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Diabinese Side Effects

Generic Name: chlorpropamide

Note: This page contains information about the side effects of chlorpropamide. Some of the dosage forms included on this document may not apply to the brand name Diabinese.

For the Consumer

Applies to chlorpropamide: oral tablet

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

Severity: Major

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

Severity: Minor

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 (the active ingredient contained in Diabinese) s pharmacologic effects. Hypoglycemia may be severe and protracted. In addition, hyponatremia, hepatic porphyria, and disulfiram-like reactions are reported.[Ref]

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 .[Ref]


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.[Ref]

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


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.[Ref]

Hypersensitivity reactions usually respond to steroid therapy and drug withdrawal.[Ref]


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


In patients with liver disease, frequent monitoring of liver function tests is recommended during chlorpropamide (the active ingredient contained in Diabinese) administration.[Ref]

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.[Ref]


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

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.[Ref]


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 (the active ingredient contained in Diabinese) has induced a photohemolysis in vitro, through a photodynamic mechanism mediated with oxygen.[Ref]


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 (the active ingredient contained in Diabinese) administration.[Ref]

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


Cardiovascular side effects have included elevations in systolic blood pressure.[Ref]

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.[Ref]


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2. Marcondes M, Genta EN "Antidiuretic action of chlorpropamide in diabetes insipidus patients and in normal subjects." Am J Med Sci 273 (1977): 185-93

3. Earley LE "Chlorpropamide antidiuresis." N Engl J Med 284 (1971): 103-4

4. Wolfsthal SD, Wiser TH "Chlorpropamide and an antabuse-like reaction." Ann Intern Med 103 (1985): 158

5. Balant L "Clinical pharmacokinetics of sulphonylurea hypoglycaemic drugs." Clin Pharmacokinet 6 (1981): 215-41

6. Jerntorp P, Almer LO "Chlorpropamide-alcohol flushing in relation to macroangiopathy and peripheral neuropathy in non-insulin dependent diabetes." Acta Med Scand 656 (1981): 33-6

7. Weissman PN, Shenkman L, Gregerman RI "Chlorpropamide hyponatremia: drug-induced inappropriate antidiuretic-hormone activity." N Engl J Med 284 (1977): 65-74

8. Jackson JE, Bressler R "Use oral hypoglycemics with caution." Geriatrics 43 (1988): 77-83

9. Tanay A, Firemann Z, Yust I, Abramov AL "Chlorpropamide-induced syndrome of inappropriate antidiuretic hormone secretion." J Am Geriatr Soc 29 (1981): 334-6

10. Klonoff DC "Association of hyperinsulinemia with chlorpropamide toxicity." Am J Med 84 (1988): 33-8

11. "Product Information. Diabinese (chlorpropamide)." Pfizer US Pharmaceuticals, New York, NY.

12. Kadowaki T, Hagura R, Kajinuma H, et al "Chlorpropamide-induced hyponatremia: incidence and risk factors." Diabetes Care 6 (1983): 468-71

13. Baciewicz Am, Dattilo R, Willis SE, Kershaw JL "Jaundice and rash associated with chlorpropamide." Diabetes Care 8 (1985): 200-1

14. Franz CB, Massullo RE, Welton WA "Lichenoid drug eruption from chlorpropamide and tolazamide." J Am Acad Dermatol 22 (1990): 128-9

15. Kanefsky TM, Medoff SJ "Stevens-Johnson syndrome and neutropenia with chlorpropamide therapy." Arch Intern Med 140 (1980): 15433

16. Parker MA "Possible pulmonary reaction to chlorpropamide." N Engl J Med 296 (1977): 945-6

17. Appel GB, D'Agati V, Bergman M, Pirani CL "Nephrotic syndrome and immune complex glomerulonephritis associated with chlorpropamide therapy." Am J Med 74 (1983): 337-42

18. Schneider HL, Hornbach KD, Kniaz JL, Efrusy ME "Chlorpropamide hepatotoxicity: report of a case and review of the literature." Am J Gastroenterol 79 (1984): 721-4

19. Ahmad S, Thagirisa A "Pulmonary infiltration eosinophilia with chlorpropamide therapy." South Med J 77 (1984): 1615

20. Geubel AP, Nakad A, Rahier J, Dive C "Prolonged cholestasis and disappearance of interlobular bile ducts following chlorpropamide and erythromycin ethylsuccinate: case of drug interaction?" Liver 7 (1988): 350-3

21. Gupta R, Sachar DB "Chlorpropamide-induced cholestatic jaundice and pseudomembranous colitis." Am J Gastroenterol 80 (1985): 381-3

22. Gill MJ, Ratliff DA, Harding LK "Hypoglycemic coma, jaundice and pure RBC aplasia following chlorpropamide therapy." Arch Intern Med 140 (1980): 714-5

23. Levitt LJ "Chlorpropamide-induced pure white cell aplasia." Blood 69 (1987): 394-400

24. Logue GL, Boyd AE, Rosse WF "Chlorpropamide-induced hemolytic anemia." N Engl J Med 283 (1970): 900-4

25. Saffouri B, Cho JH, Felber N "Chlorpropamide-induced haemolytic anaemia." Postgrad Med J 57 (1981): 44-5

26. Vargas F, Matskevitch V, Sarabia Z "Photodegradation and in vitro phototoxicity of the antidiabetic drug chlorpropamide." Arzneimittelforschung 45-2 (1995): 1079-81

27. Or R, Merin E, Stupp Y, Matzner Y "Chlorpropamide-induced hemolytic anemia." Drug Intell Clin Pharm 18 (1984): 981-2

28. Kopicky JA, Packman CH "The mechanisms of sulfonylurea-induced immune hemolysis." Am J Hematol 23 (1986): 283-8

29. Cunliffe DJ, Gorst DW, Palmer HM "Chlorpropamide-induced thrombocytopenia." Postgrad Med J 53 (1977): 87-8

30. Sosler SD, Behzad O, Garratty G, et al "Acute hemolytic anemia associated with a chlorpropamide-induced apparent auto-anti-Jk." Transfusion 24 (1984): 206-9

31. Wymore J, Carter JE "Chlorpropamide-induced optic neuropahty." Arch Intern Med 142 (1982): 381

32. Schmitt JK, Moore JR "Hypertension secondary to chlorpropamide with amelioration by changing to insulin." Am J Hypertens 6 (1993): 317-9

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

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 material does not endorse drugs, diagnose patients, or recommend therapy. This 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 combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. does not assume any responsibility for any aspect of healthcare administered with the aid of materials 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 substances you are taking, check with your doctor, nurse, or pharmacist.