Glipizide

Introduction

  • Generic Name: Glipizide
  • Brand Names: Glucotrol, Glucotrol XL
  • Pharmacological Class: Sulfonylurea
  • Mechanism of Action: Increases insulin production from the pancreas, leading to improved blood sugar control in type 2 diabetes patients.

Indications

  • Primary Use: Treatment of type 2 diabetes mellitus to improve blood glucose control.
  • Other Uses: Sometimes used in combination with other antidiabetic medications or diet and exercise to achieve better glycemic control.

Dosage

  • Adults: Initial dose is typically 5 mg orally once a day, 30 minutes before breakfast. Adjustments are made based on the patient’s response and blood sugar levels, up to a maximum of 40 mg per day.
  • Elderly: Start at a lower dose to reduce the risk of hypoglycemia.
  • Children: Not recommended for use in children.

Administration

  • Method: Oral intake.
  • Precautions: Should be taken 30 minutes before a meal to ensure that it works by the time food is being digested, increasing insulin availability.

Forms Available

  • Immediate-Release Tablets: 5 mg, 10 mg
  • Extended-Release Tablets (Glucotrol XL): 2.5 mg, 5 mg, 10 mg

Side Effects

  • Common: Hypoglycemia (low blood sugar), gastrointestinal disturbances such as nausea and diarrhea.
  • Less Common: Dizziness, headache, skin reactions.
  • Rare but Serious: Hepatic porphyria, severe hypoglycemic reactions, hematologic changes.

Warnings

  • Black Box Warning: None.
  • Contraindications: Known hypersensitivity to glipizide or any other sulfonylurea, diabetic ketoacidosis, and in patients with severe renal or hepatic impairment.

Precautions

  • General: Closely monitor blood glucose levels to avoid hypoglycemia. Be aware that stress, illness, surgery, exercise, alcohol use, or skipping meals can affect blood sugar levels.
  • Health Conditions: Use cautiously in patients with liver or kidney dysfunction as metabolism and excretion may be affected.

Interactions

  • Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs), other antidiabetics, alcohol, beta-blockers, and warfarin can increase the hypoglycemic effects.
  • Food: Alcohol can potentiate the effect of glipizide and worsen hypoglycemia.

Monitoring Parameters

  • Blood Glucose Levels: Frequent monitoring, especially during initiation of therapy and during periods of dosage adjustments.
  • Hemoglobin A1c (HbA1c): Every 3 to 6 months to assess long-term glycemic control.
  • Liver and Kidney Function: Regular monitoring due to metabolism and excretion pathways.

Use in Children

  • Guidelines: Not recommended for use in children due to lack of safety and efficacy data.

Use in Pregnancy

  • FDA Category: C. Should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Use in Elderly

  • Considerations: More prone to experiencing hypoglycemia. Lower initial dosages and cautious titration are advised.

Use in Kidney Disease

  • Adjustments: Dose adjustments may be necessary due to reduced drug clearance.

Use in Liver Disease

  • Caution: Metabolism of glipizide could be impaired in liver disease, requiring dose adjustments or monitoring.

Patient Counselling Points

  • Medication Use: Emphasize the importance of taking glipizide 30 minutes before meals and following the prescribed dietary plan.
  • Side Effects: Teach patients to recognize signs of hypoglycemia and have a source of sugar available at all times.
  • Lifestyle: Discuss the role of regular physical activity and maintaining a healthy diet in managing diabetes.

Table of Brand Names, Manufacturer, and Prices in USD

Brand NameManufacturerStrength/Dosage FormPrice (USD)
GlucotrolPfizer10 mg Tablet$0.50
Glucotrol XLPfizer10 mg Extended-Release Tablet$0.75

15 FAQs with Answers

  1. What is Glipizide used for? – To improve blood sugar control in adults with type 2 diabetes.
  2. How does Glipizide work? – By stimulating insulin release from the pancreas.
  3. Can Glipizide be taken with other diabetes medications? – Yes, but it must be closely monitored to avoid hypoglycemia.
  4. What are the signs of hypoglycemia? – Symptoms include shaking, sweating, fast heartbeat, dizziness, and hunger.
  5. Is Glipizide safe during pregnancy? – It is FDA Category C. Discuss potential risks and benefits with your doctor.
  6. Can I drink alcohol while taking Glipizide? – Alcohol can increase the risk of hypoglycemia and should be consumed with caution.
  7. How should I take Glipizide? – As prescribed, typically 30 minutes before meals.
  8. What should I do if I miss a dose of Glipizide? – Take it as soon as you remember if it is not close to the time of your next dose.
  9. How often should I monitor my blood sugar? – Frequently, especially when starting therapy or adjusting doses.
  10. Can Glipizide cause weight gain? – It can cause weight gain as a side effect, unlike some other diabetes medications.
  11. What if I experience severe hypoglycemia? – Have a source of fast-acting sugar available and seek medical attention.
  12. Who should not take Glipizide? – People with diabetic ketoacidosis or severe liver or kidney disease.
  13. How long does Glipizide take to work? – It begins to work within 30 minutes to an hour after ingestion.
  14. What are the long-term effects of taking Glipizide? – Monitoring is needed for potential liver or kidney issues.
  15. Can I stop taking Glipizide on my own? – Stopping Glipizide suddenly can cause high blood sugar levels. Consult your doctor before making any changes.