Glipizide

DEA Class; Rx

Common Brand Names; Glucotrol, Glucotrol XL, Minodiab

Indicated for the treatment of type 2 diabetes mellitus as an adjunct to diet and exercise to improve glycemic control.

Hypersensitivity; sulfa allergy

Type 1 diabetes

Diabetic ketoacidosis with or without coma

• Dermatologic reactions
• Abdominal pain
• Diarrhea
• Syncope
• Constipation
• Flatulence
• Dizziness
• Nervousness
• Headache
• Anxiety
• Depression
• Drowsiness
• Erythema
• Heartburn
• Maculopapular eruptions
• Hypoglycemia
• Morbilliform eruptions
• Nausea/vomiting
• Urticaria
• Cholestatic jaundice and hepatitis occur rarely but may progress to liver failure

Patients with risk of severe hypoglycemia include the elderly, debilitated, or malnourished; adrenal or pituitary insufficiency; stress due to infection, fever, trauma, or surgery; concomitant use with beta-blockers or other sympatholytic agents may impair the patient’s ability to recognize the signs and symptoms of hypoglycemia; use with caution

If patient is exposed to stress (fever, trauma, infection, surgery), it may be necessary to discontinue glipizide and initiate insulin

Use caution in hepatic/renal impairment

Use with caution in pregnancy and lactation

Increased risk of cardiovascular mortality suggested by product labeling but data is limited

FDA-approved product labeling for many medications have included a broad contraindication in patients with a prior allregic reaction to sulfonamides; however, recent studies have suggested that crossreactivity between antibiotic sulfonamides and nonantibiotic sulfonamides is unlikely to occur; increase in cardiovascular mortality suggested by product labeling but data is limited

Hypoglycemia is more likely to occur when caloric intake is deficient, after severe or prolonged exercise, when alcohol is ingested, or when more than one glucose-lowering drug is used

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; consider a nonsulfonylurea alternative

Avoid using the extended-release tablets in patients with severe gastrointestinal narrowing of esophageal dysmotility

Clinical studies have not found conclusive evidence that anti-diabetic drugs reduce macrovascular risk

Loss of efficacy following prolonged use possible; if no contributing factors, to explain loss of efficacy identified, consider discontinuing therapy; additional antidiabetic therapy will be required

Available data from a small number of published studies and postmarketing experience with in pregnancy over decades have not identified any drug associated risks for major birth defects, miscarriage, or adverse maternal outcomes

Breastfed infants of lactating women on therapy should be monitored for symptoms of hypoglycemia; although glipizide was undetectable in human milk in one small clinical lactation study

Glipizide

tablet

• 5mg
• 10mg

tablet, extended-release

• 2.5mg
• 5mg
• 10mg