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chlorpropamide (Rx)Brand and Other Names:Diabinese

 
 
 

Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

tablet

  • 100mg
  • 250mg
more...

Dosage should be individualized based upon patient's response

Type 2 Diabetes

Administer 30 minutes before meal to improve absorption

Middle-aged stable diabetic

  • 250 mg/day PO initially; may increase or decrease PRN by 50-125 mg/day at 3- to 5-day intervals

Older patients

  • 100-125 mg/day PO initially; may increase or decrease PRN by 50-125 mg/day at 3- to 5-day intervals

Maintenance dose

  • 100-250 mg/day; a higher dose of 500 mg/day may be required  in severe diabetes; should avoid doses >750 mg/day

Renal Impairment

CrCl <50 mL/minute: Avoid use

CrCl >50 mL/minute: Monitor therapy closely; initial and maintenance dosing should be conservative to avoid hypoglycemia

Hepatic Impairment

Use lower initial and maintenance dose in liver impairment; chlorpropamide undergoes extensive hepatic metabolism

Other Indications & Uses

Off-label: Neurogenic diabetes insipidus

Safety and efficacy not established

Not drug of choice in elderly; increased risk of hypoglycemia and drug interactions because of long half-life

Type 2 Diabetes

100-125 mg PO qDay initially; may increase or decrease PRN by 50-125 mg/day at 3-5 day intervals

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Interactions

Interaction Checker

chlorpropamide and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            Frequency Not Defined

            Dermatologic reactions

            Hypoglycemia

            Dizziness

            Headache

            Hepatic porphyria

            Liver failure

            Anorexia

            Agranulocytosis

            Aplastic anemia

            Nausea

            Disulfiram-like reactions

            Vomiting

            Blood dyscrasias

            Associated with greater number of side effects in the geriatric and renally impaired; should not be used as first line agent in these populations

            Cholestatic jaundice and hepatitis may occur rarely which may progress to liver failure

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            Warnings

            Contraindications

            Type I diabetes

            Diabetes ketoacidosis

            Hypersensitivity, sulfa allergy

            Severe renal impairment

            Cautions

            Half life prolonged in renal failure

            Efficacy may decrease with prolonged use

            Patients with risk of severe hypoglycemia, especiall elderly, debilitated, or malnourished patients, patients with risk factors for cardiovascular events, severe liver impairment

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            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: Excretion in milk unknown/not recommended

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Mechanism of Action

            Initial effect to increase beta-cell insulin secretion; may also decrease rate of hepatic glucose production, increases insulin receptor sensitivity, and increases number of insulin receptors

            Pharmacokinetics

            Half-Life: 25-48 hr

            Duration: 24 hr

            Initial effect: Diabetes mellitus: 1 hr; Diabetes insipidus: 1 d

            Maximum effect: Diabetes mellitus: 3-6 hr; Diabetes insipidus: 4-5 d

            Protein Bound: 60-90%

            Vd: 0.13-0.23 L/kg

            Metabolism: Moderately to extensively metabolized in the liver

            Metabolites: Hydroxychlorpropamide, chlorobenzene-sulfonylurea (inactive)

            Excretion: Mainly in urine (80-90%)

            Dialyzable: PD: no, HD: no

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            Formulary

            FormularyPatient Discounts

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            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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