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glipizide (Glucotrol, Glucotrol XL)
Tradename: Glucotrol, Glucotrol XL. 2nd generation sulfonylurea.
Indications: management of diabetes mellitus type 2*
* may be preferred agent in patients with renal insufficiency
Dosage:
1) start: 2.5-5 mg PO QD
2) increase: 2.5-5 mg QD weekly
3) max** 40 mg/day
4) divide dose BID if >15 mg/day
5) geriatrics: begin 2.5 mg QD, QD dosing
Tabs: 5 & 10 mg.
**Doses > 10 mg/day may not provide additional benefit.
Pharmacokinetics:
1) onset of action 1.5 hours
2) food delays absorption [3]
3) protein binding: 92-99%
4) metabolized in the liver (91-97%)
5) elimination 1/2life of 2-4 hours
6) duration of action: up to 24 hours
7) 60-80% of metabolites eliminated in the urine, 11% in the feces
Adverse effects:
1) common (> 10%)
- headache
- constipation
- diarrhea
- heartburn
- anorexia
- epigastric fullness
- dizziness
2) less common (1-10%)
- skin rash, hives, photosensitivity
3) uncommon (< 1%)
- aplastic anemia, hemolytic anemia, bone marrow depression, cholestatic jaundice, thrombocytopenia, agranulocytosis, hypoglycemia
4) produces less hypoglycemia following a prolonged fast than does glyburide [5]
Drug interactions:
1) alcohol
2) beta adrenergic receptor antagonists
3) non-steroidal anti-inflammatory agents
4) hypoglycemia may occur in combination with clarithromycin [7]
Laboratory:
- glipizide in specimen
- glipizide in serum/plasma
- glipizide in urine
Interactions
drug interactions
drug adverse effects (more general classes)
monitor with sulfonylureas
Related
glipizide/metformin (Metaglip)
General
sulfonylurea
Properties
MISC-INFO: elimination route LIVER
KIDNEY
protein-binding 92-99%
1/2life 7 HOURS
pregnancy-category C
safety in lactation ?
Database Correlations
PUBCHEM correlations
References
- The Pharmacological Basis of Therapeutics, 9th ed.
Gilman et al, eds. Permagon Press/McGraw Hill, 1996
- Kaiser Permanente Northern California Regional Drug
Formulary, 1998
- Harrison's Principles of Internal Medicine, 14th ed.
Fauci et al (eds), McGraw-Hill Inc. NY, 1998, pg 470
- Geriatric Dosage Handbook, 6th edition, Selma et al eds,
Lexi-Comp, Cleveland, 2001
- Shorr RI, JAMA 279(18):1441-a, 1998
http://jama.ama-assn.org/cgi/content/full/279/18/1441-a
- Department of Veterans Affairs, VA National Formulary
- Paauw DS
Dangerous and Deadly Drug Combinations
Medscape. June 30, 2016
http://www.medscape.com/features/slideshow/dangerous-drug-combinations
Component-of
glipizide/metformin (Metaglip)