Sulfonylureas increase both basal insulin secretion and stimulate insulin release from food.
Uses and mechanism of action
Chlorpropamide is used together with diet and exercise, and sometimes with other medications, to treat type 2 diabetes (a condition in which the body does not usually use insulin and therefore cannot control the amount of sugar in the blood).
Chlorpropamide belongs to a group of drugs called sulfonylureas, which help lower blood sugar by causing the pancreas to produce insulin (a natural substance needed to break down sugar in the body).
Belonging to the class of insulin-secreting sulfonylureas, they work by stimulating the β cells of the pancreas to release insulin.
Drugs in this class differ in dose, absorption rate, duration of action, route of elimination, and receptor site for target β-cell receptor binding in the pancreas.
Sulfonylureas also increase peripheral glucose use, decrease hepatic gluconeogenesis, and may increase the number and sensitivity of insulin receptors.
Sulfonylureas are associated with weight gain, although less so than insulin.
Due to their mechanism of action, sulfonylureas can cause hypoglycemia and require consistent food intake to decrease this risk.
The risk of hypoglycemia increases in elderly, debilitated, and malnourished individuals.
Up to 80% of the single oral dose of chlorpropamide is metabolized, probably in the liver; 80-90% of the amount is excreted in the urine as unchanged drug and metabolites.
Chlorpropamide and other sulfonylureas promote weight gain, so they are generally not favored for use in severely obese patients.
Metformin (Glucophage) is considered a better medicine for these patients.
Sulfonylureas should be used with caution or should generally be avoided in patients with impaired liver and kidney function, porphyria, breastfeeding patients, patients with ketoacidosis, and elderly patients.
This medicine comes in tablet form and is taken once a day in the morning with breakfast or the first meal of the day.
To make sure chlorpropamide is safe for you, tell your doctor if you have:
- Liver disease
- Kidney disease
- A disorder of your pituitary or adrenal glands.
- A history of heart disease.
- If you are malnourished.
Certain oral diabetes medications can increase your risk of severe heart problems. However, not treating your diabetes can damage your heart and other organs. Talk to your doctor about the risks and benefits of taking chlorpropamide.
It is not known whether chlorpropamide will harm an unborn baby.
Tell your doctor if you are pregnant or plan to become pregnant while using chlorpropamide.
Chlorpropamide can pass into breast milk and may harm a nursing baby. It would help if you did not breastfeed while you were taking chlorpropamide.
Chlorpropamide side effects
Serious side effects have been reported with chlorpropamide, including the following:
- Low blood sugar (hypoglycemia).
- Excessive hunger
- Difficulty speaking
- Feeling anxious or weak
- Loss of blood sugar control. This can lead to low blood sugar episodes, high blood sugar episodes, or both.
Tell your healthcare provider right away if you have any or all of the following symptoms of high blood sugar:
- Increased thirst.
- Frequent urination
- Soft spot.
Anemia: This is a condition where your blood has fewer red blood cells than usual. Tell your healthcare provider right away if you have the following signs and symptoms of anemia:
- Difficulty breathing.
- Coldness in hands and feet.
- Pale skin.
- Chest pain.
Chlorpropamide can cause dizziness. Do not drive or operate heavy machinery until you know how chlorpropamide affects you.
Do not take chlorpropamide if:
- Are you allergic to chlorpropamide or any of its ingredients?
- You have type 1 diabetes or diabetic ketoacidosis, with or without a comma. These conditions must be treated with insulin.
Seek emergency medical attention if you have symptoms of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Call your doctor immediately if you have:
- Easy bruising or bleeding, pale skin, fever, unusual weakness.
- Trouble concentrating, memory problems, hallucinations.
- A feeling of dizziness, as if you were passing out.
- Throbbing headache, sweating, severe nausea, shortness of breath, fast or pounding heartbeat, blurred vision, spinning sensation.
- Liver problems: nausea, upper stomach pain, itching, tired feeling, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).
- Severe skin reaction: fever, sore throat, swelling of the face or tongue, burning eyes, sore skin, followed by a spreading red or purple skin rash (especially on the front or upper body ) and causes blistering and peeling.
