PREPARATIONS: Oral tablets (glipizide/metformin): 2.5/250, 2.5/500 or 5/500 mg
- Drugs which cause blood glucose levels to increase may diminish the effectiveness of glipizide/metformin therapy. These drugs include
- Cimetidine (Tagamet), by decreasing the elimination of metformin from the body, can increase the amount of metformin in the blood by 40%. This may increase the frequency of side effects from metformin.
- Alcohol consumption increases the effect of metformin on lactate production, increasing the risk of lactic acidosis.
- Due to the risk of lactic acidosis, metformin containing products must be temporarily discontinued prior to the administration of radiopaque contrast dyes.
- Metformin should be held for at least 48 hours after contrast dye administration and should not be restarted until patient's kidney function returns back to normal.
- Beta blockers may increase the blood glucose lowering actions of sulfonylureas. Cardio-selective beta blockers such as acebutolol (Sectral), atenolol (Tenormin), metoprolol (Lopressor or Toprol XL), and penbutolol (Levatol) may be safer than their nonselective counterparts.
- Colesevelam (Welchol) may reduce blood levels of glipizide. Patients are advised to take glipizide 1 hour before or 4 hours after colesevelam administration to minimize the risk of their interaction.
- Concomitant use of systemic antifungals such as fluconazole (Diflucan), itraconazole (Sporanox), ketoconazole (Nizoral), miconazole, and voriconazole (VFEND) with glipizide may cause hypoglycemia.
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