Chlorpropamide Side Effects

Not all side effects for chlorpropamide may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

For the Consumer

Applies to chlorpropamide: oral tablet

In addition to its needed effects, some unwanted effects may be caused by chlorpropamide. In the event that any of these side effects do occur, they may require medical attention.

You should check with your doctor immediately if any of these side effects occur when taking chlorpropamide:

  • Abdominal or stomach pain
  • agitation
  • black, tarry stools
  • chills
  • clay-colored stools
  • coma
  • confusion
  • continuing diarrhea
  • continuing stomach pain
  • convulsions
  • dark urine
  • decreased urine output
  • depression
  • diarrhea
  • dizziness
  • fast or irregular heartbeat
  • fever
  • headache
  • hostility
  • increased thirst
  • irritability
  • itching
  • lethargy
  • loss of appetite
  • muscle pain or cramps
  • muscle twitching
  • nausea or vomiting
  • rapid weight gain
  • rash
  • seizures
  • shortness of breath
  • stupor
  • swelling of the face, ankles, or hands
  • unpleasant breath odor
  • unusual tiredness or weakness
  • vomiting of blood
  • yellow eyes or skin
Incidence not known
  • Anxiety
  • back, leg, or stomach pains
  • bleeding gums
  • blood in the urine or stools
  • blurred vision
  • chest pain
  • cold sweats
  • cool, pale skin
  • cough or hoarseness
  • depression
  • difficulty with breathing
  • fever with or without chills
  • fluid-filled skin blisters
  • general body swelling
  • general feeling of tiredness or weakness
  • headache
  • high fever
  • increased hunger
  • lower back or side pain
  • nervousness
  • nightmares
  • nosebleeds
  • painful or difficult urination
  • pinpoint red spots on the skin
  • sensitivity to the sun
  • shakiness
  • skin thinness
  • slurred speech
  • sore throat
  • sores, ulcers, or white spots on the lips or in the mouth
  • swollen or painful glands
  • tightness in the chest
  • unusual bleeding or bruising
  • wheezing

Some of the side effects that can occur with chlorpropamide may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

More common
  • Indigestion
  • passing of gas
Less common
  • Hives or welts
  • redness of the skin
  • weight loss
  • Blistering, peeling, or loosening of the skin
  • cracks in the skin
  • loss of heat from the body
  • red, irritated eyes
  • red, swollen skin
  • scaly skin
Incidence not known
  • Increased sensitivity of the skin to sunlight
  • redness or other discoloration of the skin
  • severe sunburn

For Healthcare Professionals

Applies to chlorpropamide: oral tablet


Metabolic side effects have included hypoglycemia, an extension of chlorpropamide's pharmacologic effects. Hypoglycemia may be severe and protracted. In addition, hyponatremia, hepatic porphyria, and disulfiram-like reactions are reported.

Hypoglycemia, an extension of chlorpropamide's pharmacologic effects, may be severe, protracted, refractory to glucose infusion, and, in some cases, may require diazoxide. Hypoglycemia may present as coma or disturbed consciousness. Other signs of hypoglycemia include tachycardia, tremor, and increased sweating.

Patients with renal dysfunction, liver disease, adrenal or pituitary insufficiency, or congestive heart failure may be at increased risk for hypoglycemia, as are those who are elderly, debilitated, or malnourished. In addition, acute illness, lack of adherence to diet, ethanol ingestion, or strenuous exercise may precipitate hypoglycemia.

A syndrome similar to the Syndrome of Inappropriate Antidiuretic Hormone (SIADH), with hyponatremia, low serum osmolality, and high urine osmolality, is reported with chlorpropamide (1% to 4%). This syndrome appears to be more common in the elderly, in women, in patients with an underlying edematous disorder, and in patients receiving 500 mg or more of chlorpropamide per day.

Patients with renal dysfunction may be at increased risk for hypoglycemia as chlorpropamide elimination, as well as gluconeogenesis and glycogenolysis, may be impaired.

Elderly patients with renal dysfunction and liver disease may be at increased risk for hypoglycemia as such patients are particularly sensitive to the hypoglycemic effects of the oral sulfonylureas and chlorpropamide metabolism and elimination, as well as hepatic gluconeogenesis and glycogenolysis, may be impaired .


Dermatologic side effects have included pruritus (3%), photosensitivity, porphyria cutanea tarda, and rare cases of Stevens-Johnson syndrome. Skin eruptions rarely progressing to erythema multiforme and exfoliative dermatitis have also been reported.

Facial skin flushing has been reported in 10% to 15% of patients, and may have been dose-related. Alcohol appeared to potentiate this effect.


Hypersensitivity side effects have included rash and eosinophilia which may have been associated with hepatitis, glomerulonephritis, interstitial nephritis, and hemolytic anemia. In addition, there are rare case reports suggestive of a chlorpropamide-induced eosinophilic pneumonia.

Hypersensitivity reactions usually respond to steroid therapy and drug withdrawal.


Gastrointestinal side effects have included nausea, vomiting, diarrhea, and anorexia.


In patients with liver disease, frequent monitoring of liver function tests is recommended during chlorpropamide administration.

Hepatic side effects have included hepatitis which presented as cholestatic jaundice (0.5%), fever, and pruritus, and was thought to be due to hypersensitivity to chlorpropamide. This typically presents within 2 to 5 weeks after initiating chlorpropamide therapy.


Renal side effects have been rare, and have included case reports of proteinuria, mild renal insufficiency, hypersensitivity glomerulonephritis, and interstitial nephritis.

The case reports of glomerulonephritis and interstitial nephritis are associated with other stigmata of hypersensitivity to chlorpropamide, such as rash, eosinophilia, and fever.

In patients with renal insufficiency, frequent monitoring of the kidney function is recommended during chlorpropamide administration.


Hematological side effects have included leukopenia, thrombocytopenia, and anemia. Pure white cell and pure red cell aplasias, hemolytic anemia, and isolated thrombocytopenia have also been reported and were thought to be due to an immune complex-mediated process. Chlorpropamide has induced a photohemolysis in vitro, through a photodynamic mechanism mediated with oxygen.


Ocular side effects have been rare and have included a case report in which optic neuropathy and loss of vision were definitely associated with chlorpropamide administration.

Although extremely rare, optic neuropathy should be considered in diabetic patients on chlorpropamide therapy who complain of vision disturbances.


Cardiovascular side effects have included elevations in systolic blood pressure.

A retrospective analysis of 22 type II diabetic patients switched from insulin to chlorpropamide revealed a significant increase in systolic blood pressures after initiation of chlorpropamide therapy. Diastolic pressures were not significantly affected. Chlorpropamide-induced hypertension occurred more frequently in black patients, although the study population was too small to adequately evaluate this effect.

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