glipizide/metformin (Metaglip) (cont.)

Pharmacy Author:
Medical and Pharmacy Editor:

Metformin can cause a rare but serious condition known as lactic acidosis, a build-up of acid in the blood. Lactic acidosis can cause death and requires immediate treatment.

Symptoms of lactic acidosis include:

  • tiredness,
  • weakness,
  • unusual muscle pain,
  • pain in the stomach,
  • difficulty breathing,
  • dizziness, and
  • slow or irregular heartbeat.

Patients suspected of presenting with signs or symptoms of lactic acidosis must seek emergency medical help.

PRESCRIPTION: Yes

GENERIC AVAILABLE: Yes

PREPARATIONS: Oral tablets (glipizide/metformin): 2.5/250, 2.5/500 or 5/500 mg

STORAGE: Tablets should be stored at room temperature between 15 C to 30 C (59 F to 86 F).

DOSING:

  • For patients inadequately controlled on diet and exercise alone: Generally, the recommended starting dose of glipizide/metformin is 2.5/250 mg administered once or twice daily. A starting dose of 2.5/500 mg twice daily may be considered for patients with fasting plasma glucose (FPG) of 280-320 mg/dL. If necessary, dosage may be increased by 1 tablet daily every 2 weeks to achieve adequate blood glucose control. The maximum daily dose is 20/2000 mg. Avoid starting treatment with the 5/500 mg strength due to the risk of hypoglycemia (low blood glucose levels).
  • For patients inadequately controlled on glipizide or metformin monotherapy: Treatment may be started with either 2.5/500 mg or 5/500 mg administered by mouth twice daily with meals. To avoid hypoglycemia, the starting dose must not exceed the current dose of glipizide or metformin that the patient has been already taking.
  • For patients who are already taking a combination of sulfonylurea/metformin who desire to switch to a combination pill: To avoid hypoglycemia, avoid exceeding the current dose of sulfonylurea and metformin. If necessary, dose may be increased gradually to the minimum dosage required to achieve adequate blood glucose control.
  • Patients with liver disease: Use of glipizide/metformin in patients with liver disease is generally not recommended. Liver disease increases the risk of metformin associated lactic acidosis, a rare but potentially fatal condition which causes an accumulation of acid in the body.
  • Patients with kidney disease: Metformin should not be used in females with serum creatinine concentration > 1.4 mg/dL or in males with serum creatinine concentration > 1.5 mg/dL.
  • Pediatrics: The safety and efficacy of glipizide/metformin has not been established in pediatric patients. Therefore, use of glipizide/metformin in this patient population is not recommended.
Medically Reviewed by a Doctor on 2/5/2015


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