Gliclazide modified release (MR) belongs to the class of medications called oral hypoglycemics. It is used for the control of blood glucose in people with type 2 diabetes. It is used when diet, exercise, and weight reduction have not been found to control blood glucose well enough without medication. Gliclazide MR increases the amount of insulin released by the pancreas and helps the body use insulin more efficiently.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

The recommended starting dose of gliclazide MR is 30 mg taken once daily at the same time every day. Your doctor will gradually increase the dose every 2 weeks to a maximum of 120 mg daily, depending on the reduction of your blood glucose. You should take the medication at breakfast time. Do not chew or crush the tablets. The 60 mg tablets can be split in half. The 30 mg tablets cannot be split in half and should be swallowed whole.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, skip the missed dose and take your usual dose at the regular time the next day. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

30 mg
Each white-to-off-white, oblong, biconvex tablet debossed with "M" on one side and "GL30" on the other contains 30 mg of gliclazide. Nonmedicinal ingredients: hypromellose, magnesium stearate, and microcrystalline cellulose.

60 mg
Each white-to-off-white, oblong, biconvex tablet debossed with "M" on one side, and "GL" on the left side of the score line and "60" on the right side of the score line on the other side, contains 60 mg of gliclazide. Nonmedicinal ingredients: hypromellose, magnesium stearate, and microcrystalline cellulose.

• are allergic to gliclazide or any ingredients of the medication
• are allergic to other sulfonylureas (such as glyburide) or sulfonamides (such as sulfamethoxazole)
• are pregnant or breast-feeding
• are taking some forms of miconazole (ask your doctor or pharmacist for details)
• are experiencing physical stress such as serious infection, injury, or surgery
• have severe kidney or liver disease
• have type 1 diabetes
• have unstable diabetes or ketoacidosis (a high amount of ketones in your urine)

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• abdominal pain
• back, muscle, or joint pain
• constipation
• diarrhea
• dizziness
• flu-like symptoms (e.g., cough, sore throat, runny nose)
• headache
• itchiness
• nausea
• pink eye (inflammation or redness of the white part of the eye)
• sinus, nose, and throat infections

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• high blood pressure
• signs of anemia (low red blood cells; e.g., dizziness, pale skin, unusual tiredness or weakness, shortness of breath)
• signs of clotting problems (e.g., unusual nosebleeds, bruising, blood in urine, coughing blood, bleeding gums, cuts that don't stop bleeding)
• signs of depression (e.g., poor concentration, changes in weight, changes in sleep, decreased interest in activities, thoughts of suicide)
• signs of liver problems (e.g., nausea, vomiting, diarrhea, loss of appetite, weight loss, yellowing of the skin or whites of the eyes, dark urine, pale stools)
• skin rash or hives
• swelling of the legs or unexpected weight gain
• symptoms of low blood sugar (e.g., cold sweat, cool pale skin, headache, fast heartbeat, weakness, shakiness, feeling drunk, headache, slurred speech)
• symptoms of high blood sugar (e.g., frequent urination, increased thirst, excessive eating, unexplained weight loss, poor wound healing, infections, fruity breath odour)
• symptoms of low sodium levels in the blood (e.g., achy, stiff or uncoordinated muscles, confusion, tiredness, weakness)
• symptoms of a urinary tract infection (e.g., pain when urinating, urinating more often than usual, low back or flank pain)
• unusual or more frequent infections (symptoms may include fever or chills, severe diarrhea, shortness of breath, prolonged dizziness, headache, stiff neck, weight loss, or listlessness)

Stop taking the medication and seek immediate medical attention if any of the following occur:

• chest pain or pressure and/or shortness of breath
• signs of a serious allergic reaction (e.g., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)
• signs of a severe skin reaction such as blistering, peeling, a rash covering a large area of the body, a rash that spreads quickly, or a rash combined with fever or discomfort
• unconsciousness

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Before you begin taking a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should take this medication.

Alcohol use: Gliclazide MR can cause an unpleasant "intolerance reaction" to alcohol. People taking gliclazide MR may experience flushing, warmth, nausea, giddiness, and possibly increased heart rate when they use alcohol. To prevent this reaction, avoid drinking alcohol.

Diabetes complications: Similar to other medications for diabetes, the use of gliclazide MR will not prevent the development of diabetes complications.

Drowsiness/reduced alertness: Gliclazide may cause drowsiness or dizziness, affecting your ability to drive or operate machinery. Avoid driving, operating machinery, or performing other potentially hazardous tasks until you have determined how you are affected by this medication.

Glucose-6-phosphate dehydrogenase (G6PD) deficiency: If you have G6PD-deficiency, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Hypersensitivity Reaction: Severe allergic reactions have been reported by people taking gliclazide. In rare cases, Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS syndrome) may occur. This reaction involves symptoms including fever, swollen glands, yellowing of the skin or eyes, flu-like symptoms with skin rash or blistering, or other organ involvement. These reactions are medical emergencies. Get immediate medical attention if you have symptoms of a severe allergic reaction. If you experience any unusual symptoms, contact your doctor.

