Chlorpropamide Dosage
This dosage information may not include all the information needed to use Chlorpropamide safely and effectively. See additional information for Chlorpropamide.
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Usual Adult Dose for:
Usual Geriatric Dose for:
Additional dosage information:
Usual Adult Dose for Diabetes Mellitus Type II
Initial dose: 250 mg orally once a day with breakfast.
Maintenance dose: 100 to 500 mg orally in 1 or 2 divided doses. Five to seven days after the initial therapy, the blood level of chlorpropamide reaches a plateau. Dosage may subsequently be adjusted upward or downward by increments of not more than 50 to 125 mg at intervals of three to five days to obtain optimal control. More frequent adjustments are usually undesirable.
Usual Geriatric Dose for Diabetes Mellitus Type II
Initial dose: 100 to 125 mg orally once a day with breakfast.
Renal Dose Adjustments
CrCl < 25 mL/min: Use not recommended due to potential for accumulation and increased risk of severe, protracted hypoglycemia.
CrCl 25 to 80 mL/min: Initial dose: 100 to 125 mg orally once a day with breakfast.
Liver Dose Adjustments
Initial dose: 100 to 125 mg orally once a day with breakfast.
Dose Adjustments
Patients requiring more than 40 units of insulin daily may be initiated on chlorpropamide with a 50% reduction in insulin for the first few days, and with subsequent reductions dependent upon the response.
Precautions
Patients with impaired renal or hepatic function are at an increased risk of hypoglycemia and chlorpropamide should be used with extreme caution. During the initial period of therapy with chlorpropamide, hypoglycemic reactions may occasionally occur, particularly during the transition from insulin to the oral drug.
Dialysis
Hemoperfusion resulted in a decrease in chlorpropamide levels by 24% and 19% on two separate occasions, over 4 and 2 hours, respectively, using the Absorba 300C hemoperfusion column (Gambro).
Based on a limited study in a single pediatric patient, peritoneal dialysis did not reduce serum levels of chlorpropamide.
Other Comments
The maximum dose is 750 mg/day. In addition to the usual monitoring of urinary glucose, the patient's blood glucose must also be monitored periodically to determine the minimum effective dose for the patient, to detect primary failure, i.e., inadequate lowering of blood glucose at the maximum recommended dose of medication, and to detect secondary failure, i.e., loss of an adequate blood glucose lowering response after an initial period of effectiveness. Glycosylated hemoglobin levels may also be of value in monitoring the patient's response to therapy.
