Glipizide

Introduction: Glipizide is a medicine used to treat type 2 diabetes mellitus in adults. It belongs to a group of medicines called sulfonylureas and helps control blood sugar levels in people with diabetes.

How it works: Glipizide stimulates insulin release from pancreatic beta-cells and reduces glucose output from the liver. It also increases insulin sensitivity at peripheral target sites.

Important Information: Take on an empty stomach (30 minutes before a meal). Take it regularly at the same time each day. Do not stop without consulting your doctor. Regular blood sugar monitoring is recommended.

• Type 2 diabetes mellitus (NIDDM) - as an adjunct to diet and exercise

Sulfonylureas

Sulfonylurea antidiabetic

Glipizide lowers blood glucose by stimulating the release of insulin from the pancreas, an effect dependent upon functioning beta cells. The extrapancreatic effects of Glipizide are increase in insulin sensitivity and decrease in hepatic glucose production.

Glipizide increases insulin secretion from the pancreas and reduces liver glucose production to lower blood sugar levels.

Adult Dose:

• Initial: 2.5-5 mg daily as a single dose
• Adjust at intervals of several days in increments of 2.5-5 mg
• Doses >15 mg may be given in 2 divided doses
• Maximum: 40 mg daily

Extended-release tablets:

• Initial: 5 mg/day with breakfast
• Maintenance: 5-10 mg once daily, not to exceed 20 mg/day

Elderly: Initial 2.5 mg once daily

Renal Impairment (GFR <50): Decrease dose by 50%

* Use as directed by the registered physician

Oral tablet. Take on an empty stomach (30 minutes before a meal). Swallow whole, do not chew or crush.

If a meal is skipped, skip the dose, and add a dose if you eat an extra meal.

Common Side Effects:

• Dizziness
• Diarrhea
• Nervousness
• Tremor
• Hypoglycemia (low blood sugar)
• Flatulence

Other Side Effects:

• Gastrointestinal complaints (nausea, constipation)
• Allergic skin reactions
• Hematologic reactions (leukopenia, thrombocytopenia)

Precautions:

• All sulfonylurea drugs are capable of producing severe hypoglycemia.
• Irregular meals, skipping meals or fasting may cause hypoglycemia.
• Avoid alcohol (increases hypoglycemia risk).
• Renal or hepatic insufficiency may cause elevated blood levels of Glipizide.
• Elderly, debilitated or malnourished patients are particularly susceptible to hypoglycemia.

Contraindications:

• Hypersensitivity to Glipizide or any component
• Juvenile onset diabetes (Type 1)
• Severe or unstable 'brittle' diabetes
• Diabetes complicated by ketosis and acidosis
• Severe renal, hepatic or thyroid impairment
• Pregnancy and lactation

Drug Interactions:

• May increase hypoglycemic effect with NSAIDs, salicylates, sulfonamides, chloramphenicol, probenecid, coumarins, MAOIs, beta-blockers
• May decrease hypoglycemic effect with thiazide diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, OC, phenytoin, rifampicin

Food Interactions:

• Unsafe to consume alcohol with Glipizide.

Use in Pregnancy: Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Discontinue at least one month before expected delivery date.

Use in Lactation: It is not known whether Glipizide is excreted in human milk. Breastfeeding is not recommended.

Pediatric Use: Safety and efficacy in children have not been established.

Geriatric Use: Initial dose 2.5 mg once daily. May be more sensitive to hypoglycemia.

Renal Impairment: If GFR <50 mL/min, decrease dose by 50%. Not recommended in severe kidney disease.

Hepatic Impairment: Initial dose 2.5 mg once daily. Not recommended in severe liver disease.

Overdose: Hypoglycemia may occur. Mild hypoglycemia: oral glucose and dose adjustment. Severe hypoglycemia: IV glucose, glucagon. Monitor for at least 24-48 hours.

Storage: Keep below 30°C, away from light and moisture. Keep out of reach of children.

Glipizide Tablet