Hypoglycemia (low blood sugar): Gliclazide MR, like other sulfonylurea drugs, can cause symptoms of hypoglycemia (low blood sugar) including dizziness, lack of energy, drowsiness, headache, and sweating. Weakness, nervousness, shakiness, and numbness or tingling have also been reported. Seniors, those with reduced liver or kidney function, and those who are fragile or malnourished are more likely to have low blood sugar when they take these medications. Low blood sugar is more likely to occur when food intake is inadequate or after strenuous or prolonged physical exercise. Blood glucose should be monitored regularly and emergency glucose (and glucagon kit) kept available in case the need arises to increase blood sugar levels.

Illness/stress: People on gliclazide MR therapy may experience loss of blood sugar control during illness or stressful situations, such as trauma or surgery. Under these conditions, the doctor may consider stopping the medication and prescribing insulin until the situation improves.

Kidney function: Kidney disease or reduced kidney function may cause this medication to build up in the body, causing side effects. If you have reduced kidney function or kidney disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Liver function: Liver disease or reduced liver function may cause this medication to build up in the body, causing side effects. If you have liver problems, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Your doctor may want to test your liver function regularly with blood tests while you are taking this medication.

If you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin, contact your doctor immediately.

Porphyria: Gliclazide may cause attacks of a condition called acute porphyria (a disorder that affects the production of heme in the body). If you have a history of porphyria, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Proper diet: The use of gliclazide MR must be considered as treatment in addition to proper diet and not as a substitute for diet.

Worsening of condition: Over a period of time, gliclazide MR may become less effective because of the worsening of diabetes. If gliclazide MR no longer controls blood glucose to target levels, it should be stopped and another medication added.

Pregnancy: This medication should not be used during pregnancy as it may cause harm to the developing baby. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: It is not known if gliclazide MR passes into breast milk. If you are breast-feeding and taking this medication, it may affect your baby. Breast-feeding women should not take gliclazide MR.

Children: The safety and effectiveness of using this medication have not been established for children.

Seniors: Seniors may be more likely to experience side effects with this medication.

There may be an interaction between gliclazide MR and any of the following:

• acetylsalicylic acid (ASA)
• alcohol
• American ginseng
• amiodarone
• anticoagulants (e.g., warfarin, heparin)
• anti-psychotics (e.g., aripiprazole, cariprazine, chlorpromazine, clozapine, haloperidol, olanzapine, quetiapine, risperidone)
• "azole" antifungals (e.g., fluconazole, voriconazole)
• beta-blockers (e.g., atenolol, metoprolol, propranolol, sotalol)
• bezafibrate
• bismuth subsalicylate
• bortezomib
• bromocriptine
• buserelin
• cimetidine
• clarithromycin
• oral corticosteroids (e.g., dexamethasone, hydrocortisone, prednisone)
• danazol
• other diabetes medications (e.g., acarbose, glyburide, insulin, linagliptin, lixisenatide, metformin, rosiglitazone, sitagliptin)
• diazoxide
• disopyramide
• diuretics (water pills; e.g., furosemide, hydrochlorothiazide)
• dolutegravir
• elagolix
• enfortumab
• enzalutamide
• epinephrine
• everolimus
• fenofibric acid
• flaxseed oil
• estrogens (e.g., conjugated estrogen, estradiol, ethinyl estradiol)
• enzalutamide
• glucagon
• garlic
• gemfibrozil
• ginger
• goserelin
• hepatitis C antivirals (e.g., elbasvir and grazoprevir, glecaprevir and pibrentasvir, ledipasvir, velpatasvir, voxilaprevir)
• HIV protease inhibitors (e.g., atazanavir, darunavir, lopinavir, ritonavir)
• hydroxychloroquine
• inhaled corticosteroids (e.g., budesonide, ciclesonide, fluticasone)
• leuprolide
• linezolid
• lumacaftor and ivacaftor
• megestrol
• methotrimeprazine
• miconazole
• mifepristone
• monoamine oxidase inhibitors (MAOIs; e.g., moclobemide, phenelzine, rasagiline, selegiline, tranylcypromine)
• omeprazole
• oral contraceptives (birth control pills)
• probenecid
• certain protein kinase inhibitors (e.g., bortezomib, brigatinib, ceritinib, dabrafenib, nilotinib, sunitinib)
• quinine
• quinolone antibiotics (e.g., ciprofloxacin, levofloxacin, norfloxacin)
• rifampin
• St. John's wort
• selective serotonin reuptake inhibitors (SSRIs; e.g., citalopram, fluoxetine, paroxetine, sertraline, vortioxetine)
• sirolimus
• somatostatin analogues (e.g., lanreotide, octreotide, pasireotide)
• somatrogon
• somatropin
• sulfamethoxazole
• tacrolimus
• temsirolimus
• terbutaline
• testosterone
• tetracyclines (e.g., doxycycline, minocycline, tetracycline)
• tramadol
• vilazodone
• vorinostat
• warfarin

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.