Your doctor must monitor your progress at regular visits. This will allow your doctor to check if the medicine is working properly to decide if you should continue taking the medication.
Blood and urine tests may be needed to check for undesirable effects.
It is essential to follow the instructions of your healthcare providers: carefully.
Alcohol: Drinking alcohol can cause severe hypoglycemia. Talk to your health team.
Counseling family members: they need to learn to avoid side effects or help the patient if they occur.
In addition, patients with diabetes may need particular advice on therapy, dosage, and changes due to changes in lifestyle, such as changes in diet and exercise.
In addition, counseling on contraception and pregnancy may be necessary due to problems in patients with diabetes during pregnancy.
Travel – Keep your most recent prescription and medical history. Be prepared to deal with an emergency, as you would in a normal situation. Adjust when changing time zone, keeping meal times as close to your usual meals.
There may be a time when you need emergency help for a problem caused by diabetes in an emergency. It would help if you were prepared for these emergencies.
It is a good idea to wear a medical identification bracelet (ID or a chain around your neck). Also, carry an ID card in your purse or purse that says you have diabetes and a list of all your medications.
Glucagon is used in emergencies when severe symptoms such as seizures or unconsciousness occur. Have a Glucagon kit available, a syringe or needle, and know how to use it. Members of your household should know how to use it too.
Avoid exposure to sunlight or tanning beds. Chlorpropamide can cause sunburn more easily. Wear protective clothing and sunscreen (SPF 30 or higher) when outside.
You are more likely to have hypoglycemia (low blood sugar) if you take doses of chlorpropamide with other medicines that can lower blood sugar, such as:
- Exenatide (Byetta).
- Probenecid (Benemid).
- Aspirin or other salicylates (including Pepto Bismol).
- A blood thinner (warfarin, Coumadin, Jantoven).
- Sulfates (Bactrim, SMZ-TMP, and others).
- A monoamine oxidase inhibitor.
- Insulin or other oral diabetes medications.
Chlorpropamide Genetic Information
G6PD is an enzyme in your body that is responsible for helping red blood cells work properly.
Some patients are born with less of this enzyme in their bodies, leading to the destruction of red blood cells. Chlorpropamide can also lead to the destruction of red blood cells.
When chlorpropamide is used in patients with G6PD deficiency, they are more likely to experience hemolytic anemia (a condition in which the body does not have enough red blood cells to deliver oxygen to its tissues).
G6PD tests can be done to determine if you are at an increased risk of experiencing hemolytic anemia if you are to be treated with chlorpropamide.
Presentation of chlorpropamide
- 100 mg oral tablets
- Color: green
- Shape: round
- Size: 9.00
Tell your doctor about all the medicines you take, including prescription and nonprescription medicines, vitamins, and herbal supplements. In particular, tell your doctor if you take:
- Corticosteroids such as prednisone (Cortan, Deltasone, Orasone, Sterapred), budesonide (Entocort), dexamethasone (Decadron), triamcinolone (Kenacort, Aristocort), flunisolide (AeroBid, Aerospan), ciclesonide (Alvesco).
- Other similar medications such as mometasone (Asmanex, Nasonex), fluticasone (Flovent), methylprednisolone (Medrol, Solu-Medrol), fludrocortisone (Florinef), and hydrocortisone (Cortef, Hydrocortone).
- Fenotiazinas como clorpromazina (Thorazine), tioridazina (Mellaril), flufenazina (Prolixin), perfenazina (Triavil), proclorperazina (Compazine) y trifluoperazina (Stelazine).
- Thyroid medications such as levothyroxine, Synthroid, and Levothroid.
- Diuretics such as spironolactone (Aldactazide, Aldactone), torsemide (Demadex), chlorothiazide (Diuril), hydrochlorothiazide (Microzide, Oretic), furosemide (Lasix), chlorthalidone (Thalitone) and metolazone (Zaroxolyn).
