Chlorpropamide (oral route)


    Brand Name

    US Brand Name

    Diabinese


    Description

    Chlorpropamide is used to treat high blood sugar levels caused by a type of diabetes mellitus called type 2 diabetes. In type 2 diabetes, your body does not work properly to store excess sugar and the sugar remains in your blood. High blood sugar over a long time can lead to serious health problems.

    Proper diet is the first step in managing type 2 diabetes, but often medicines are needed. Chlorpropamide belongs to a class of drugs called sulfonylureas. It increases the release of insulin from the pancreas, which helps your body store sugar. This also lowers the level of sugar in the blood and restores the way you use food to make energy.

    This medicine is available only with your doctor's prescription.

    This product is available in the following dosage forms:

    • Tablet

    Before Using

    In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

    Allergies

    Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

    Pediatric

    Appropriate studies have not been performed on the relationship of age to the effects of chlorpropamide in the pediatric population. Safety and efficacy have not been established.

    Geriatric

    Although appropriate studies on the relationship of age to the effects of chlorpropamide have not been performed in the geriatric population, geriatric-specific problems are not expected to limit the usefulness of chlorpropamide in the elderly. However, elderly patients are more likely to have age-related liver or kidney problems, which may require an adjustment in the dose for patients receiving chlorpropamide.

    Breastfeeding

    There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

    Drug Interactions

    Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

    Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

    • Abiraterone Acetate
    • Abiraterone Acetate, Micronized
    • Acarbose
    • Alogliptin
    • Aspirin
    • Bexagliflozin
    • Chloroquine
    • Chlorothiazide
    • Chlorthalidone
    • Ciprofloxacin
    • Delafloxacin
    • Desmopressin
    • Disopyramide
    • Dulaglutide
    • Enoxacin
    • Furosemide
    • Gatifloxacin
    • Gemifloxacin
    • Grepafloxacin
    • Hydrochlorothiazide
    • Hydroflumethiazide
    • Hydroxychloroquine
    • Indapamide
    • Insulin
    • Insulin Aspart, Recombinant
    • Insulin Bovine
    • Insulin Degludec
    • Insulin Detemir
    • Insulin Glargine, Recombinant
    • Insulin Glulisine
    • Insulin Lispro, Recombinant
    • Lanreotide Acetate
    • Levofloxacin
    • Liraglutide
    • Lixisenatide
    • Lomefloxacin
    • Metformin
    • Methotrexate
    • Metolazone
    • Metreleptin

    Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

    • Acebutolol
    • Aminolevulinic Acid
    • Atenolol
    • Betaxolol
    • Bisoprolol
    • Bitter Melon
    • Carteolol
    • Carvedilol
    • Celiprolol
    • Chloramphenicol
    • Clofibrate
    • Esmolol
    • Fenugreek
    • Garlic
    • Glecaprevir
    • Glucomannan
    • Guar Gum
    • Isocarboxazid
    • Labetalol
    • Levobunolol
    • Linezolid
    • Methylene Blue
    • Metipranolol
    • Metoprolol
    • Nadolol
    • Nebivolol
    • Oxprenolol
    • Ozanimod
    • Penbutolol
    • Phenelzine
    • Pibrentasvir
    • Pindolol
    • Practolol
    • Procarbazine
    • Propranolol
    • Psyllium
    • Rasagiline
    • Rifampin
    • Rifapentine
    • Safinamide

    Other Interactions

    Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

    Using this medicine with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

    • Ethanol

    Other Medical Problems

    The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

    • Alcohol intoxication or
    • Underactive adrenal glands or
    • Underactive pituitary gland or
    • Undernourished condition or
    • Weakened physical condition—May cause side effects to become worse.
    • Diabetic ketoacidosis (ketones in the blood) or
    • Type I diabetes—Should not be used in patients with these conditions.
    • Glucose 6-phosphate dehydrogenase (G6PD) deficiency (an enzyme problem)—Use with caution. May cause hemolytic anemia (blood disorder) in patients with this condition.
    • Heart or blood vessel disease—Use with caution. May make this condition worse.
    • Kidney disease or
    • Liver disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

    Proper Use

    Carefully follow the special meal plan your doctor gave you. This is the most important part of controlling your diabetes, and is necessary if the medicine is to work properly. Also, exercise regularly and test for sugar in your blood or urine as directed.

    You should take your medicine each morning with breakfast.

    Dosing

    The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

    The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

    • For oral dosage form (tablets):
      • For type 2 diabetes:
        • Adults—At first, 250 milligrams (mg) once a day. Your doctor may adjust your dose as needed. The dose is usually not more than 750 mg per day.
        • Children—Use and dose must be determined by your doctor.

    Missed Dose

    If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

    Storage

    Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

    Keep out of the reach of children.

    Do not keep outdated medicine or medicine no longer needed.

    Ask your healthcare professional how you should dispose of any medicine you do not use.


