- What is glipizide/metformin? What is glipizide/metformin used for?
- What are the uses for glipizide/metformin?
- What are the side effects of glipizide/metformin?
- What is the dosage for glipizide/metformin?
- Which drugs or supplements interact with glipizide/metformin?
- Is glipizide/metformin safe to use during pregnancy or while breastfeeding?
- What else should I know about glipizide/metformin?
What is glipizide/metformin? What is glipizide/metformin used for?
Glipizide/metformin is a
combination antidiabetic medication that contains two commonly used glucose
lowering agents, glipizide (Glucotrol) and metformin (Glucophage). These agents
work in different, yet complementary ways to improve
blood glucose control in
type 2 diabetes.
- 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 blood sugar.
- Metformin is an oral biguanide antidiabetic medication that decreases the production of glucose in the liver, decreases the absorption of glucose by the intestines, and 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.
- Combination glipizide and metformin was approved by the FDA in October 2002.
What brand names are available for glipizide/metformin?
- There are no brand names available for glipizide/metformin in the US.
- Metaglip is a discontinued brand name for glipizide/metformin.
Do I need a prescription for glipizide/metformin?
What are the uses for glipizide/metformin?
- Glipizide/metformin is used as an adjunct to diet and exercise to improve blood glucose control in adults with type 2 diabetes.
What are the side effects of glipizide/metformin?
The most common side effects associated with glipizide/metformin treatment are:
- High blood pressure
- Muscle or joint pain
- Upper respiratory tract infection
- Urinary tract infection (UTI)
Side effects related to the stomach were most commonly reported by patients who newly started treatment with glipizide/metformin and included:
Other less common but potentially serious side effects include:
- Blood disorders
- Liver disease
- Kidney disease
- Photosensitivity (sun sensitivity)
- Syndrome of inappropriate antidiuretic hormone secretion (SIADH)
- Ovulation induction
- Low sodium levels (hyponatremia)
- Disulfiram-like reactions (for example, heart palpitations, nausea, vomiting, dizziness, and headache)
- Reduced number of platelets
- Reduced number of white blood cells
- Hypersensitivity type reactions
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:
- Unusual muscle pain
- Pain in the stomach
- Difficulty breathing
- Slow or irregular heartbeat
Patients suspected of presenting with signs or symptoms of lactic acidosis must seek emergency medical help.
What is the dosage for glipizide/metformin?
- 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, the 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.
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Which drugs or supplements interact with glipizide/metformin?
Drugs which cause blood glucose levels to increase may diminish the
effectiveness of glipizide/metformin therapy. These drugs include:
- Thiazides and other diuretics
- Thyroid medications
- Birth control pills
- Phenytoin (Dilantin)
- Nicotinic acid
- Calcium channel blockers (CCBs)
- Isoniazid (Nydrazid)
- 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.
Is glipizide/metformin safe to use during pregnancy or while breastfeeding?
- Glipizide/metformin has not been adequately evaluated in pregnant women. Due to the lack of conclusive safety data, glipizide/metformin should be avoided 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 recommended.
What else should I know about glipizide/metformin?
What preparations of glipizide/metformin are available?
- Oral tablets (glipizide/metformin): 2.5/250, 2.5/500 or 5/500 mg
How should I keep glipizide/metformin stored?
- Tablets should be stored at room temperature between 15 C and 30 C (59 F and 86 F).
Subscribe to MedicineNet's Diabetes Newsletter
Glipizide/metformin hydrochloride (Metaglip has been discontinued in the US) is a combination of two antidiabetic medications prescribed in conjunction with diet and exercise to improve blood glucose control in adults with type 2 diabetes. Side effects include high blood pressure, muscle or joint pain, upper respiratory tract infection, urinary tract infection, vomiting, stomach pain, decreased appetite, metallic taste in the mouth.
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Type 2 Diabetes Diet Plan
A type 2 diabetes diet or a type 2 diabetic diet is important for blood sugar (glucose) control in people with diabetes to prevent complications of diabetes. There are a variety of type 2 diabetes diet eating plans such as the Mediterranean diet, Paleo diet, ADA Diabetes Diet, and vegetarian diets.Learn about low and high glycemic index foods, what foods to eat, and what foods to avoid if you have type 2 diabetes.
High Blood Sugar (Hyperglycemia)
Hyperglycemia or high blood sugar is a serious health problem for diabetics. There are two types of hyperglycemia, 1) fasting, and 2)postprandial or after meal hyperglycemia. Hyperglycemia can also lead to ketoacidosis or hyperglycemic hyperosmolar nonketotic syndrome (HHNS). There are a variety of causes of hyperglycemia in people with diabetes. Symptoms of high blood sugar may include increased thirst, headaches, blurred vision, and frequent urination.Treatment can be achieved through lifestyle changes or medications changes. Carefully monitoring blood glucose levels is key to prevention.
Low Blood Sugar (Hypoglycemia)
Low blood sugar or hypoglycemia occurs when blood sugar is dangerously low and is often complication of type 1 and type 2 diabetes. Learn about symptoms, dangers, and treatment.
A stroke is an interruption of the blood supply to part of the brain caused by either a blood clot (ischemic) or bleeding (hemorrhagic). Symptoms of a stroke may include weakness, numbness, double vision or vision loss, confusion, vertigo, difficulty speaking, or understanding speech. A physical exam, imaging tests, neurological exam, and blood tests may be used to diagnose a stroke. Treatment may include administration of clot-busting drugs, supportive care, and in some instances, neurosurgery. The risk of stroke can be reduced by controlling high blood pressure, high cholesterol, diabetes, and stopping smoking.
Type 2 Diabetes
Type 2 diabetes is a chronic condition that may be reversible with diet and lifestyle changes. Symptoms include excessive thirst, frequent urination, weight loss, fatigue, and an unusual odor to your urine. Most people don't know they have type 2 diabetes until they have a routine blood test. Treatment options include medications, a type 2 diabetes diet, and other lifestyle changes.
Diabetes Treatment: Medication, Diet, and Insulin
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Type 1 vs. Type 2 Diabetes: Differences
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Diabetes Foot Problems
Diabetes related foot problems can affect your health with two problems: diabetic neuropathy, where diabetes affects the nerves, and peripheral vascular disease, where diabetes affects the flow of blood. Common foot problems for people with diabetes include athlete's foot, fungal infection of nails, calluses, corns, blisters, bunions, dry skin, foot ulcers, hammertoes, ingrown toenails, and plantar warts.
Eye Problems and Diabetes
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Types of Diabetes Type 2 Medications
Type 2 diabetes oral medications are prescribed to treat type 2 diabetes in conjuction with lifestyle changes like diet and exercise. There are nine classes of drugs approved for the treatment of type 2 diabetes. Examples of type 2 oral diabetes medications include acarbose (Precose), chlorpropamide (Diabinese), glipizide (Glucotrol, Glucotrol XL), and metformin (Glucophage). Side effects, drug interactions, warnings and precautions, dosage, and breastfeeding and pregnancy safety information should be reviewed prior to taking any medication.
Tips for Managing Type 1 and 2 Diabetes at Home
Managing your diabetes is a full time commitment. The goal of diabetic therapy is to control blood glucose levels and prevent the complications of diabetes. Information about exercise, diet, and medication will help you manage your diabetes better. Blood glucose reagent strips, blood glucose meters, urine glucose tests, tests for urinary ketones, continuous glucose sensors, and Hemoglobin A1C testing information will enable you to mange your diabetes at home successfully.
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