glipizide, Glucotrol, Glucotrol XL

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GENERIC NAME: glipizide

BRAND NAME: Glucotrol, Glucotrol XL

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 which also 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 glucose-removing 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. The FDA approved glipizide in May 1984.



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

STORAGE: Glipizide should be stored between 15-30 C (59-86 F).

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 daily administered 30 minutes before a meal. The maximum dose is 40 mg daily. Doses higher than 15 mg per day should be divided and given as a divided doses daily. 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 (Questran, Questran Light) 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 for example,(ibuprofen), sulfa drugs, warfarin (Coumadin), miconazole, and beta-blockers (for example, propranolol [Inderal, Inderal LA, Innopran XL]). Drug interactions which cause high blood glucose (hyperglycemia) can occur with thiazide diuretics, corticosteroids, thyroid medicines, estrogens, niacin, phenytoin, and calcium channel blocking drugs (for example, diltiazem [Cardizem, Dilacor, Tiazac]). Patients should be monitored closely for loss of glucose control when such drugs are administered.

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