    Precautions

    It is very important that your doctor check your progress at regular visits. This will allow your doctor to see if the medicine is working properly and to decide whether you should continue to take it. Blood and urine tests may be needed to check for unwanted effects.

    It is very important to carefully follow any instructions from your health care team about:

    • Alcohol—Drinking alcohol may cause severe low blood sugar. Discuss this with your health care team.
    • Counseling—Other family members need to learn how to prevent side effects or help with side effects if they occur. Also, patients with diabetes may need special counseling about diabetes medicine dosing changes that might occur because of lifestyle changes, such as changes in exercise and diet. Furthermore, counseling on contraception and pregnancy may be needed because of the problems that can occur in patients with diabetes during pregnancy.
    • Travel—Keep your recent prescription and your medical history with you. Be prepared for an emergency as you would normally. Make allowances for changing time zones and keep your meal times as close as possible to your usual meal times.
    • In case of an emergency—There may be a time when you need emergency help for a problem caused by your diabetes. You need to be prepared for these emergencies. It is a good idea to wear a medical identification (ID) bracelet or neck chain at all times. Also, carry an ID card in your wallet or purse that says you have diabetes and a list of all of your medicines.

    Check with your doctor right away if you start having chest pain or discomfort; nausea; pain or discomfort in arms, jaw, back, or neck; shortness of breath; sweating; or vomiting while you are using this medicine. These may be symptoms of a serious heart problem, including a heart attack.

    Chlorpropamide can cause hypoglycemia (low blood sugar). However, this can also occur if you delay or miss a meal or snack, drink alcohol, exercise more than usual, cannot eat because of nausea or vomiting, take certain medicines, or take chlorpropamide with another type of diabetes medicine. The symptoms of low blood sugar must be treated before they lead to unconsciousness (passing out). Different people feel different symptoms of low blood sugar. It is important that you learn which symptoms of low blood sugar you usually have, so you can treat it quickly.

    Symptoms of low blood sugar include anxiety; behavior change similar to being drunk; blurred vision; cold sweats; confusion; cool, pale skin; difficulty with thinking; drowsiness; excessive hunger; fast heartbeat; headache (continuing); nausea; nervousness; nightmares; restless sleep; shakiness; slurred speech; or unusual tiredness or weakness.

    If symptoms of low blood sugar occur, eat glucose tablets or gel, corn syrup, honey, or sugar cubes; or drink fruit juice, non-diet soft drink, or sugar dissolved in water. Also, check your blood for low blood sugar. Glucagon is used in emergency situations when severe symptoms such as seizures (convulsions) or unconsciousness occur. Have a glucagon kit available, along with a syringe or needle, and know how to use it. Members of your household also should know how to use it.

    Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.


    Side Effects

    Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

    Check with your doctor immediately if any of the following side effects occur:

    Rare

    • Abdominal or stomach pain
    • agitation
    • black, tarry stools
    • chills
    • clay-colored stools
    • coma
    • confusion
    • continuing diarrhea
    • continuing stomach pain
    • convulsions
    • dark urine
    • decreased urine output
    • depression
    • diarrhea
    • dizziness
    • fast or irregular heartbeat
    • fever
    • headache
    • hostility
    • increased thirst
    • irritability
    • itching
    • lethargy
    • loss of appetite
    • muscle pain or cramps
    • muscle twitching
    • nausea or vomiting
    • rapid weight gain
    • rash
    • seizures
    • shortness of breath
    • stupor
    • swelling of the face, ankles, or hands
    • unpleasant breath odor
    • unusual tiredness or weakness
    • vomiting of blood
    • yellow eyes or skin

    Incidence not known

    • Anxiety
    • back, leg, or stomach pains
    • bleeding gums
    • blood in the urine or stools
    • blurred vision
    • chest pain
    • cold sweats
    • cool, pale skin
    • cough or hoarseness
    • depression
    • difficulty with breathing
    • fever with or without chills
    • fluid-filled skin blisters
    • general body swelling
    • general feeling of tiredness or weakness
    • headache
    • high fever
    • increased hunger
    • lower back or side pain
    • nervousness
    • nightmares
    • nosebleeds
    • painful or difficult urination
    • pinpoint red spots on the skin
    • sensitivity to the sun
    • shakiness
    • skin thinness
    • slurred speech
    • sore throat
    • sores, ulcers, or white spots on the lips or in the mouth
    • swollen or painful glands
    • tightness in the chest
    • unusual bleeding or bruising
    • wheezing

    Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

    More common

    • Indigestion
    • passing of gas

    Less common

    • Hives or welts
    • redness of the skin
    • weight loss

    Rare

    • Blistering, peeling, or loosening of the skin
    • cracks in the skin
    • loss of heat from the body
    • red, irritated eyes
    • red, swollen skin
    • scaly skin

    Incidence not known

    • Increased sensitivity of the skin to sunlight
    • redness or other discoloration of the skin
    • severe sunburn

    Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

    Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.






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