#antidebetic

Brand Name: Glucotrol and Glucotrol XL

Generic Available

Common Dosage Forms:

Tablets: 5 mg, 10 mg

Tablets, sustained-release (XL): 2.5 mg, 5 mg, 10 mg

FDA Indications/Dosages:

An as adjunct to diet in the treatment of non-insulin dependant stable of maturity onset type of mild to moderately severe diabetes mellitus: Usual initial dose is between 2.5 mg and 5 mg, given before breakfast. Make dosage increases in increments of 2.5 mg to 5 mg every 2-3 days. If a single dose proves to be unsatisfactory, divide daily dose and give twice a day. Daily dosages above 15 mg should be divided into two equal doses. Normal dosage range is 5-20 mg per day. Maximum recommended daily dosage is 40 mg.

*Patients receiving less than 20 units of insulin per day may be switched to to glipizide and their insulin discontinued. Patients receiving more than 20 units of insulin per day may be switched to glipizide and their insulin decreased by 50% per day. Further reductions in insulin dosage may be applied dependant upon results. No transition period is needed when transferring patients from other oral hypoglycemics.

Pharmacology/Pharmacokinetics: Glipizide is a sulfonylurea antidiabetic medication that stimulates insulin synthesis and release from beta cells in the pancreatic islets. May also improve binding between insulin and insulin receptors, and increase the number of insulin receptors in the periphery. Peak plasma levels are reached in 1-3 hours with a half-life of 2-4 hours. Food delays absorption. 99% is bound to plasma proteins. Metabolism occurs in the liver and excretion in the urine.

Drug Interactions: Dicumarol, chloramphenicol, alcohol, monoamine oxidase inhibitors, phenylbutazone, salicylates, sulfinpyrazone, and sulfonamides may increase effects. Diazoxide, rifampin, and thiazide diuretics may decrease effects.

Contraindications/Precautions: Contraindicated in juvenile, unstable (labile), or complicated diabetes mellitus as the sole therapy, in patients allergic to sulfa drugs, and it diabetic ketoacidosis with or without coma. Use with caution in patients with serious impairment of renal, hepatic, or thyroid function, and in pregnant and nursing women. In patients with severe burns, infections, or trauma, glipizide may be need to be discontinued and insulin given. Pregnancy Category C.

Adverse Effects: Nausea, diarrhea, heartburn, pruritus, and urticaria. Mild hypoglycemic reactions (sweating, tremor, blurred vision, weakness, hunger, and  confusion) may occur rarely and should be treated with oral glucose.

Patient Consultation:

Take 30 minutes before meals.

Compliance with therapy is essential for optimal effect.

Follow prescribed diet closely.

Avoid excessive use of alcohol.

If a dose is missed, take it as soon as possible. If it is closer to the time of your next dose than the dose you missed, skip the missed dose and return to your dosing schedule. Do not double doses.