Glipizide

Indications & Dose:

Type 2 diabetes mellitus 

• BY MOUTH

2.5-5mg daily adjusted according to response, max 20mg daily may be given as a single dose before breakfast, higher doses divided. Usual maintainance 2.5-20mg daily

Children  Not recommended. 

Contraindications:

Diabetes mellitus, type 1; ketoacidosis. Elderly, cardiac disease, severe renal disease, severe hepatic disease, thyroid disease, adrenal or pituitary insufficiency, debilitated or malnourished patients 

Side Effects:

Cautions:

Precautions:

Interaction:

Drugs

Anabolic steroids: Enhanced hypoglycemic response

Angiotensin converting enzyme inhibitor: Increased risk of hypoglycemia

Antacids: Enhanced rate of absorption

Aspirin: Enhanced hypoglycemic effects

ß-Adrenergic blockers: Altered response to hypoglycemia; prolonged recovery ofnormoglycemia, hypertension, blockade of tachycardia; may increase blood glucose concentration

Clofibrate: Enhanced effects of oral hypoglycemic drugs

Corticosteroids: Increased blood glucose in diabetic patients

Ethanol: Excessive intake may lead to altered glycernic control; Antabuse like reaction may occur

Gemfibrozil: Increased risk of hypoglycemia

H2-receptor antagonists (cimetidine, ranitidine, etc.): Enhanced rate of absorption

MAOIs: Excessive hypoglycemia may occur in patient with diabetes

Phenylbutazone: Increases serum concentrations of oral hypoglycemics

Rifampin: Reduced sulfonylurea concentrations

Sulfonamides: Enhanced hypoglycemic effects of sulfonylureas

Thiazide diuretics: Potential increased dosage requirement of antidiabetic drugs 

Warnings:

Adverse Effects:

Lactations:

Inappropriate for use during pregnancy due to inadequate for blood glucose control, potential for prolonged neonatal hypoglycemia, and risk of congenital abnormalities; insulin is the drug of choice for control of blood sugars during pregnancy; breast milk secretion unknown; the potential for neonatal hypoglycemia dictates caution in nursing mothers 

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

CNS: Dizziness, drowsiness, headache, paresthesia
EENT: Tinnitus, vertigo
GI: Cholestatic jaundice, constipation, diarrhea, elevated liver function tests, gastralgia, nausea
GU: Mild to moderate elevations in BUN and creatinine
HEME: Agranulocytosis, aplastic anemia, hemolytic anemia, hepatic porphyria, leukopenia, pancytopenia, thrombocytopenia
METAB: Hypoglycemia, SIADH
MS: Fatigue, weakness
SKIN: Eczema, erythema, morbilliform or maculopapular eruptions, pruritus, urticaria 

Patient And Carer Advice: