Glipizide is an oral hypoglycemic agent of the second generation sulfonylurea class used in Type 2 diabetes.
USES FOR GLIPIZIDE
- Used for Type 2 diabetes
- Type 2 diabetes is also called adult onset diabetes which is characterized by high blood sugar, insulin resistance & relative lack of insulin.
- Given along with a diabetic diet.
- Glipizide not indicated for use in type 1 diabetes.
- The drug is a second generation sulfonylurea hypoglycemic agent, therefore it has rapid absorption & mechanism of action.
- Glipizide also has a higher potency for reduction of sugar levels.
- The drug acts by sensitizing the beta cells of the pancreas and therefore stimulates more release of insulin.
Dosage forms available:
- Tablet: 5 mg, 10 mg
- Extended release tablet: 2.5 mg, 5 mg, 10 mg
- Diabetes Type 2:a) Immediate release dose: Starting initally from 2.5 mg administered once daily, 30 mins before a meal. Dose can be gradually increased according to the needs, with max dose effective: 20 mg per day.b) Extended release dose: Initially 2.5 mg to 5 mg with breakfast or before the first meal. Dose can be gradually increased according to the needs, with max dose effective: 20 mg per day.
Missed Dose: Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.
a) Administration of gastric lavage
b) IV administration of dextrose to restore normal blood glucose levels in hypoglycemia
c) Administration of stomatostatin which suppresses insulin release from the pancreas.
SIDE EFFECTS OF GLIPIZIDE
- Low blood sugar levels
- Muscle pain
- Decreased WBC count
- Decreased platelet count
- Increased cardiovascular mortality
- Severe hypoglycemia
- Steven-Johnson Syndrome
- Reduced serum sodium levels
- Inappropriate secretion of Anti-diuretic hormone
- Altered level of liver enzymes
- Altered levels of SGOT, LDH, Alkaline phosphatase, BUN & creatinine in lab tests
- Liver damage
- Low blood pressure.
PRECAUTIONS & CONTRAINDICATIONS
Glipizide is contraindicated & precaution is advised in patients with following conditions:
- People with alcohol addiction
- Renal impairment
- Kidney impairment
- Autonomic neuropathy
- Adrenal insufficiency
- Pituitary insufficiency
- Glucose-6-phosphate dehydrogenase (G6PD) deficiency in patients
- Patients exposed to stress like trauma & surgery
- Contraindicated in patients with type 1 Diabetes
- Diabetic ketoacidosis
- Hypersensitivity to the drug.
INTERACTIONS OF GLIPIZIDE
- When given in presence with alcohol can aggravate the hypoglycemic effect of the drug.
- Glipizide given along with beta blockers can lead to adverse hypoglycemic effect.
- Chloramphenicol increases the serum concentration of glipizide.
- Oral miconazole can enhance the effect of glipizide.
- Antidepressant drugs like MAO inhibitors & SSRIs can increase the serum concentration of glipizide.
- Thiazide diuretics when given in presence of oral hypoglycemic agents can decrease/diminish the effect of the latter.
- The anticoagulant effect of Vitamin K increases in the presence of glipizide.
- Clarithromycin increases the serum concentration of glipizide.
IN PREGNANCY, BREAST FEEDING & CHILDREN
- Pregnancy: Listed as a pregnancy category C drug, therefore the drug is contraindicated in pregnant women.
- Breast Feeding: Precaution advised in nursing mothers as the drug may or may not be excreted in the breast milk.
- Children: Safety for use of glipizide in children & pediatric patients is not established.