Diaprel mr

Package leaflet: Information for the patient

Warning! Keep this leaflet! Information on the immediate packaging is in a foreign language.
DIAPREL MR (GLICLAZIDE BIOGARAN)
60 mg, modified-release tablets
Gliclazidum
DIAPREL MR and GLICLAZIDE BIOGARAN are different brand names for the same medicine.
Please read this leaflet carefully before taking the medicine, as it contains
important information for the patient.

• Keep this leaflet, so that you can read it again if necessary.
• If you have any doubts, consult your doctor or pharmacist.
• This medicine has been prescribed for a specific individual. Do not pass it on to others. The medicine may harm another person, even if their symptoms are the same.
• If you experience any adverse reactions, including any not listed in this leaflet, inform your doctor or pharmacist. See section 4.

Table of contents of the leaflet:

1. What Diaprel MR, modified-release tablet is and what it is used for
2. Important information before taking Diaprel MR, modified-release tablet
3. How to take Diaprel MR, modified-release tablet
4. Possible side effects
5. How to store Diaprel MR, modified-release tablet
6. Contents of the pack and other information

1. What Diaprel MR, modified-release tablet is and what it is used for

Diaprel MR, modified-release tablet is a medicine that lowers blood glucose levels (contains an oral antidiabetic agent belonging to the sulfonylurea derivatives group).
Diaprel MR, modified-release tablet is used in the treatment of a certain form of diabetes (type 2 diabetes) in adults, when diet alone, physical exercise, and weight reduction are insufficient to maintain normal blood glucose levels.

2. Important information before taking Diaprel MR, modified-release tablet

When not to use Diaprel MR, modified-release tablet:

• if the patient is allergic to gliclazide or any of the other ingredients of this medicine (listed in section 6), other medicines of the same group (sulfonylurea derivatives), or other sulfonamides with blood glucose-lowering action;
• if the patient has insulin-dependent diabetes (type 1 diabetes);
• if ketone bodies and sugar are present in the urine (this may indicate that the patient has diabetic ketoacidosis), pre-comatose or comatose states;
• if the patient has severe kidney or liver disease;
• if the patient is taking medicines used to treat fungal infections (miconazole, see section "Diaprel MR, modified-release tablet and other medicines");
• if the patient is breastfeeding (see section "Pregnancy and breastfeeding").

Warnings and precautions
Before starting treatment with Diaprel MR, modified-release tablet, discuss this with your doctor.
You must follow your doctor's recommendations regarding treatment to achieve proper blood glucose levels. This means that, in addition to taking the tablets regularly, you should follow a diet, engage in physical exercise, and, if necessary, reduce body weight.
During treatment with gliclazide, regular monitoring of blood glucose (and possibly urine glucose) levels is required, as well as measurement of glycated hemoglobin (HbA1c).
The risk of low blood glucose (hypoglycemia) may be increased during the first weeks of treatment. Therefore, close medical supervision is particularly important.
Low blood glucose (hypoglycemia) may occur if:

• the patient eats irregularly or skips meals;
• the patient is fasting;
• the patient is undernourished;
• the patient changes their diet;
• the patient increases physical activity without adequate carbohydrate intake;
• the patient consumes alcohol, especially when skipping meals;
• the patient is taking other medicines or herbal products at the same time;
• the patient takes too high a dose of gliclazide;
• the patient has certain hormonal disorders (thyroid, pituitary, or adrenal cortex dysfunction);
• kidney or liver function is severely impaired.

