- Type 2 Diabetes: Learn the Warning Signs
- Diabetes Friendly Dining
- Type 2 Diabetes: Test Your Medical IQ
- 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?
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:
- 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).
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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Related Disease Conditions
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.
Diabetes (Type 1 and Type 2)
Diabetes is a chronic condition characterized by high levels of sugar (glucose) in the blood. The two types of diabetes are referred to as type 1 (insulin dependent) and type 2 (non-insulin dependent). Symptoms of diabetes include increased urine output, thirst, hunger, and fatigue. Treatment of diabetes depends on the type.
Low Blood Sugar (Hypoglycemia)
Low blood sugar, or hypoglycemia, is a syndrome in which a person's blood sugar is dangerously low. People with type 1 and type 2 diabetes are at risk for this condition. There are other diseases that can cause a person's blood sugar levels to go too low, for example, pancreatitis, Cushing's syndrome, and pancreatic cancer. Symptoms and signs that your blood sugar levels are too low include palpitations, trembling, intense hunger, sweating, nervousness, and weakness. If your blood sugars become too low, use these nearby as a quick treatment table sugar, soda, juice, and glucose tablets.
Diabetes Treatment (Type 1 and Type 2 Medications and Diet)
The major goal in treating diabetes is controlling elevated blood sugar without causing abnormally low levels of blood sugar. Type 1 diabetes is treated with: insulin, exercise, and a diabetic diet. Type 2 diabetes is first treated with: weight reduction, a diabetic diet, and exercise. When these measures fail to control the elevated blood sugar, oral medications are used. If oral medications are still insufficient, insulin medications are considered.
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.
Type 1 vs Type 2 Diabetes (Similarities and Differences)
Diabetes mellitus is a metabolic condition in which a person's blood sugar (glucose) levels are too high. Over 29.1 million children and adults in the US have diabetes. Of that, 8.1 million people have diabetes and don't even know it. Type 1 diabetes (insulin-dependent, juvenile) is caused by a problem with insulin production by the pancreas. Type 2 diabetes (non-insulin dependent) is caused by: Eating a lot of foods and drinking beverages with simple carbohydrates (pizza, white breads, pastas, cereals, pastries, etc.) and simple sugars (donuts, candy, etc.) Consuming too many products with artificial sweeteners (We found out that they are bad for us!) Lack of activity Exercise Stress Genetics While the signs and symptoms of both types of diabetes are the same, which include: Increased urination Increased hunger Increased thirst Unexplained weight loss. However, the treatments are different. Type 1 diabetes is insulin dependent, which means a person with this type of diabetes requires treatment with insulin. People with type 2 diabetes require medication, lifestyle changes like eating a healthy diet, and getting regular exercise.
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 and Foot Problems (Treatment)
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
Diabetes and eye problems are generally caused by high blood sugar levels over an extended period of time. Types of eye problems in a person with diabetes include glaucoma, cataracts, and retinopathy. Examples of symptoms include blurred vision, headaches, eye aches, pain, halos around lights, loss of vision, watering eyes. Treatment for eye problems in people with diabetes depend on the type of eye problem. Prevention of eye problems include reducing blood pressure, cholesterol levels, quitting smoking, and maintaining proper blood glucose levels.
Diabetes and Kidney Disease
In the United States diabetes is the most common cause of kidney failure. High blood pressure and high levels of blood glucose increase the risk that a person with diabetes will eventually progress to kidney failure. Kidney disease in people with diabetes develops over the course of many years. albumin and eGFR are two key markers for kidney disease in people with diabetes. Controlling high blood pressure, blood pressure medications, a moderate protein diet, and compliant management of blood glucose can slow the progression of kidney disease. For those patients who's kidneys eventually fail, dialysis or kidney transplantation is the only option.
Fitness: Exercise for a Healthy Heart
Regular exercise can help reduce the risk of heart disease. To achieve maximum benefits, do a mix of stretching exercise, aerobic activity, and strengthening exercise. Aim to get 20 to 30 minutes of aerobic exercise at least three to four times a week. Consult a doctor before exercising for the first time, especially if you have health problems.
Type 2 Diabetes Medications (Side Effects, Differences)
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.
Regular physical activity can reduce the risk of disease. Regular exercise can also reduce the symptoms of stress and anxiety. There are fitness programs that fit any age or lifestyle.
Diabetes: Caring for Your Diabetes at Special Times
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