The daily dose of Diamicron MR 60 mg may vary from ½-2 tab/day ie, from 30-120 mg taken orally in a single intake at breakfast time.
As with any hypoglycaemic agent, the dose should be adjusted according to the individual patient's metabolic response (blood glucose, HbAlc).
Recommended Initial Dose: 30 mg daily (½ tab of Diamicron MR 60 mg). If blood glucose is effectively controlled, this dose may be used for maintenance treatment.
If blood glucose is not adequately controlled, the dose may be increased to 60, 90 or 120 mg daily, in successive steps. The interval between each dose increment should be at least 1 month except in patients whose blood glucose has not reduced after 2 weeks of treatment. In such cases, the dose may be increased at the end of the 2nd week of treatment. Maximum Daily Dose: 120 mg.
The breakability of the Diamicron MR 60 mg tablet enables flexibility of dosing to be achieved.
Switching from Diamicron 80 mg Tablets to Diamicron MR 60 mg Tablets: 1 tab of Diamicron 80 mg is comparable to 30 mg of the modified-release formulation (ie, ½ tab of Diamicron MR 60 mg). Consequently, the switch can be performed with careful blood monitoring.
Switching from Another Oral Antidiabetic Agent to Diamicron MR 60 mg: Diamicron MR 60 mg can be used to replace other oral antidiabetic agents. The dosage and the half-life of the previous antidiabetic agent should be taken into account when switching to Diamicron MR 60 mg.
A transitional period is not generally necessary. A starting dose of 30 mg should be used and this should be adjusted to suit the patient's blood glucose response, as previously described.
When switching from a hypoglycaemic sulfonylurea with a prolonged half-life, a treatment-free period for a few days may be necessary to avoid an additive effect of the 2 products, which might cause hypoglycaemia.
The procedure described for initiating treatment should also be used when switching to treatment with Diamicron MR 60 mg ie, a starting dose of 30 mg/day, followed by a stepwise increase in dose, depending on the metabolic response.
Combination Treatment with Other Antidiabetic Agents: Diamicron MR 60 mg can be given in combination with biguanides, α-glucosidase inhibitors or insulin.
In patients not adequately controlled with Diamicron MR 60 mg, concomitant insulin therapy can be initiated under close medical supervision.
Mild to Moderate Renal Impairment: The same dosing regimen can be used as in patients with normal renal function with careful patient monitoring. These data have been confirmed in clinical trials.
Patients at Risk of Hypoglycaemia: Undernourished or malnourished; severe or poorly compensated endocrine disorders (hypopituitarism, hypothyroidism, adrenocorticotropic insufficiency); withdrawal of prolonged and/or high-dose corticosteroid therapy; severe vascular disease (severe coronary heart disease, carotid impairment, diffuse vascular disease). It is recommended that the minimum daily starting dose of 30 mg is used.
Elderly >65 years: Diamicron MR 60 mg should be prescribed using the same dosing regimen recommended for patients <65 years.
Administration: For oral and adult use only. Do not crush or chew. If a dose is forgotten, there must be no increase in the dose taken the next day.