If the patient has low blood glucose, the following symptoms may occur:
headache, intense hunger, nausea, vomiting, fatigue, sleep disturbances, restlessness, aggression,
impaired concentration, reduced alertness and reaction time, depression, disorientation, speech or
visual disturbances, trembling, sensory disturbances, dizziness, weakness.
Additional symptoms may include: sweating, clammy skin, anxiety, rapid or irregular heartbeat, high
blood pressure, sudden, severe chest pain that may radiate (angina pectoris).
If blood glucose continues to drop, severe confusion (delirium), seizures, loss of self-control, shallow
breathing, slow heartbeat, or loss of consciousness may occur.
In most cases, symptoms of low blood glucose disappear quickly when the patient consumes sugar,
e.g., glucose tablets, sugar cubes, sweet juice, or sweetened tea.
Therefore, it is essential to always carry sugar-containing products (glucose tablets, sugar cubes).
Artificial sweeteners are ineffective. Contact your doctor or nearest hospital if sugar intake does
not help or if symptoms recur.
Symptoms of low blood glucose may not occur, may be mild or develop slowly, or the patient may
not be aware that blood glucose has dropped. This may happen in elderly patients or in those taking
certain medications (e.g., central nervous system agents or beta-blockers).
In stressful situations (accidents, surgery, fever, etc.), your doctor may temporarily switch treatment
to insulin therapy.
Symptoms of high blood glucose (hyperglycemia) may occur when gliclazide has not yet sufficiently
lowered blood glucose, if the patient has not followed the treatment plan recommended by the
doctor, if the patient is taking preparations containing St. John's wort (Hypericum perforatum) (see
section "Diaprel MR, modified-release tablet and other medicines"), or during particularly stressful
situations. Symptoms may include thirst, frequent urination, dry mouth, dry and itchy skin, skin
infections, and reduced activity.
If these symptoms occur, the patient must contact their doctor or pharmacist.
When gliclazide is taken concomitantly with antibiotics known as fluoroquinolones, especially in
elderly patients, disturbances in blood glucose levels (low and high blood glucose) may occur. In
such cases, the doctor will remind the patient of the importance of monitoring blood glucose levels.
If a congenital deficiency of glucose-6-phosphate dehydrogenase (G6PD) (abnormal red blood
cells) has been diagnosed in the patient or in a family member, hemolytic anemia (destruction of
red blood cells and decreased hemoglobin) may occur. Consult your doctor before taking this
medicine.
In patients with porphyria (a hereditary genetic disorder involving accumulation of porphyrins or
their precursors in the body), cases of porphyria exacerbation have been reported after using certain
other sulfonylurea derivatives.
Diaprel MR, modified-release tablet is not recommended for use in children due to lack of data.

Diaprel MR, modified-release tablet and other medicines
Inform your doctor or pharmacist about all medicines you are currently taking or have recently
taken, as well as any medicines you plan to take.
The blood glucose-lowering effect of gliclazide may be enhanced, and symptoms of low blood
glucose may occur, when one of the following medicines is taken:

• other medicines used to treat high blood glucose (oral antidiabetic drugs, GLP-1 receptor agonists, or insulin);
• antibiotics (sulfonamides, clarithromycin);
• medicines used to treat high blood pressure or heart failure (beta-blockers, ACE inhibitors such as captopril or enalapril);
• medicines used to treat fungal infections (miconazole, fluconazole);
• medicines used to treat stomach or duodenal ulcers (H₂-receptor blockers);
• medicines used to treat depression (MAO inhibitors);
• painkillers or anti-rheumatic drugs (phenylbutazone, ibuprofen);
• medicines containing alcohol.

The following medicines may reduce the effect of gliclazide and cause increased blood glucose:

• medicines used to treat central nervous system disorders (chlorpromazine);
• anti-inflammatory medicines (corticosteroids);
• medicines used to treat asthma or administered during childbirth (intravenous salbutamol, ritodrine, terbutaline);
• medicines used to treat breast diseases, severe menstrual bleeding, and endometriosis (danazol);
• preparations containing St. John's wort (Hypericum perforatum).

When Diaprel MR is taken concomitantly with antibiotics known as fluoroquinolones, disturbances in blood glucose levels (low and high blood glucose) may occur, especially in elderly patients.
Diaprel MR, modified-release tablet may enhance the effect of anticoagulant medicines (warfarin).
Consult your doctor before starting any new medicine.
If the patient is admitted to hospital, they should inform medical staff that they are taking Diaprel MR, modified-release tablet.

Diaprel MR, modified-release tablet with food, drink, and alcohol
Diaprel MR, modified-release tablet can be taken with food and non-alcoholic drinks.
Drinking alcohol is not recommended, as it may alter diabetes control in an unpredictable way.

Pregnancy and breastfeeding
Use of Diaprel MR, modified-release tablet is not recommended during pregnancy.
If the patient is pregnant, suspects she may be pregnant, or is planning a pregnancy, she should consult her doctor before using this medicine.
Diaprel MR, modified-release tablet must not be used during breastfeeding.

Driving and operating machinery
If blood glucose is too low (hypoglycemia) or too high (hyperglycemia), or if vision disturbances occur due to abnormal blood glucose levels, the ability to concentrate or react may be impaired. Remember that the patient may pose a risk to themselves or others (e.g., when driving a car or operating machinery).
Ask your doctor whether you may drive:

• if low blood glucose (hypoglycemia) occurs frequently;
• if symptoms of low blood glucose (hypoglycemia) are very mild or absent.

