Medical and Pharmacy Editor: Jay W. Marks, MD

GENERIC NAME: glipizide

BRAND NAME: Glucotrol

DRUG CLASS AND MECHANISM: Glipizide is an oral drug that is used for treating patients with type 2 diabetes. It belongs to the sulfonylurea class of drugs that includes glimepiride (Amaryl), glyburide (Micronase, Diabeta), tolbutamide (Orinase) and tolazamide (Tolinase).

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 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.

PRESCRIPTION: Yes

GENERIC AVAILABLE: Yes

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

STORAGE: Store below 86°F (30°;C).

PRESCRIBED FOR: Glipizide is used together with diet and exercise to reduce blood glucose in patients with type 2 diabetes.

DOSING: The usual starting dose when using immediate release tablets is 5 mg administered 30 minutes before a meal. The maximum dose is 40 mg daily. Doses higher than 15 mg per day should be divided.

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.

DRUG INTERACTIONS: 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 may reduce the absorption and consequently the effect of glipizide. Therefore, glipizide should be administered 1-2 hours before cholestyramine is administered. Fluconazole (Diflucan) may increase the absorption and therefore increase the effect of glipizide.

Many drugs can potentially increase or decrease glucose levels thus increasing or decreasing the effect of glipizide. Drug interactions which cause low blood glucose (hypoglycemia) can occur with nonsteroidal anti-inflammatory drugs (e.g., ibuprofen), sulfa drugs, warfarin, miconazole, and beta-blockers (e.g., propranolol). Drug interactions which cause high blood glucose (hyperglycemia) can occur with thiazide diuretics, corticosteroids, thyroid medicines, estrogens, niacin, phenytoin, and calcium channel blocking drugs (e.g., diltiazem). Patients should be monitored closely for loss of glucose control when such drugs are administered.

PREGNANCY: Use of glipizide during pregnancy has not been adequately studied.

NURSING MOTHERS: It is not known whether glipizide is excreted in breast milk.

SIDE EFFECTS: Side effects include headache, dizziness, diarrhea, 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 sodium concentration. Glipizide may also cause hypoglycemia. The risk of hypoglycemia increases when glipizide is combined with other glucose reducing agents.

References: Facts and Comparisons. Wolters Kluwer Health, Inc 2005, Prescribing Information for Glucotrol, Pfizer Inc. 2000

From the Doctors at MedicineNet.com

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