glipizide (Glipizide XL, Glucotrol)

Glipizide is an oral drug that is used for treating patients with type 2 diabetes. It belongs to the sulfonylurea class of drugs which also includes glimepiride (Amaryl), glyburide (Diabeta, Glynase), tolbutamide and tolazamide. Insulin is a hormone that is made in the pancreas that when released into the blood causes cells in the body to remove sugar (glucose) from the blood and reduces the formation of glucose by the liver. Patients with type 2 diabetes have high glucose (sugar) levels in their blood because the cells in their bodies are resistant to the glucose-removing effect of the insulin, and the liver produces too much glucose. In addition, in type 2 diabetes the pancreas is unable to produce the increased amounts of insulin that are necessary to overcome the resistance. Glipizide reduces blood glucose by stimulating the pancreas to produce more insulin.

Glipizide is not a cure for diabetes.

The FDA approved glipizide in May 1984.

Glipizide XL, Glucotrol, Glucotrol XL

GENERIC AVAILABLE: Yes

Yes

Side effects include:

headache,

dizziness,

nausea,

vomiting,

diarrhea,

heartburn, and

gas.

Skin rashes can occur and cause itching, hives, or a diffuse measles-like rash.

Rare but serious side effects include:

• hepatitis,
• jaundice, and
• a low blood sodium concentration (hyponatremia).

Glipizide also may cause hypoglycemia. The risk of hypoglycemia increases when glipizide is combined with other glucose reducing agents.

• The usual starting dose when using immediate release tablets is 5 mg daily administered 30 minutes before a meal.
• The maximum dose is 40 mg daily.
• Doses higher than 15 mg per day should be divided and given in divided doses daily.
• The starting dose when using extended-release tablets is 5 mg daily up to a maximum dose of 20 mg daily.
• Patients using immediate release tablets may be converted to the nearest equivalent extended-release dose.

:

• Alcohol may prolong the action of glipizide by delaying the absorption and elimination of glipizide. Patients taking glipizide should keep alcohol consumption to a minimum.
• Cholestyramine (Questran, Questran Light) may reduce both the absorption and effects of glipizide. Glipizide should therefore be administered 1-2 hours before cholestyramine is given.
• Fluconazole (Diflucan) also can increase the absorption and effects of glipizide.
• Many drugs can potentially increase or decrease glucose levels thus increasing or decreasing the effects of glipizide. Drug interactions that cause low blood glucose (hypoglycemia) can occur with:
  • nonsteroidal anti-inflammatory drugs (for example [ibuprofen]),
  • sulfa drugs,
  • warfarin (Coumadin),
  • miconazole (Oravig),
  • fluconazole (Diflucan),
  • voriconazole (Vfend),
  • beta-blockers (for example, propranolol [Inderal, Inderal LA, Innopran XL]),
  • androgens (for example fluoxymesterone [Androxy]),
  • chloramphenicol,
  • cimetidine (Tagamet HB),
  • ranitidine (Zantac),
  • clarithromycin (Biaxin),
  • MAO Inhibitors (for example, isocarboxazid [Marplan] and phenelzine [Nardil]),
  • mifepristone (Mifeprex),
  • probenecid,
  • quinolone antibiotics, and
  • selective serotonin reuptake inhibitors (for example paroxetine [Paxil], fluoxetine [Prozac], and sertraline [Zoloft].
• Drug interactions involving glipizide which can result in high blood glucose (hyperglycemia) can occur with:
  • thiazide diuretics (for example, hydrochlorothiazide [Microzide]),
  • loop diuretics (for example, furosemide [Lasix]),
  • corticosteroids such as prednisone and methylprednisolone (Medrol),
  • phenytoin (Dilantin),
  • colesevelam (Welchol),
  • danazol and somatropin (Genotropin).
• Rifampin may reduce the blood levels of glipizide and this may result in higher levels of sugar in the blood.

Studies of adverse effects in animal studies indicate that glipizide crosses the placenta. It is not recommended to use glipizide for the routine management of diabetes in pregnant women. Insulin is preferred. In the event that glipizide is used during pregnancy, the manufacturer recommends that it be stopped at least 1 month before the expected date of delivery.

According to reports, glipizide is not found in breast milk. However, the risk of developing hypoglycemia in the nursing infant should be weighed against the potential benefit to the monther of taking glipizide and a decision should be made to discontinue the drug or to discontinue breastfeeding.

What preparations of glipizide are available?

: Immediate-release tablets; 5 and 10 mg. Extended-release tablets; 2.5, 5, and 10 mg.

How should I keep glipizide stored?

Glipizide should be stored between 15 C and 30 C (59 F and 86 F).