Aspirin and other MANEs (non-steroidal anti-inflammatory drugs) such as:
- Celecoxib (Celebrex).
- Diclofenac (Cambia, Cataflam, Flector, Voltaren, Zipsor and others).
- Etodolac (Lodine).
- Ibuprofeno (Advil, Motrin, Nuprin).
- Indometacina (Indocin, Indocin SR).
- Ketoprofeno (Orudis, Actron, Oruvail).
- Ketorolaco (Toradol).
- Meloxicam (Mobic).
- Nabumetona (Relafen).
- Naproxen (Naprosyn).
- Sodium naproxen (Aleve, Anaprox, Naprelan).
- Oxaprozin (Daypro).
- Piroxicam (Feldene).
- Sulfonamidas tales como trimetoprim / sulfametoxazol (Septra, Bactrim), sulfasalazina (Azulfidine), dapsona (DDS), hydrochlorothiazide (Microzide), sumatriptan (Imitrex, Sumavel Dosepro), la zonisamida (Zonegran), acetazolamida (Diamox) y celecoxib (Celebrex).
- Probenecid (Benemid, Probalan).
- Warfarina (Coumadin, Jantoven).
- Inhibidores de la monoamina oxidasa tales como tranilcipromina (Parnate), fenelzina (Nardil), selegilina (Eldepryl, Zelapar), isocarboxazid (Marplan), y rasagilina (Azilect).
- Bloqueadores beta, tales como metoprolol (Toprol XL, Lopressor), carvedilol (Coreg), bisoprolol (Zebeta), betaxolol (Kerlone), nebivolol (Bystolic) y propranolol (Inderal).
- Miconazol (Lotrimin, Monistat).
- Fenitoína (Dilantin).
- Nicotinic acid medications such as niacin (Niacor, Niaspan, Slo-Niacin) and vitamin B3.
- Bloqueadores de los canales de calcio tales como amlodipina (Norvasc), clevidipina (Cleviprex), diltiazem (Cardizem, Dilacor, Tiazac), felodipina (Plendil), isradipina (DynaCirc), nicardipina (Cardene), nifedipina (Adalat, Procardia), nisoldipina (Sular) , Verapamil (Calan, Covera, Isoptin, Verelan).
- Birth control pills.
Chlorpropamide interactions with food
Medicines sometimes interact with various foods and edibles. This can be catastrophic and extremely dangerous for some patients. In these cases, your doctor should recommend that you avoid certain foods that may harm your health while taking this medicine.
On the other hand, no research has been conducted to show which foods should be excluded from the patient’s daily diet not to harm their health while taking chlorpropamide.
Be sure to follow all the diet and exercise recommendations your doctor or dietitian makes. It is essential to eat a healthy diet, exercise regularly, and lose weight if necessary.
Take chlorpropamide precisely as prescribed by your doctor. Scrupulously follow the steps on the packaging mask.
The dose of chlorpropamide recommended by your doctor will be based on the following:
- Other medical conditions you have.
- Other medications you are taking.
- How do you respond to this drug?
- Your liver function.
- Your kidney function.
- Your age.
The recommended dose range for chlorpropamide is 100 to 750 mg once a day, with breakfast or with the first meal of the day.
If you take too much chlorpropamide, call your healthcare provider or local Poison Control Center or seek emergency medical attention immediately.
If someone overdoses and has severe symptoms, such as fainting or shortness of breath, call 911. Otherwise, call a poison control center right away.
- Store chlorpropamide at room temperature between 20 ° and 25 ° C (68 ° to 77 ° F).
- Keep this and all medicines out of the reach of children.
- Do not share this medicine with others.
- Attend a diabetes education program to learn more about diabetes and the critical aspects of its treatment, including medications, diet, exercise, and regular eye/foot checkups / medical exams.
- Learn about high and low blood sugar symptoms and how to treat low blood sugar. Check your blood sugar regularly as directed.
- Keep all medical and laboratory appointments. Laboratory and medical tests (such as liver and kidney function tests, fasting blood glucose, and hemoglobin A1c) should be performed to monitor your progress or check for side effects.