Formulary
Glipizide: Indications, Dosing, Side Effects and Interactions
The sulfonylureas act mainly by augmenting insulin secretion and consequently are effective only when some residual pancreatic beta-cell activity is present;...
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Glipizide: Indications, Dosing, Side Effects and Interactions
The sulfonylureas act mainly by augmenting insulin secretion and consequently are effective only when some residual pancreatic beta-cell activity is present;...
Drug action
The sulfonylureas act mainly by augmenting insulin secretion and consequently are effective only when some residual pancreatic beta-cell activity is present; during long-term administration they also have an extrapancreatic action.
Indications and dose
**Type 2 diabetes mellitus**
- **Adult** (By Mouth): Initially 2.5-5 mg daily, adjusted according to response, dose to be taken shortly before breakfast or lunch, doses up to 15 mg may be given as a single dose, higher doses to be given in divided doses; maximum 20 mg per day.
Cautions
Can encourage weight gain; elderly; G6PD deficiency Cautions, further information Elderly Screening Tool of Older Persons' potentially inappropriate Prescriptions (STOPP) criteria to aid medication reviews (see Prescribing in the elderly for information): potentially inappropriate if prescribed a long-acting sulfonylurea (e.g. glibenclamide, chlorpropamide, glimepiride) in type 2 diabetes mellitus (risk of prolonged hypoglycaemia). Cautions For glipizide Cautions, further information Porphyria Sulfonylureas should be avoided where possible in Acute porphyrias but glipizide is thought to be safe.
Contraindications
Presence of ketoacidosis
Side effects
Common or very common Abdominal pain; diarrhoea; hypoglycaemia; nausea Uncommon Hepatic disorders; vomiting Rare or very rare Agranulocytosis; erythropenia; granulocytopenia; haemolytic anaemia; leucopenia; pancytopenia; thrombocytopenia Frequency not known Allergic dermatitis (usually in the first 6-8 weeks of therapy); constipation; photosensitivity reaction; skin reactions; visual impairment Side-effects For glipizide Common or very common Abdominal pain upper Uncommon Dizziness; drowsiness; tremor; vision disorders Frequency not known Confusion; headache; hyponatraemia; malaise
Interactions
**Other interactions (16):**
- Alcohol Increase in hypoglycaemic reaction, which can lead to hypoglycaemic coma.
- Voriconazole Although not studied, voriconazole may increase the plasma levels of sulfonylureas, (e.g.
- Careful monitoring of blood glucose is recommended during co-administration.
- Beta-blockers All beta-blockers mask some of the symptoms of hypoglycaemia (i.e.
- Most non cardio selective beta-blockers increase the incidence and severity of hypoglycaemia.
- Cimetidine The use of cimetidine may be associated with a reduction in post prandial blood glucose in patients treated with glipizide.
Pregnancy
The use of sulfonylureas in pregnancy should generally be avoided because of the risk of neonatal hypoglycaemia.
Breast feeding
Avoid-theoretical possibility of hypoglycaemia in the infant.
Hepatic impairment
In general, manufacturers advise avoid in severe impairment (increased risk of hypoglycaemia). Hepatic impairment For glipizide Manufacturer advises caution in mild to moderate impairment. Dose adjustments Manufacturer advises consider initial dose of 2.5 mg daily and conservative maintenance dosing in mild to moderate impairment.
Renal impairment
Sulfonylureas should be used with care in those with mild to moderate renal impairment, because of the hazard of hypoglycaemia. Care is required to use the lowest dose that adequately controls blood glucose. Avoid where possible in severe renal impairment.
Medicinal forms
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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