are pregnant or you intend to become pregnant, or if you think you may be at risk from drug treatment for any other reason. Some types of medication can cause serious adverse effects when taken side by side so it is important to tell your doctor of any other medication you are already taking. This should also include any over-the-counter medication. For example: Painkillers, cold remedies, herbal and complimentary / alternative medication.

Over 60’s & Children

Other oral antidiabetic drugs would be preferred to chlorpropamide. As for children this drug would not be used for diabetes mellitus, and a reduced dose would be necessary if used for diabetes insipidus.

Overdose

Take chlorpropamide exactly as directed by your doctor. You should seek immediate medical advice in all cases. If symptoms of low blood sugar show such as: faintness, confusion, sweating or shaking occur eat or drink something sugary. If fits or loss of consciousness occur take emergency action or go to your nearest accident and emergency department of your local hospital taking the container with you. Even if it is empty. An overdose of chlorpropamide can be fatal.

Other Medication Reactions

Other drugs such as warfarin, beta blockers, non-steroidal anti-inflammatory drugs (aspirin) may enhance the effects of chlorpropamide leading to low blood sugar levels. Some drugs may increase blood sugar levels resulting in loss of control by chlorpropamide. These include corticosteroids, oestrogens, diuretics and phenytoin.

Missed A Dose

If you miss a dose, take it as soon as you remember (with food) and take your next dose at the usual time, unless, it is nearly time for your next dose, in which case leave out the missed dose. Never take two doses at the same time to make up for a missed dose.

Reducing or Stopping Medication

Do not stop taking this medication without first speaking to your doctor. It is quite possible that stopping this drug will lead to a worsening of your diabetes.

Effect Of Medication (from one dose)

The onset of effects will be within one hour. The duration of the action could be 1 to 3 days.

Storage and Safety

• Do not store medication above a tempreture of 25°C.
• Keep medicine in its original container, in a cool dry place, away from the reach of children.
• Chlorpropamide may cause your skin to become more sensitive to sunlight. Avoid sunlight and sun beds and use a sun protection cream higher than factor 15 until you know how your skin reacts.
• Never take more than the original dosage prescribed by your doctor.
• It is important that you follow any dietary instructions that you have been given by your doctor or diabetic nurse.
• Never take medication that has past the expiry date shown on the box or container.
• Do not discard old or unwanted medication/drugs into your trash, sink or toilet.
• Return all un-used or old medicines/drugs to your pharmacist.

If chlorpropamide has been prescribed for you never allow anyone else to use it, even if you know or others feel their symptom are similar to your own.

Do not leave your doctors surgery until you have a clear understanding of what the drug your doctor has prescribed for you does, and why you have been prescribed it. It is common for people who do not understand the reason behind there treatment to take their medication correctly.