Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
Glipizide/metformin has not been adequately evaluated in pregnant
women. Due to the lack of conclusive safety data, glipizide/metformin should be
during pregnancy if possible. Glipizide/metformin is classified as FDA
pregnancy risk category C (animal reproduction studies have shown an adverse
effect on the fetus and there are no adequate and well-controlled studies in
humans, but potential benefits may warrant use of the drug in pregnant women
despite potential risks).
It is not known if glipizide/metformin is excreted in breast
milk. Due to the lack of safety data and the potential risk for hypoglycemia in
the nursing infant, use of glipizide/metformin during
breastfeeding is not
STORAGE: Tablets should be stored at room temperature between 15 C to 30 C
(59 F to 86 F).
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
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
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, the dose may
be increased gradually to the minimum dosage required to achieve adequate blood
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.
Glipizide is a second generation oral sulfonylurea that lowers blood glucose
by stimulating the production of
insulin from the pancreas. It is the major
hormone responsible for regulating
an oral biguanide antidiabetic medication that decreases the production of
glucose in the
liver, decreases the absorption of glucose by the
increases response to insulin.
In clinical studies, glipizide/metformin therapy was superior in improving
fasting plasma glucose, postprandial plasma glucose (blood glucose levels after
a meal), and
HbA1c versus treatment with either agent alone.
was approved by the FDA in October 2002.