Diaprel MR, modified-release tablet contains monohydrate lactose
If the patient has previously been diagnosed with intolerance to certain sugars, they should consult their doctor before taking this medicine.

3. How to use Diaprel MR, modified-release tablet

Dosage
This medicine should always be taken exactly as prescribed by the doctor or pharmacist.
If in doubt, consult your doctor or pharmacist.
The dosage is determined by the doctor, depending on blood and urine glucose levels.
Any changes related to external factors (weight loss, lifestyle changes, stress) or improvement in blood glucose control may require adjustment of gliclazide dosage.
The recommended daily dose ranges from half a tablet to two tablets (maximum 120 mg), taken once during breakfast. The dose depends on the individual response to treatment.
The tablet may be divided into halves.
Diaprel MR, modified-release tablet, is intended for oral use.
The tablet(s) should be taken with a glass of water at breakfast time (preferably at the same time every day). Swallow half or one whole tablet (or tablets) at once. Do not chew or crush the tablets. Always eat a meal after taking the tablet(s).

In combination therapy with Diaprel MR, modified-release tablet, together with metformin, an alpha-glucosidase inhibitor, a thiazolidinedione, a dipeptidyl peptidase IV inhibitor, a GLP-1 receptor agonist, or insulin, the appropriate dosage of each medicine will be individually determined by the doctor.

If the patient notices high blood glucose levels despite taking the medicine as prescribed, they should consult their doctor or pharmacist.

Taking more than the recommended dose of Diaprel MR, modified-release tablet
In case of overdose, contact a doctor immediately or go to the nearest hospital.
Symptoms of overdose are those of low blood glucose (hypoglycaemia), as described in section 2. In such cases, eating sugar (4 to 6 sugar cubes) or drinking a sweet beverage, followed by a snack or meal, may help. If the patient is unconscious, contact a doctor immediately and call emergency services. The same action should be taken if someone (e.g. a child) accidentally takes this medicine. Do not give food or drink to unconscious patients.
Ensure that someone close is always informed and able to call a doctor in case of an emergency.

Missing a dose of Diaprel MR, modified-release tablet
It is important to take the medicine every day, as regular use ensures better effectiveness.
However, if a patient forgets to take a dose of Diaprel MR, modified-release tablet, they should take the next dose at the usual time.
Do not take a double dose to make up for a missed dose.

Stopping treatment with Diaprel MR, modified-release tablet
Since diabetes treatment usually lasts a lifetime, consult your doctor before stopping this medicine.
Discontinuing treatment may lead to increased blood glucose levels (hyperglycaemia), increasing the risk of diabetes complications.

If you have any further questions about the use of this medicine, consult your doctor or pharmacist.

4. Possible adverse effects

Like all medicines, this medicine can cause adverse effects, although not everyone will experience them.
The most commonly observed adverse effect is low blood sugar (hypoglycaemia).
Subjective and objective symptoms are described in the section "Warnings and precautions".
If these symptoms are left untreated, they may progress to drowsiness, loss of consciousness or coma.
If hypoglycaemia is severe or prolonged, even if temporarily controlled by sugar intake, medical advice should be sought immediately.

Liver disorders
Isolated cases of impaired liver function have been observed, which may cause yellowing of the skin and eyes (jaundice). If these symptoms occur, consult a doctor immediately. Symptoms usually resolve after discontinuation of the medicine. The doctor will decide whether treatment should be discontinued.

Skin disorders
Skin reactions such as rash, redness, itching, urticaria, blisters, and angioedema (rapid swelling of tissues such as eyelids, face, lips, mouth, tongue or throat, which may cause breathing difficulties) have been observed. The rash may progress to extensive blistering or lead to skin exfoliation.
If a patient experiences these symptoms, Diaprel MR should be discontinued immediately and the patient should urgently contact a doctor and inform them about taking this medicine.

Rarely, symptoms of severe hypersensitivity reactions (DRESS, Drug Reaction with Eosinophilia and Systemic Symptoms) have been reported: initially presenting as influenza-like symptoms and facial rash, which subsequently spreads, along with high fever.

Blood disorders
Reduced numbers of blood cells (e.g. platelets, red and white blood cells) may cause paleness, prolonged bleeding, bruising, sore throat and fever. These symptoms usually resolve after stopping treatment.

