Chlorpropamide


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Chlorpropamide
Chlorpropamide (Diabinese)
Chlorpropamide
(klor- PROH-pah-myd)
Pregnancy Category: C Apo-Chlorpropamide Diabinese Novo-Propamide (Rx)

Classification: Sulfonylurea, first-generation

See Also: See also Antidiabetic Agents: Hypoglycemic Agents and Insulins .

Action/Kinetics: May be effective in clients who do not respond well to other antidiabetic agents. Onset: 1 hr. t 1/2: 36 hr. Time to peak levels: 2-4 hr. Duration: 24-60 hr (due to slow excretion and active metabolites). Eighty percent metabolized in liver; 100% excreted in the urine.

Additional Uses Investigational: Neurogenic diabetes insipidus.

Special Concerns: Monitor frequently in those susceptible to fluid retention or impaired cardiac function.

Additional Side Effects: Side effects are frequent. Severe diarrhea, occasionally accompanied by bleeding in the lower bowel. Relieve severe GI distress by dividing total daily dose in half. In older clients, hypoglycemia may be severe. Inappropriate ADH secretion, leading to hyponatremia, water retention, low serum osmolality, and high urine osmolality.

Additional Drug Interactions: Ammonium chloride / Chlorpropamide effect due to kidney excretion Barbiturates / Prolonged action of barbiturates Disulfiram / More likely to interact with chlorpropamide than other oral antidiabetics Probenecid / Chlorpropamide effect Sodium bicarbonate / Chlorpropamide effect due to kidney excretion

How Supplied: Tablet: 100 mg, 250 mg

Dosage
?Tablets Diabetes.
Adults, middle-aged clients, mild to moderate diabetes, initial: 250 mg/day as a single or divided dose; geriatric, debilitated, or malnourished, impaired renal/hepatic function, initial: 100-125 mg/day. All clients, maintenance: 100-250 mg/day as single or divided doses. Severe diabetics may require 500 mg/day; doses greater than 750 mg/day are not recommended.
Note: Use the following guidelines when transferring Type 2 diabetics on insulin to chlorpropamide. If the insulin dose is 40 units or less, start with 250 mg/day of chlorpropamide; insulin may be abruptly discontinued. If the insulin dose is over 40 units, start with 250 mg/day of chlorpropamide and reduce insulin dose by 50%; further reduce as response is seen. Consider hospitalization during the transition.
Neurogenic diabetes insipidus.
Adults: 200-500 mg/day.

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