Glipizide

Indications
 Oral
Type 2 diabetes mellitus
Adult: Initially, 2.5-5 mg daily as a single dose, increased gradually at increments of 2.5-5 mg daily after several days. Doses >15 mg may be given in 2 divided doses. Max: 40 mg daily.
Contraindications
 Hypersensitivity. Type 1 DM; ketoacidosis; severe renal or hepatic insufficiency. Pregnancy, lactation.
Warnings / Precautions
 Hypoglycaemia, stress, elderly. Thyroid impairment; moderate hepatic or renal impairment. Monitor blood glucose concentration.
Adverse Reactions
 GI upsets, diarrhoea, nausea; allergic skin reactions, leucopenia, thrombocytopenia, agranulocytosis, hyponatraemia; jaundice; haemolytic anaemia, pancytopenia.
Potentially Fatal: Hypoglycaemia in presence of renal or hepatic damage and alcohol.
Overdose Reactions
 Mild hypoglycaemic symptoms may be treated with oral glucose and adjustments in drug dosage and/or meal patterns. Monitor closely until patient is out of danger. Severe hypoglycaemic reactions with coma, seizure, or other neurological impairment may occur requiring immediate hospitalisation. If hypoglycaemic coma is diagnosed or suspected, patient may be given rapid IV inj of concentrated (50%) glucose solution, followed by continuous infusion of a more dilute (10%) glucose solution at a rate that will maintain the blood glucose level >100 mg/dL. Close monitoring for the next 24-48 hr is advisable as hypoglycemia may recur.
Drug Interactions
 Decreased effect with β-blockers, cholestyramine, hydantoins, thiazide diuretics and urinary alkalinizers. Increased hypoglycaemic effects with H2 antagonists, anticoagulants, androgens, cimetidine, salicylates, TCAs, fluconazole, gemfibrozil, ketoconazole, NSAIDs, pioglitazone, sulfonamides, probenecid, MAOIs, methyldopa, digitalis glycosides and urinary acidifiers.
See Below for More glipizide Drug Interactions
Mechanism of Actions
 Glipizide stimulates insulin release from pancreatic β-cells and reduces gluconeogenesis in liver cells. It also increases insulin sensitivity at target sites.
Duration: 24 hr.
Absorption: Readily absorbed from the GI tract (oral); peak plasma concentrations after 1-3 hr.
Distribution: Protein-binding: Extensive.
Metabolism: Hepatic.
Excretion: Urine (as inactive metabolites); faeces; 2-4 hr (elimination half-life).
Administration
 Immediate-release: Should be taken on an empty stomach. (Take ½ hr before meals.)
Extended-release: Should be taken with food. (Swallow whole, do not chew/crush/divide.)
ATC Classification
 A10BB07 - glipizide ; Belongs to the class of sulfonamides, urea derivatives. Used in the treatment of diabetes.
Available As
  • Glipizide 10 mg
  • Glipizide 2.5 mg
  • Glipizide 5 mg
  • Glipizide 7.5 mg

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