INDICATIONS     CONTRA-INDICATIONS     DOSAGE     SIDE-EFFECTS     PREGNANCY     OVERDOSE     IDENTIFICATION     PATIENT INFORMATION
DAONIL® Tablets

SCHEDULING STATUS:
S3

PROPRIETARY NAME:
(and dosage form)

DAONIL^® Tablets

COMPOSITION:
Each tablet contains 5 mg glibenclamide.

PHARMACOLOGICAL CLASSIFICATION:
A: 21.2 –Oral hypoglycaemics.

PHARMACOLOGICAL ACTION:
DAONIL^® is an oral sulphonylurea antidiabetic preparation with a hypoglycaemic effect.

INDICATIONS:
DAONIL^® is indicated as an adjunct to diet to lower the blood glucose level in patients with non-insulin dependent (Type 2) diabetes mellitus whose hyperglycaemia cannot be controlled by diet alone.

CONTRA-INDICATIONS:
Hypersensitivity to sulphonylureas;
Diabetes mellitus in patients with a history of metabolic decompensation e.g. acidosis, diabetic precoma and coma;
Diabetes mellitus complicated by fever, trauma or gangrene and in patients with impaired renal or hepatic function or serious impairment of thyroid or adrenal function;
Insulin-dependent diabetes mellitus;
Diabetes mellitus in young people;
Pregnancy and lactation. Women who plan to become pregnant should consult their doctor.
Hypersensitivity to glibenclamide.

WARNING:

The administration of oral hypoglycaemic drugs has been reported to be associated with increased cardiovascular mortality as compared to treatment with diet alone or diet plus insulin, although controversy exists concerning interpretation of these findings.

DOSAGE AND DIRECTIONS FOR USE:
The dosage of DAONIL^® used for treatment of new patients is determined by results of medical and laboratory examinations. In general the initial dose is half a tablet (= 2,5 mg DAONIL^® ) daily. The daily dose can then be raised gradually in steps of half a tablet, but only after repeating medical examination. Raising the dose beyond 15 mg daily does not usually produce any increased response.
When changing over from another oral antidiabetic preparation, with a similar mode of action, the dosage of DAONIL^® is determined by the amount of the previously administered dose and the medical examination. It may be considered that the effect of 1 g tolbutamide or glycodiazine, 0,5 g carbutamide or 250 mg chlorpropamide corresponds roughly to that of 5 mg DAONIL^® (1 tablet).
In combination therapy with a biguanide, there may be a greater risk of cardiovascular mortality than with the use of glibenclamide alone.

SIDE-EFFECTS AND SPECIAL PRECAUTIONS:
Side-effects include skin rashes, photosensitivity, diarrhoea, nausea, vomiting, epigastric pain, feeling of gastric fullness, dizziness, headache, weakness, fever, hypoglycaemic reactions and paraesthesia. Eosinophilia, cholestasis, hepatitis, jaundice, blood disorders including leucopenia, thrombocytopenia, aplastic anaemia, pancytopenia, haemolytic anaemia and agranulocytosis may occur. The incidence of hypoglycaemia can be reduced if DAONIL^® is taken with or immediately after a meal.
Transient visual disturbances may occur at the commencement of treatment.
Intolerance to alcohol may occur.
Adjustment of dosage of DAONIL^® may be required in patients suffering from recurrent infections, trauma, shock or after anaesthesia. When major surgery is to be performed, DAONIL^® should be substituted with insulin therapy.
Interactions:
The hypoglycaemic effects may be enhanced by: chloramphenicol, clofibrate, halofenate, cyclophosphamide, dicoumarol, monoamine oxidase inhibitors, salicylates, phenylbutazone, propranolol and other beta-adrenergic blocking agents, sulphonamides, anabolic steroids, bezafibrate, biguanides, fenfluramine, fenyramidol, miconazole, parenteral pentoxifylline in high doses, phosphamides, ACE-inhibitors, fluoxetine, guanethidine, probenecid, reserpine, sulphinpyrazone, tritoqualine and tetracyclines.
The hypoglycaemic effect may be diminished by adrenaline, oestrogens, corticosteroids or diuretics, abuse of laxatives, high doses of nicotinates, phenothiazines, acetazolamide, clonidine, diazoxide, glucagon, phenytoin, saluretics, sympathomimetics and thyroid hormones. Propranolol may inhibit normal physiological response to hypoglycaemia and mask the symptoms of hypoglycaemia.
Under treatment with beta-blockers as also with clonidine, guanethidine or reserpine, the perception of the warning symptoms of a hypoglycaemic attack may be impaired. In rare instances, undesired potentiation or attenuation of the blood-sugar-lowering effect of DAONIL^® have been observed during concomitant medication with H2-receptor antagonists.
Alcohol:
If the drug is taken at the same time as alcohol, there may be either a potentiation or an attenuation of the hypoglycaemic effect.
Special Precautions:
The treatment of diabetes with DAONIL^® requires regular follow-up checks. Until optimal control has been achieved, or when changing from one antidiabetic preparation to another, or if the tablets have not been taken regularly, alertness and reaction time may be altered to such an extent that the patient cannot safely cope with road traffic or operate machinery.
Strict adherence to the diet and regularity in taking the tablets are essential to maintain physical efficiency and to prevent the blood sugar from rising too high (hyperglycaemia) or falling too low (hypoglycaemia).
The signs of such undesirable changes in the blood sugar level are:
Hyperglycaemia:
Severe thirst, dryness of mouth, frequent micturition, dry skin.
Hypoglycaemia:
Intense hunger, sweating, tremor, restlessness, irritability, depression of mood, headaches and disturbed sleep.
Artificial sweeteners are of no use for this purpose.
Any hypoglycaemic reactions should be reported as soon as possible to the doctor, who will then check whether the dose of DAONIL^® requires correction. If simple measures fail to relieve a hypoglycaemic attack promptly, a doctor should be called immediately.
Should other illnesses arise during the treatment with DAONIL^®, the doctor in charge should be consulted without delay.

KNOWN SYMPTOMS OF OVERDOSAGE AND PARTICULARS OF ITS TREATMENT:
Hypoglycaemic symptoms, e.g. excessive perspiration, light-headedness, etc., can be treated by giving the patient glucose orally or intravenously. Further treatment is symptomatic and supportive.

IDENTIFICATION:
Almost white, biplane, oblong tablets, 10 mm by 5 mm in dimension. Each side with a scoreline and engraved the letters LDL on one side of the scoreline and company logo on the other side.

PRESENTATION:
30', 100' and 500' in securitainers.

STORAGE INSTRUCTIONS:
Store below 25°C.
KEEP OUT OF REACH OF CHILDREN.

REFERENCE NUMBER:
G3036 (Act 101/1965)

NAME AND BUSINESS ADDRESS OF THE APPLICANT:
Aventis Pharma (Pty) Ltd
2 Bond Street, Midrand, 1685

DATE OF PUBLICATION OF THIS PACKAGE INSERT:
9 January 1989

Aventis Pharma (Pty) Ltd
2 Bond Street
Midrand
1685
        DL2-A0001
Updated on this site: June 2003
Source: Community Pharmacy
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