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Risk benefit should be considered when the following medical problems exist: Severe diarrhoea, severe gastroparesis, intestinal obstruction, prolonged vomiting, hyperglycaemia, hyperthyroidism, hypoglycaemia, hypothyroidism and renal function impairment. Use of sulphonylureas increases the risk of possibly prolong hypoglycaemia with renal function impairment.
Risk benefit should also be considered in hepatic disease, sulphonylureas that are extensively metabolised in the liver should not be used when there is hepatic impairment. Hypoglycaemia that develops may be more severe when these are being used.
Note: Hypoglycaemia - Severe hypoglycaemia may occur in any patient treated with any sulphonylurea. The propensity to cause hypoglycaemia does not appear to be solely related to the half-life of the drug. So caution must always be taken when taking any sulphonylureas, especially in renal or hepatic function impairment.
Adjustment of dosage of hypoglycaemic agents may be required in patients suffering from intercurrent infections, traumas, shock or after anaesthesia. When major surgery is to be performed, insulin therapy should be substituted for oral hypoglycaemics.
Use in Children: Paediatric: Safety and efficacy of oral antidiabetic agents have not been established in paediatrics.
Effects on Ability to Drive and Use Machines: Care is necessary during excessive exercise, especially while driving and during the use of machines, because hypoglycaemia may be provoked. If hypoglycaemia may occur, any moving action should be stopped until recovery is complete.
