Ramipril – a tablet for high blood pressure
Ramipril – a tablet for high blood pressure Ramipril is a tablet for high blood pressure, especially useful in many CKD patients What is Ramipril? Ramipril is an ACE inhibitor (angiotensin-conve...

Gliclazide is a common tablet used for type 2 diabetes.
Gliclazide (brand name Diamicron) is a well-established medication used to treat Type 2 diabetes. It belongs to a group of medicines called sulfonylureas and works by prompting your pancreas to release more insulin into your bloodstream.
Insulin is a hormone normally made by the pancreas. Its function is to help your body use glucose (sugar) for energy, keeping your blood sugar levels within a healthy range.
Unlike insulin therapy, which requires injections, gliclazide is an oral tablet that helps your body use its own natural insulin production more effectively.
An Insulin Secretagogue: It is specifically designed to stimulate the beta cells in your pancreas to produce more insulin.
Established Therapy: It is a synthetic compound that has been used safely for decades to manage blood sugar levels.
Metformin Alternative or Add-on: Often used for patients who cannot take metformin, or added as a second treatment when metformin alone isn’t enough.
Type 2 Diabetes: Primarily used when lifestyle changes haven’t been enough to manage blood sugar.
Complication Prevention: Helps prevent long-term issues like kidney disease (CKD), nerve damage, and vision loss.
Note: It cannot be used to treat Type 1 diabetes, as the body must be able to produce some of its own insulin for the drug to work.
Hypoglycaemia (‘Hypo’): The most common risk. Symptoms include sweating, shakiness, hunger, and dizziness.
Weight Gain: Because insulin helps the body store energy, some weight gain is common.
Nausea/Indigestion: Often reduced by taking the tablet with food.
Rare: Liver issues (jaundice) or skin rashes.
Dose: Initially 40mg to 80mg daily, adjusted according to response. Maximum dose is usually 320mg daily.
Form: Available as standard tablets or Modified Release (MR) tablets.
Schedule: Standard tablets are usually taken twice a day (breakfast and dinner). MR tablets are typically taken once a day with breakfast.
Important: It is vital to take gliclazide with a meal. If you skip a meal, you should usually skip the dose, as taking it on an empty stomach can cause hypoglycaemia (dangerously low blood sugar).
Pancreas Stimulation: Gliclazide binds to specific receptors on the surface of the pancreas cells. This triggers the release of insulin.
Glucose Lowering: By increasing insulin levels, it helps move sugar out of the blood and into your cells.
Fast Acting: It starts working relatively quickly, making it effective at controlling the “spikes” in sugar that happen after meals.
| Feature | Metformin (Biguanide) | Gliclazide (Sulfonylurea) |
| Main Action | Improves insulin sensitivity. | Stimulates insulin release. |
| Hypoglycaemis (‘hypo’) Risk | Very low. | Higher risk. |
| Weight Change | Weight neutral or slight loss. | Potential for modest gain. |
| When to Take | With or after meals. | With breakfast/meals. |
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