Skip to main content
Log in

Wide variation in serum chlorpropamide concentration in outpatients

  • Originals
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Summary

Serum chlorpropamide concentrations (s-CPA) were determined and related to clinical findings in 83 outpatients with maturity onset diabetes. The daily doses of CPA (mg/kg) varied six-fold, but s-CPA ranged 18-fold between the patients. There was a significant correlation between dose and s-CPA (r=0.61), which rose to 0.75 in the 30 patients who had prescribed no other drugs. Patients given other drugs concomitantly were over-represented amongst subjects with extreme values of apparent plasma clearance of CPA. There was no correlation either between serum creatinine or age and s-CPA. Of the 83 patients 40 (48%) had acceptable blood and urinary glucose values according to our criteria; but as 17 were overweight, only 23 patients (28%) had acceptable clinical control. Of the remaining 60 patients, too low a dose was being given to only 12, and dietary failure was the most probable explanation in the others. Thirteen patients (16%) probably did not need CPA. It is likely that this is a partial explanation for the high utilisation of oral antidiabetic drugs in Sweden. There was no general correlation between dose or s-CPA and blood glucose values, but analysis of s-CPA may still be of value in explaining unexpected changes in clinical control.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Bergman U, Elmes P, Halse M, Halvorsen T, Hood H, Lunde PKM, Sjöqvist F, Wade OL, Westerholm B (1975) The measurement of drug consumption. Drugs for diabetes in Northern Ireland, Norway and Sweden. Eur J Clin Pharmacol 8: 83–89

    Google Scholar 

  2. Bergman U (1979) International comparisons of drug utilization. Antidiabetic drugs in seven European countries. In: Bergman U, Grímson A, Wahba AHW, Westerholm B (eds) Studies in drug utilization. Methods and applications. World Health Organization, Copenhagen (WHO Regional Publications, European Series no 8)

  3. Wade OL, Hadden DR, Hood H (1973) The prescribing of drugs used in the treatment of diabetes. Br J Prev Soc Med 27: 44–48

    Google Scholar 

  4. Prescott LF, Redman DR (1972) Gas-liquid chromatographic estimation of tolbutamide and chlorpropamide in plasma. J Pharm Pharmacol 24: 713–716

    Google Scholar 

  5. Wagner JG, Northam JJ, Alway CD, Carpenter OS (1965) Blood levels of drug at the equilibrium state after multiple dosing. Nature 207: 1301–1302

    Google Scholar 

  6. Taylor JA (1972) Pharmacokinetics and biotransformation of chlorpropamide in man. Clin Pharmacol Ther 13: 710–718

    Google Scholar 

  7. Bergman U (1978) Drug utilization — geographical differences and clinical implications — antidiabetic drugs. In: Duchène-Marullaz P (ed) Advances in pharmacology and therapeutics, vol. 6. Pergamon Press, Oxford New York pp 123–132

    Google Scholar 

  8. Melander A, Sartor G, Wåhlin E, Scherstén B, Bitzén PO (1978) Serum tolbutamide and chlorpropamide concentrations in patients with diabetes mellitus. Br. Med. J. 1: 142–144

    Google Scholar 

  9. Bechtel P, Richard A, Sandoz M, Grandmottet P, Narboni G, Schwager JC (1976) Usefulness of determination of plasma concentrations of glicazide in monitoring the treatment of diabetics. In: Siest G, Young N, Young DS (eds) Drug interference and drug measurement in clinical chemistry. Karger, Basel, pp 153–158

    Google Scholar 

  10. Shen SH, Bressler R (1977) Clinical pharmacology of oral antidiabetic agents. N Engl J Med 296: 493–497

    Google Scholar 

  11. Marble A, Selenkow HA, Rose LI, Dluky RG, Williams GH (1976) Endocrine diseases. In: Avery GS (ed) Drug treatment. Principles and practice of clinical pharmacology and therapeutics. Adis Press, Churchill Livingstone, Sydney, London, pp 386–424

    Google Scholar 

  12. Krall LP, Chabot VA (1978) Oral hypoglycemic agent update. Med Clin North Am 62: 681–694

    Google Scholar 

  13. Petitpierre B, Perrin L, Rudhardt M, Herrera A, Fabre J (1972) Behaviour of chlorpropamide in renal insufficiency and under the effect of associated drug therapy. Int J Clin Pharmacol 6: 120–124

    Google Scholar 

  14. Taylor T, Assinder DF, Chasseaud LF, Bradford PM, Burton JS (1977) Plasma concentrations, bioavailability and dissolution of chlorpropamide. Eur J Clin Pharmacol 11: 207–212

    Google Scholar 

  15. Alván G (1978) Individual differences in the disposition of drugs metabolised in the body. Clin. Pharmacokinet 3: 155–175

    Google Scholar 

  16. Logie AW, Galloway DB, Petrie JC (1976) Drug interactions and long-term antidiabetic therapy. Br J Clin Pharmacol 3: 1027–1032

    Google Scholar 

  17. Hansen IM, Christensen LK (1977) Drug interactions with oral hypoglycemic drugs. Drugs 13: 24–34

    Google Scholar 

  18. Sackett DL (1976) The magnitude of compliance and noncompliance: In: Sackett DL, Haynes RB (eds) Compliance with therapeutic regimens. John Hopkins University Press, Baltimore, pp 9–25

    Google Scholar 

  19. Wiholm B-E (1980) Irregular drug intake and serum chlorpropamide concentrations. Eur J Clin Pharmacol 18: 159–163

    Google Scholar 

  20. Tomkins AM, Bloom A (1972) Assessment of the need for continued oral therapy in diabetics. Br Med J 1: 649–651

    Google Scholar 

  21. Lev-Ran A (1974) Trial of placebo in long-term chlorpropamide-treated diabetics. Diabetologia 10: 197–200

    Google Scholar 

  22. Gonen B, Rubenstein AH (1978) Haemoglobin Al and diabetes mellitus. Diabetologia 15: 1–8

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bergman, U., Christenson, I., Jansson, B. et al. Wide variation in serum chlorpropamide concentration in outpatients. Eur J Clin Pharmacol 18, 165–169 (1980). https://doi.org/10.1007/BF00561585

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00561585

Key words

Navigation