Diabinese Side Effects

Generic Name: chlorpropamide

Please note - some side effects for Diabinese may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA at http://www.fda.gov/medwatch/ or 1-800-FDA-1088 (1-800-332-1088).

Side Effects of Diabinese - for the Consumer

Diabinese

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome when using Diabinese:

Dizziness; headache; nausea.

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); confusion; dark urine; fainting; fever, chills, or persistent sore throat; irregular heartbeat; low blood sugar symptoms (eg, anxiety, drowsiness, fast heartbeat, lightheadedness, severe or persistent dizziness or headache, tremors, unusual sweating, weakness); severe or persistent blurred vision or other vision problems; unusual bruising or bleeding; unusual tiredness or weakness; yellowing of the eyes or skin.

Diabinese Side Effects - for the Professional

Diabinese

Body as a Whole

Disulfiram-like reactions have rarely been reported with Diabinese.

Central and Peripheral Nervous System

Dizziness and headache.

Hypoglycemia

See PRECAUTIONS and OVERDOSAGE sections.

Gastrointestinal

Gastrointestinal disturbances are the most common reactions; nausea has been reported in less than 5% of patients, and diarrhea, vomiting, anorexia, and hunger in less than 2%. Other gastrointestinal disturbances have occurred in less than 1% of patients including proctocolitis. They tend to be dose-related and may disappear when dosage is reduced.

Liver/Biliary

Cholestatic jaundice may occur rarely; Diabinese should be discontinued if this occurs. Hepatic porphyria and disulfiram-like reactions have been reported with Diabinese.

Skin/Appendages

Pruritus has been reported in less than 3% of patients. Other allergic skin reactions, e.g., urticaria and maculopapular eruptions have been reported in approximately 1% or less of patients. These may be transient and may disappear despite continued use of Diabinese; if skin reactions persist the drug should be discontinued.

As with other sulfonylureas, porphyria cutanea tarda and photosensitivity reactions have been reported.

Skin eruptions rarely progressing to erythema multiforme and exfoliative dermatitis have also been reported.

Hematologic Reactions

Leukopenia, agranulocytosis, thrombocytopenia, hemolytic anemia, aplastic anemia, pancytopenia, and eosinophilia have been reported with sulfonylureas.

Metabolic/Nutritional Reactions

Hypoglycemia. Hepatic porphyria and disulfiram-like reactions have been reported with Diabinese. See DRUG INTERACTIONS section.

Endocrine Reactions

On rare occasions, chlorpropamide has caused a reaction identical to the syndrome of inappropriate antidiuretic hormone (ADH) secretion. The features of this syndrome result from excessive water retention and include hyponatremia, low serum osmolality, and high urine osmolality. This reaction has also been reported for other sulfonylureas.

Side Effects by Body System

Metabolic

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

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

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

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

Hepatic

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

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.

Hematologic

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

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

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.

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date, and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This information does not endorse drugs, diagnose patients, or recommend therapy. This drug information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug of drug combination is safe, effective, or appropriate for any given patient. Drugs.com does not assume any responsibility for any aspect of healthcare administered with the aid of information provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse, or pharmacist.