5 mg PO qDay initially; increase by 2.5-5 mg PRN every several days based on blood glucose Maintenance range: 2.5-20 mg PO qDay or q12hr; not to exceed 40 mg/day
Extended-release tablets (Glucotrol XL)
Initial: 5 mg/day PO given with breakfast; dose adjustment based on blood glucose should not be done more frequently than every 7 days Maintenance range: 5-10 mg PO qDay; not to exceed 20 mg/day
Dosing considerations
Doses >15 mg: PO divided q12hr recommended
Conversion From Immediate Release to Extended Release
Administer the nearest equivalent immediate-release daily dose as extended-release tablet
once daily
Alternatively, administer 5 mg PO initially; titrate as necessary
Conversion From Long Half-Life Agents
Observe patients carefully for 1-2 weeks when being converted from long half-life sulfonylureas to glipizide, because of potential for overlapping of hypoglycemic effects
Transferring From Insulin Therapy to Glipizide IR or ER
Current insulin dose <20 units: Discontinue insulin and initiate glipizide therapy at recommended dose
Current insulin dose >20 units: Decrease insulin dose by 50% and initiate glipizide at recommended dose; decrease insulin dose gradually based on patient’s response
Dosing Modifications
Hepatic impairment: 2.5 mg PO qDay initially (immediate release); extended release not studied
Renal impairment: Not studied; if GFR <50 mL/min, may decrease dose by 50% (suggested)
PEDIATRIC
Safety and efficacy not established
GERIATRIC
Diabetes
2.5 mg PO qDay initially; increase by 2.5-5 mg/day every 1-2 weeks as determined by blood glucose response at intervals of several days
May switch to extended release once daily tablets at the nearest equivalent total daily dose or lower end of recommended range; not to exceed 20 mg/day Dosing considerations
Because elderly patients are susceptible to the hypoglycemic effects of glucose-lowering
drugs, the question of how tightly glucose levels should be controlled in the elderly is controversial
Recognizing hypoglycemia in elderly patients may be challenging
Monitoring other parameters associated with cardiovascular disease, such as blood pressure and cholesterol, may be more important than normalized glycemic control
Initial and maintenance dosing should be conservative
Drug Interactions Interaction Checker glipizide and
Type a dru
Sort by :
Contraindicated (0)
Serious - Use Alternative (1)
ethanol
ethanol, glipizide. Other (see comment). High likelihood serious or life-threatening
interaction. Contraindicated unless benefits outweigh risks and no alternatives available. Never use combination. Comment: Excessive EtOH consumption may alter glycemic control. Some sulfonylureas may produce a disulfiram like rxn.
Cholestatic jaundice and hepatitis occur rarely but may progress to liver failure
Contraindications & Cautions
Contraindications
Hypersensitivity; sulfa allergy
Type 1 diabetes
Diabetic ketoacidosis with or without coma
Cautions
Patients with risk of severe hypoglycemia: Elderly, debilitated, or malnourished; adrenal or
pituitary insufficiency; stress due to infection, fever, trauma, or surgery
If patient is exposed to stress, it may be necessary to discontinue glipizide and initiate insulin
Use caution in hepatic/renal impairment
Pregnancy, lactation
Increased risk of cardiovascular mortality
Persons allergic to other sulfonamide derivatives may develop allergic reaction to glipizide
Hypoglycemia may be difficult to recognize in patients with autonomic neuropathy
Hemolytic anemia may occur with glucose 6-phosphate dehydrogenase (G6PD) deficiency when treated with sulfonylurea agents
Avoid using the extended-release tablets in patients with severe gastrointestinal narrowing of esophageal dysmotility
Pregnancy & Lactation
Pregnancy category: C
Lactation: Not known if crosses into breast milk; not recommended
Pregnancy Categories
A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal
risk.
B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive
evidence of human fetal risk.
X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA:Information not available.
Pharmacology Mechanism of Action
Initial effect to increase insulin secretion from pancreatic beta cells; may also decrease rate of hepatic glucose production and increase insulin receptor sensitivity
Absorption
Bioavailability: 100% (Glucotrol)
Onset: Initial effect (30 min); max effect: (2-3 hr) (Glucotrol)
Duration: 12-24 hr (Glucotrol)
Peak plasma time: 1-3 hr (IR); 6-12 hr (ER)
Distribution
Protein bound: 99% (Glucotrol)
Vd: 10-11 L (Glucotrol)
Metabolism
Extensively metabolized in liver to inactive metabolites
Patient Handout Print w/ Office Info Print w/out Office Info 62 Patient Education glipizide oral
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
GLIPIZIDE EXTENDED-RELEASE TABLET - ORAL
(GLIP-i-zide)
COMMON BRAND NAME(S): Glucotrol XL
USES: Glipizide is used with a proper diet and exercise program to control high blood sugar in people with type 2 diabetes. It may also be used with other diabetes medications. Controlling high blood sugar helps prevent kidney damage, blindness, nerve problems, loss of limbs, and sexual function problems. Proper control of diabetes may also lessen your risk of a heart attack or stroke. Glipizide belongs to the class of drugs known as sulfonylureas. It lowers blood sugar by causing the release of your body's natural insulin.
HOW TO USE: Read the Patient Information Leaflet if available from your pharmacist before you start taking glipizide and each time you get a refill. If you have any questions, ask your doctor or pharmacist.
Take this medication by mouth with breakfast as directed by your doctor, usually once daily. The dosage is based on your medical condition and response to treatment.
To reduce your risk of side effects, your doctor may direct you to start this medication at a low dose and gradually increase your dose. Follow your doctor's instructions carefully.
If you are already taking another anti-diabetic drug (such as chlorpropamide), follow your doctor's directions carefully for stopping the old drug and starting glipizide.
