Daonil

Generic Name: Glibenclamide
Product Name: Daonil

Indication

Daonil is used to control blood glucose levels in patients with type 2 diabetes mellitus. It is used in conjunction with diet control and exercise to control blood sugar. Daonil can be used alone, or in combination with insulin or other anti-diabetic drugs.

Action

Daonil belongs to a group of medicines called sulphonylureas. It lowers high blood glucose by increasing the amount of insulin released by your pancreas.

Dose advice

Dose information

1. Daonil should be taken with food once daily;
2. Initial dose of Daonil is 2.5 mg daily. It is then increased by 2.5 mg weekly to a maximum of 20 mg per day, depending on the response;
3. Do not skip meals whilst using Daonil. Take your dose at the same times each day;
4. Continue taking Daonil for as long as your doctor recommends. It is important to make sure that you have enough Daonil to last over weekends and holidays;
5. Daonil may increase your skin sensitivity to sunlight. Exposure to sunlight may cause a skin rash, itching, redness or severe sunburn. If outdoors, you must wear protective clothing and use a highly effective sunscreen;
6. If you have to be alert, for example when driving, be especially careful not to let your blood glucose levels fall too low as low blood glucose levels may slow your reaction time and affect your ability to drive or operate machinery. Drinking alcohol can make this worse;
7. While you are using Daonil, you must ensure all your friends, family and work colleagues can recognise the symptoms of hypoglycaemia and hyperglycaemia and know how to treat them. At the first signs of hypoglycaemia, you may raise your blood glucose quickly by taking jelly beans, sugar or honey, soft drink (non-diet) or glucose tablets. Signs and symptoms of hypoglycaemia should be attended to urgently. Unless you are within 10 to 15 minutes of your next meal or snack, follow up with extra carbohydrates such as plain biscuits, fruit or milk. Taking this extra carbohydrate will prevent a second drop in your blood glucose level;
8. You should check your blood glucose levels regularly. This is the best way to tell if your diabetes is being controlled properly. Your doctor or diabetes educator will show you how and when to do this;
9. You should visit your doctor for regular checks of your eyes, feet, kidneys, heart, circulation, blood and blood pressure;
10. You should carefully follow your doctor’s and your dietician’s advice on diet, drinking alcohol and exercise;
11. If you drink alcohol while taking Daonil, you may get flushing, headache, breathing difficulties, rapid heart beat, stomach pains or feel sick and vomit.

Contraindications

Daonil should not be taken under certain circumstances. Tell your doctor if you have:

• Allergy to Daonil or related medicines (such as sulfur antibiotics or sulfonylureas);
• Type 1 diabetes mellitus (insulin-dependent diabetes mellitus or juvenile or growth onset diabetes);
• Unstable diabetes;
• Diabetic ketoacidosis;
• Diabetic coma or pre-coma;
• Severe kidney disease;
• Severe liver disease;
• Bosentan use;
• Glucose-6-phosphate dehydrogenase (G6PD) deficiency.

Precautions

Certain conditions require special consideration before using Daonil. Tell your doctor if you have:

• Impaired alertness;
• Surgery or infection;
• Alcohol use;
• Use of any other antidiabetic drugs;
• Sulfonamide allergy;
• Kidney and liver problems;
• History of diabetic coma;
• Adrenal, pituitary (or thyroid) problems;
• Heart failure;
• Do not eat regular meals;
• Do a lot of exercise or heavy work;
• Use of any other medicines, including medicines that you buy without a prescription from your pharmacy, supermarket or health food shop.

Pregnancy

Daonil is a Pregnancy Category C medication and should not be used during pregnancy. Insulin is more suitable for controlling blood sugar during pregnancy. Your doctor will replace Daonil with insulin while you are pregnant. You must inform your doctor if you are pregnant or intend to become pregnant.

Use in breastfeeding 

It is not known if Daonil passes into breastmilk. Daonil should not be taken while you are breastfeeding unless the benefits outweigh potential risks. Tell your doctor if you are breastfeeding or plan to breastfeed.

Schedule

Daonil is a Schedule 4 medication.

Common side effects

All medicines have side effects. Most commonly the side effects are minor; however, some can be more serious. Usually the benefits of taking a medication outweigh the associated side effects. Your doctor would have considered these side effects before starting you on Daonil.

Very common side effects are those that occur in more than 10% of people given Daonil. These include:

• Signs of hypoglycaemia (include weakness, trembling or shaking, sweating, light headedness, headache, dizziness, lack of concentration, tearfulness or crying, irritability, hunger and numbness around the lips and fingers);
• Unusual weight gain.

Common side effects are those that occur in 1–10% of people given Daonil. These include:

• Stomach upset (such as nausea, vomiting, heartburn, indigestion, cramps, diarrhoea, constipation or a feeling of fullness in the stomach);
• Loss of appetite;
• Headache;
• Weakness;
• Eye problems, including blurred or double vision.

Uncommon side effects

Side effects that occur in less than 1% of people given Daonil are considered uncommon. People do not necessarily experience any of these side effects, so do not become alarmed by this list:

• Fits;
• Deafness;
• Blindness;
• Severe pain or tenderness in the stomach;
• Sudden onset of abnormal thoughts;
• Swelling of the face, lips or tongue which may cause difficulty in swallowing or breathing;
• Symptoms of lactic acidosis (include loss of appetite, unexplained weight loss, nausea, vomiting, stomach pain, trouble breathing, feeling weak, tired or uncomfortable, unusual muscle pain, slow heart beat);
• Rash, sores, redness or itching of the skin, itchy hives-like rash or spots;
• Symptoms of sunburn (such as redness, itching, swelling or blistering which may occur more quickly than normal);
• Bleeding or bruising more easily than normal, reddish or purplish blotches under the skin;
• Jaundice;
• Signs infections (fever, severe chills, sore throat or mouth ulcers);
• Signs of anaemia (tiredness, being short of breath and looking pale);
• Change in the colour or amount of urine passed, blood in the urine.

In very rare cases (< 0.1%), intolerance to alcohol may occur. Drinking large amounts of alcohol may interfere with the way Daonil works. It may not work at all or it may take much longer than usual to work.

If you experience any of the listed side effects, or any other symptoms that appear abnormal or unusual, please tell your doctor.

References

1. Daonil [online]. Adelaide, SA: Australian Medicines Handbook; July 2008 [cited 28 June 2008]. Available from: [URL link]
2. Daonil [online]. St Leonards, NSW: MIMS Online; 9 November 2007 [cited 28 June 2008]. Available from: [URL link]

For further information talk to your doctor.