Taking into account the experience of the use of gliclazide and other derivatives of sulfonylureas, one should remember about the possibility of developing the following side effects.
Hypoglycaemia
Like other drugs of the sulfonylurea group, glycazide may cause hypoglycemia in the event of an irregular intake of food and especially if the ingestion of food is omitted.Possible symptoms of hypoglycemia include headache, severe hunger, nausea, vomiting, fatigue, sleep disturbance, irritability, agitation, decreased concentration, slowed reactions, depression, confusion, impaired vision and speech, aphasia, tremor, paresis, self-loss , helplessness, impaired perception, dizziness, weakness, convulsions, bradycardia, lightheadedness, shortness of breath, drowsiness, loss of consciousness with the possible development of coma, or death. Also can be marked adrenergic reactions: sweating, "sticky" skin, anxiety, tachycardia, hypertension, palpitations, arrhythmia, and angina pectoris.
As a rule, the symptoms of hypoglycemia are stopped by the intake of carbohydrates (sugar). The intake of sugar substitutes is ineffective. Against the background of other derivatives of sulfonylureas, there were relapses of hypoglycemia after its successful cupping.
With severe or prolonged hypoglycemia, emergency medical care is indicated, possibly with hospitalization, even if there is an effect of taking carbohydrates.
Other side effects
From the gastrointestinal tract: abdominal pain, nausea, vomiting, diarrhea, constipation. Taking the drug during breakfast allows you to avoid these symptoms or minimize them.
Less common are the following side effects:
- from the skin and subcutaneous tissues: rash, itching, urticaria, Quincke's edema, erythema, maculopapular rash, bullous reactions (such as Stevens-Johnson syndrome and toxic epidermal necrolysis);
- from the blood and lymphatic system, hematological disorders (anemia, leukopenia, thrombocytopenia, granulocytopenia) are rare. As a rule, these phenomena are reversible in the event of discontinuation of therapy;
- from the liver and biliary tract: increased activity "hepatic" enzymes (aspartate aminotransferase (ACT), alanine aminotransferase (ALT), alkaline phosphatase), hepatitis (isolated cases). When cholestatic jaundice occurs, therapy should be discontinued.
The following side effects are usually reversible in the event of discontinuation of therapy:
- from the side of the organ of vision: transient visual disorders caused by changes in blood glucose concentration, especially at the beginning of therapy;
- side effects inherent in sulfonylurea derivatives, as against the background of taking other sulfonylurea derivatives, the following side effects were noted: erythrocytopenia, agranulocytosis, hemolytic anemia, pancytopenia, allergic vasculitis, hyponatremia. There was an increase in the activity of liver enzymes, a violation of liver function (for example, with the development of cholestasis and jaundice) and hepatitis, the manifestations decreased with time after the withdrawal of sulfonylureas, but in some cases led to life-threatening liver failure.
Side effects, noted during clinical trials
In the clinical study, there was a slight difference in the incidence of various serious adverse events between the two groups of patients. No new safety data was received. A small number of patients experienced severe hypoglycemia, but the overall incidence of hypoglycemia was low. The frequency of hypoglycemia in the group of intensive glycemic control was higher than in the group of standard glycemic control. Most episodes of hypoglycemia in the group of intensive glycemic control were noted against the background of concomitant insulin therapy.