Sugril Dosage/Direction for Use

In principle, the dosage of Glibenclamide is governed by the desired blood glucose level. The dosage of Glibenclamide must be the lowest possible dose which is effective.
Treatment with Glibenclamide must be initiated and monitored by a doctor. The patients must take Glibenclamide at the times and in the doses prescribed by the doctor.
Mistakes, e.g. forgetting to take a dose, must never be corrected by subsequently taking a large dose.
Measures for dealing with such mistakes (in particular forgetting a dose or skipping a meal) or in the event a dose cannot be taken at the prescribed time must be discussed and agreed between doctor and patient beforehand.
If it is discovered that too high a dose or an extra dose of Glibenclamide has been taken, doctor must be notified immediately.
Initial dose and dose titration: The usual initial dosage is ½ to 1 tablet Glibenclamide once daily.
It is recommended that treatment be started with the smallest possible dose. This applies in particular to patients who are prone to hypoglycemia or who weigh less than 50 kg.
If necessary, the daily dose can be raised. It is recommended that the dose be increased gradually, i.e. in increments of not more than ½ tablet and at intervals of one to two weeks, and that the increase be guided by regular blood glucose monitoring.
Dose range in patients with well controlled diabetes; maximum doses: The usual single dose is ½ - 2 tablets Glibenclamide. A single dose of 2 tablets Glibenclamide must not be exceeded. Large daily doses must be divided into at least two separate single doses.
The usual daily dose is 1 to 2 tablets Glibenclamide. Exceeding a total daily dose of 3 tablets Glibenclamide is not recommended because higher daily doses of up to 4 tablets Glibenclamide are more effective only in exceptional cases.
Distribution of doses: Timing and distribution of doses are to be decided by the doctor. Taking into consideration the patient's current life-style. Normally a single daily dose of Glibenclamide is sufficient. It is recommended that daily doses of up to 2 tablets. Glibenclamide be taken before a substantial breakfast or before the first main meal and any remaining portions of the total daily dose before the evening meal. It is very important not to skip meals after the tablets have been taken.
Secondary dosage adjustment: Glibenclamide requirements may fall as treatment proceeds. To avoid hypoglycemia timely dose reduction or cessation of Glibenclamide therapy must therefore be considered. Correction of dosage must also be considered, whenever: the patient's weight changes; or the patient's life-style changes; or other factors arise which cause an increased susceptibility to hypoglycemia or hyperglycemia.
Duration of treatment: Treatment with Glibenclamide is normally a long-term therapy.
Changeover from other oral antidiabetics to Glibenclamide and other oral antidiabetics: When substitution Glibenclamide and other oral antidiabetics for other oral antidiabetics (drugs to lower blood glucose), it is recommended that the procedure be the same as for initial dosage starting with daily doses of ½ to 1 tablet Glibenclamide. This applies even on cases where the patient is being switched from the maximum dose of another oral antidiabetic.
Consideration must be given to the potency and duration of action of the previous antidiabetic agent. A break from medication may be required to avoid any summation of effects entailing a risk of hypoglycemia.
Administration: Glibenclamide tablets must be swallowed whole with sufficient amounts of liquid, e.g. with roughly half to one glass of water.