What is the recommended dose of Diamicron MR (Gliclazide)

Recommended Dosage of Diamicron MR (Gliclazide)

The recommended dosage of Diamicron MR (gliclazide modified release) is 30-120 mg once daily, taken with breakfast in the morning.

Initial Dosing and Titration

• Initial dose is 30 mg once daily, taken with the first meal of the day 1, 2
• Dose can be increased after 4 weeks of therapy based on clinical response, up to a maximum of 120 mg once daily 1
• The once-daily dosing regimen improves patient compliance compared to twice-daily regimens (93.5% vs 87.2% compliance) 3

Advantages of Diamicron MR Formulation

• The hydrophilic matrix allows progressive release of the drug that better parallels the 24-hour glycemic profile in patients with type 2 diabetes 2
• Once-daily dosing has been shown to be as effective as the standard gliclazide formulation taken twice daily 1
• Morning administration contributes to improved patient compliance 4
• The formulation shows high bioavailability and its absorption profile is unaffected by food intake 2

Efficacy and Safety

• Diamicron MR 30-120 mg once daily is as effective as standard gliclazide 80-320 mg/day (in divided doses) in controlling blood glucose levels 1
• The incidence of hypoglycemia is particularly low (0.2 hypoglycemic events per 100 patient-months), especially in elderly patients 1
• No episodes of nocturnal hypoglycemia or hypoglycemia requiring third-party assistance were observed in clinical trials 2
• The modified-release formulation has demonstrated better glycemic control (both fasting plasma glucose and HbA1c) compared to twice-daily glibenclamide 3

Special Populations

• Diamicron MR is effective in elderly patients, with HbA1c reductions similar to those observed in the general population 2
• For patients fasting during Ramadan, newer sulfonylureas like gliclazide MR have been shown to be effective with a lower risk of hypoglycemia compared to older sulfonylureas 5

Clinical Considerations

• Diamicron MR can be used alone or in combination with metformin, glitazones, acarbose, or insulin 4
• The once-daily dosing regimen provides better therapeutic coverage throughout the day compared to twice-daily regimens 3
• Body weight typically remains stable during treatment with Diamicron MR 2
• Common adverse events include arthralgia, arthritis, back pain, and bronchitis (each <5%) 2

Caution

• Like all sulfonylureas, gliclazide should be used with caution during periods of fasting due to the risk of hypoglycemia, though this risk is lower with newer agents like gliclazide MR 5
• Sulfonylureas should be individualized and utilized with caution during fasting periods such as Ramadan 5