Do not crush or chew extended-release tablets. Doing so can release all of the drug at once, increasing the risk of side effects. Also, do not split the tablets unless they have a score line and your doctor or pharmacist tells you to do so. Swallow the whole or split tablet without crushing or chewing.
Colesevelam can decrease the absorption of glipizide. If you are taking colesevelam, take glipizide at least 4 hours before taking colesevelam.
Use this medication regularly to get the most benefit from it. To help you remember, take it at the same time each day.
Tell your doctor if your condition does not improve or if it worsens (your blood sugar levels are too high or too low).
SIDE EFFECTS: Nausea, vomiting, loss of appetite, diarrhea, constipation, upset stomach, gas, headache, and weight gain may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.
An empty tablet shell may appear in your stool. This effect is harmless because your body has already absorbed the medication.
Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
Tell your doctor right away if you have any serious side effects, including: signs of infection (such as persistent sore throat, fever), easy bleeding/bruising, stomach pain, yellowing eyes/skin, dark urine, unusual tiredness/weakness, unusual/sudden weight gain, mental/mood changes, swelling hands/feet, seizures.
This medication can cause low blood sugar (hypoglycemia). This may occur if you do not consume enough calories from food or if you do unusually heavy exercise. Symptoms of low blood sugar include sudden sweating, shaking, fast heartbeat, hunger, blurred vision, dizziness, or tingling hands/feet. It is a good habit to carry glucose tablets or gel to treat low blood sugar. If you don't have these reliable forms of glucose, rapidly raise your blood sugar by eating a quick source of sugar such as table sugar, honey, or candy, or drink fruit juice or non-diet soda. Tell your doctor immediately about the reaction and the use of this product. To help prevent low blood sugar, eat meals on a regular schedule, and do not skip meals. Check with your doctor or pharmacist to find out what you should do if you miss a meal.
Symptoms of high blood sugar (hyperglycemia) include thirst, increased urination, confusion, drowsiness, flushing, rapid breathing, and fruity breath odor. If these symptoms occur, tell your doctor immediately. Your dosage may need to be increased.
A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
In the US -
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Before taking glipizide, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
Before using this medication, tell your doctor or pharmacist your medical history, especially of: liver disease, kidney disease, thyroid disease, certain hormonal conditions (adrenal/pituitary insufficiency, syndrome of inappropriate secretion of antidiuretic hormone- SIADH), electrolyte imbalance (hyponatremia), stomach/intestine problems (such as gastrointestinal stenosis or stricture, impaired emptying).
You may experience blurred vision, dizziness, or drowsiness due to extremely low or high blood sugar levels. Do not drive, use machinery, or do any activity that requires alertness or clear vision until you are sure you can perform such activities safely.
Limit alcohol while taking this medication because it can increase your risk of developing low blood sugar. Alcohol can rarely interact with glipizide and cause a serious reaction (disulfiram-like reaction) with symptoms such as facial flushing, nausea, vomiting, dizziness, or stomach pain. Consult your doctor or pharmacist about the safe use of alcohol.
It may be harder to control your blood sugar when your body is stressed (such as due to fever, infection, injury, or surgery). Consult your doctor because this may require a change in your treatment plan, medications, or blood sugar testing.
This medication may make you more sensitive to the sun. Avoid prolonged sun exposure, tanning booths, and sunlamps. Use a sunscreen and wear protective clothing when outdoors. Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).
Older adults may be more sensitive to the side effects of this drug, especially low blood sugar.
During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.
Pregnancy may cause or worsen diabetes. Discuss a plan with your doctor for managing your blood sugar while pregnant. Your doctor may change your diabetes treatment during your pregnancy (such as diet and medications including insulin).
It is unknown if this medication passes into breast milk. However, similar drugs pass into breast milk. Consult your doctor before breast-feeding.
DRUG INTERACTIONS: See also How to Use section.
Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.
Many drugs can affect your blood sugar levels, making it more difficult to control your blood sugar. Before you start, stop, or change any medication, talk with your doctor or pharmacist about how the medication may affect your blood sugar. Check your blood sugar levels regularly as directed by your doctor. Tell your doctor about the results and of any symptoms of high or low blood sugar. (See also Side Effects section.) Your doctor may need to adjust your anti-diabetic medication, exercise program, or diet.
Beta-blocker medications (including metoprolol, propranolol, glaucoma eye drops such as
timolol) may prevent the fast/pounding heartbeat you would usually feel when your blood sugar level falls too low (hypoglycemia). Other symptoms of low blood sugar such as dizziness, hunger, or sweating are unaffected by these drugs.
Check the labels on all your medicines (such as cough-and-cold products) because they may contain ingredients that could affect your blood sugar. Ask your pharmacist about using those products safely.
OVERDOSE: If overdose is suspected, contact a poison control center or emergency room immediately. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: shakiness, fast heartbeat, sweating, loss of consciousness.
NOTES: Do not share this medication with others. Attend a diabetes education program to learn more about diabetes and the important aspects of its treatment, including medications, diet, exercise, and getting regular eye/foot/medical exams.
Learn the symptoms of high and low blood sugar and how to treat low blood sugar. Check your blood sugar levels regularly as directed.
Keep all regular medical and laboratory appointments. Laboratory and/or medical tests (such as liver and kidney function tests, fasting blood glucose, hemoglobin A1c, complete blood counts) should be performed periodically to monitor your progress or check for side effects.
MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.
STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.
Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
MEDICAL ALERT: Your condition can cause complications in a medical emergency. For information about enrolling in MedicAlert, call 1-888-633-4298 (US) or 1-800-668-1507 (Canada).
Information last revised November 2013. Copyright(c) 2013 First Databank, Inc.
