Sulfonylureas
ATC code: A10BB09 (Gliclazide)
Brand names
Gliclazida Cinfa, Gliclazida Normon
A second-generation sulfonylurea. Closes ATP-dependent potassium channels in pancreatic beta-cells, stimulating insulin secretion. Unlike glibenclamide, gliclazide has an additional antiplatelet effect and lower severe hypoglycemia risk. In Spanish practice the modified-release form (Diamicron MR) is widely used – once-daily dosing with a flatter concentration profile and reduced hypoglycemia risk in older patients.
Second line
Type 2 diabetes with inadequate glycemic control on . Starting dose Diamicron MR 30 mg once daily with breakfast; titrate up to 120 mg. 2024 and Spanish redGDPS 2023 position sulfonylureas as third-line after metformin and SGLT-2 inhibitors or GLP-1 agonists, especially in patients with cardiovascular comorbidities. Gliclazide MR has lower severe hypoglycemia and cardiovascular mortality risk than (ADVANCE trial).
The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.
Not recommended
Gliclazide is a sulfonylurea antidiabetic. It is prescribed for type 2 diabetes as a non-first-line drug ( 2024, 2024). In people without diabetes, gliclazide is not used for weight loss: the drug causes hypoglycemia (life-threatening, especially in people with normal blood sugar), weight gain (paradoxically, via insulin stimulation), and cardiovascular risks. If gliclazide was prescribed for weight loss without diabetes, seek a second opinion immediately.
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Contraindicated in pregnancy. For gestational diabetes and pre-existing T2DM during pregnancy, first-line is insulin (detemir, aspart, lispro). Metformin is acceptable in T2-T3 if insulin is declined.
Contraindicated during lactation – neonatal hypoglycemia risk via breast milk. Alternative – insulin.
Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.
Gliclazide is evaluated for the following indications with varying evidence strength: Type 2 diabetes mellitus (evidence tier A), Weight loss (evidence tier F). See the full indication matrix with dosing and citations above on this page.
Common side effects of Gliclazide (≥ 1 in 100): Hypoglycemia (sweating, tremor, hunger, confusion), Weight gain (1-3 kg in the first year), Nausea, Skin rash. See the Safety section for uncommon and serious reactions.
FDA category C. Contraindicated in pregnancy. For gestational diabetes and pre-existing T2DM during pregnancy, first-line is insulin (detemir, aspart, lispro). Metformin is acceptable in T2-T3 if insulin is declined.
Contraindicated during lactation – neonatal hypoglycemia risk via breast milk. Alternative – insulin.
Gliclazide is contraindicated in: Gliclazide, other sulfonylurea, or sulfonamide hypersensitivity; Type 1 diabetes; Diabetic ketoacidosis, precoma, or coma; Severe hepatic or renal impairment; Pregnancy and lactation. Full list in the Safety section.