Gastrointestinal disorders
Abdominal pain, nausea, vomiting, dyspepsia, diarrhoea and constipation. These symptoms may be reduced by taking Diaprel MR modified-release tablet with food, as recommended.

Eye disorders
Vision disturbances may occur, especially at the beginning of treatment. This effect is related to changes in blood glucose levels.

As with other sulphonylurea derivatives, the following adverse events have been observed:
significant blood cell count changes, allergic vasculitis, reduced sodium levels in blood (hyponatraemia), and signs of liver damage (e.g. jaundice), which in most cases resolved after discontinuation of sulphonylurea derivatives; however, in isolated cases, these may lead to life-threatening liver failure.

Reporting of adverse effects
If any adverse effects occur, including any not listed in this leaflet, inform your doctor or pharmacist. Adverse effects can also be reported directly to the Department of Monitoring Adverse Drug Reactions, Office for Registration of Medicinal Products, Medical Devices and Biocidal Products, Al. Jerozolimskie 181C, 02-222 Warsaw,
tel.: +48 22 49 21 301, fax: +48 22 49 21 309, website: https://smz.ezdrowie.gov.pl.
Reporting adverse effects helps to provide more information on the safety of the medicine.

5. How to store Diaprel MR, modified-release tablet

Keep this medicine out of sight and reach of children.
Do not use this medicine after the expiry date stated on the packaging. The expiry date refers to the last day of the stated month.
No special storage conditions are required.
Medicines must not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer in use. This will help protect the environment.

6. Contents of the pack and other information

What Diaprel MR modified-release tablet contains

• The active substance is gliclazide. Each modified-release tablet contains 60 mg of gliclazide.
• Other ingredients are: lactose monohydrate, maltodextrin, hypromellose, magnesium stearate, anhydrous colloidal silicon dioxide.

What Diaprel MR modified-release tablet looks like and contents of the pack
Diaprel MR is a white, elongated modified-release tablet, 15 mm long and 7 mm wide, with a central dividing groove and engraved markings "DIA 60" on both sides. The tablets are available in blisters packed in cardboard boxes containing 30, 60 and 90 tablets.

For further information, please contact the marketing authorisation holder or the parallel importer.
Marketing Authorisation Holder in France, the country of export:
Biogaran, 15, boulevard Charles de Gaulle, 92700 Colombes, France
Manufacturer:
Les Laboratoires Servier Industrie, 905, route de Saran, 45520 Gidy, France
Servier (Ireland) Industries Limited, Gorey Road, Arklow, Co. Wicklow, Ireland
Anpharm Przedsiebiorstwo Farmaceutyczne S.A., ul. Annopol 6B, 03-236 Warsaw, Poland
Laboratorios Servier S.L., Avenida de Los Madroños, 33, 28043 Madrid, Spain
Parallel Importer:
InPharm Sp. z o.o., ul. Strumykowa 28/11, 03-138 Warsaw, Poland
Repackaged in:
InPharm Sp. z o.o. Services sp. k., ul. Chełmżyńska 249, 04-458 Warsaw, Poland
Marketing Authorisation Numbers in France, the country of export: 34009 275 862 3 1
34009 275 867 5 0
Parallel Import Authorisation Number: 442/22
This medicinal product is authorised for sale in the European Economic Area under the following names:
Austria DIAMICRON MR 60 mg
Belgium UNI DIAMICRON 60 mg
Bulgaria DIAPREL MR 60 mg
Croatia DIAPREL MR 60 mg
Cyprus DIAMICRON MR 60 mg
Czech Republic DIAPREL MR 60 mg
Denmark DIAMICRON UNO 60 mg
Estonia DIAPREL MR 60 mg
France DIAMICRON 60 mg
Germany DIAMICRON UNO 60 mg
Greece DIAMICRON MR 60 mg
Hungary DIAPREL MR 60 mg
Ireland DIAMICRON MR 60 mg
Italy DIAMICRON 60 mg
Latvia DIAPREL MR 60 mg
Lithuania DIAPREL MR 60 mg
Luxembourg DIAMICRON 60 mg
Malta DIAMICRON MR 60 mg
Netherlands DIAMICRON MR 60 mg
Poland DIAPREL MR
Portugal DIAMICRON LM 60 mg
Romania DIAPREL MR 60 mg
Slovakia DIAPREL MR 60 mg
Slovenia DIAPREL MR 60 mg
Spain DIAMICRON 60 mg