Apo-Chlorpropamide , Diabinese, Novopropamide
Classifications: hormone; antidiabetic sulfonylurea; Therapeutic: antidiabetic; sulfonylurea
Pregnancy Category: C
100 mg, 250 mg tablets
Longest-acting first-generation sulfonylurea compound. Lowers blood glucose by stimulating beta cells in pancreas to synthesize
and release endogenous insulin. May potentiate available antidiuretic hormone (ADH) secretion, a property not shared by
Antidiabetic effect is due to the ability of the drug to stimulate the beta cells of the pancreas to manufacture and release
insulin. Therapeutic effectiveness is indicated by HbA1c levels >7%.
Stable non-insulin-dependent diabetes mellitus (type 2) in patients who cannot be controlled by diet alone and who do not
have complications of diabetes.
Neurogenic diabetes insipidus.
Known hypersensitivity to sulfonylureas and to sulfonamides; diabetes complicated by severe infection; acidosis; severe
renal, hepatic, or thyroid insufficiency; pregnancy (category C), lactation. Safe use in children not established.
Older adult patients, Addison's disease, CHF, and hepatic porphyria.
Route & Dosage
Adult: PO Initial: 100250 mg/d with breakfast, adjust by 50125 mg/d q35d until glycemic control is achieved, up
to 750 mg/d
- Give as a single morning dose with breakfast. To reduce GI adverse effects, drug may be prescribed as 2 or 3 doses and taken
- Store below 40° C (104° F), preferably at 15°30° C (59°86° F) in a tightly closed
container, unless otherwise directed.
Adverse Effects (≥1%) Body as a Whole:
Flushing, photosensitivity, alcohol
GI distress, anorexia, nausea, diarrhea
, cholestatic jaundice
. Hematologic: Leukopenia
, agranulocytosis. Metabolic: Hypoglycemia,
antidiuretic effect (SIADH), dilutional hyponatremia, water intoxication. CNS:
Drowsiness, muscle cramps, weakness, paresthesias. Skin:
Adverse effects of oral anticoagulants
, phenytoin, salicylates
may be increased along with those of chlorpropamide; thiazide diuretics
may increase blood sugar; alcohol
reaction; probenecid, mao inhibitors
may increase hypoglycemic effects. Herbal: Garlic, ginseng
may increase hypoglycemic effects.
Readily from GI tract. Onset:
1 h. Peak:
36 h. Distribution:
Highly protein bound; distributed into breast milk. Metabolism:
In liver. Elimination:
8090% in urine in 96 h. Half-Life:
Assessment & Drug Effects
- Monitor therapeutic effectiveness: Indicated by HbA1c levels >7%.
- Monitor blood and urine glucose to determine effectiveness of glycemic control.
- Lab tests: Periodic fasting and postprandial blood glucose; HbA1c every 3 mo; baseline and periodic hematologic and hepatic studies are advisable, particularly in patients receiving high
doses. A CBC should be performed if symptoms of anemia appear.
- Report dizziness, shortness of breath, malaise, fatigue.
- Monitor for S&S of hypoglycemia (see Appendix F).
- Monitor I&O ratio and pattern: Infrequently, chlorpropamide produces an antidiuretic effect, with resulting severe hyponatremia,
edema, and water intoxication. If fluid intake far exceeds output and edema develops (weight gain), report to the physician.
Patient & Family Education
- Report hypoglycemic episodes to physician. Because chlorpropamide has a long half-life, hypoglycemia can be severe, although
onset is not as fast or as dramatic as with use of insulin.
- Report any of the following immediately to physician: skin eruptions, malaise, fever, or photosensitivity. Immediately report
these symptoms to physician. A change to another hypoglycemic agent may be indicated.
- Do not self-dose with OTC drugs unless approved or prescribed by the physician.