glipizide (Rx)

Brand and Other Names:Glucotrol, Glucotrol XL, more...Minodiab
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Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

tablet

  • 5mg
  • 10mg

tablet, extended-release

  • 2.5mg
  • 5mg
  • 10mg

Type 2 Diabetes Mellitus

Immediate-release tablet

  • 5 mg PO qDay initially; increase by 2.5-5 mg PRN every several days based on blood glucose
  • Maintenance range: 2.5-20 mg PO qDay or q12hr; not to exceed 40 mg/day

Extended-release tablets (Glucotrol XL)

  • Initial: 5 mg/day PO given with breakfast; dose adjustment based on blood glucose should not be done more frequently than every 7 days
  • Maintenance range: 5-10 mg PO qDay; not to exceed 20 mg/day

Dosing considerations

  • Doses >15 mg: PO divided q12hr recommended

Conversion From Immediate Release to Extended Release

Administer the nearest equivalent immediate-release daily dose as extended-release tablet once daily

Alternatively, administer 5 mg PO initially; titrate as necessary

Conversion From Long Half-Life Agents

Observe patients carefully for 1-2 weeks when being converted from long half-life sulfonylureas to glipizide, because of potential for overlapping of hypoglycemic effects

Transferring From Insulin Therapy to Glipizide IR or ER

Current insulin dose <20 units: Discontinue insulin and initiate glipizide therapy at recommended dose

Current insulin dose >20 units: Decrease insulin dose by 50% and initiate glipizide at recommended dose; decrease insulin dose gradually based on patient’s response

Dosing Modifications

Hepatic impairment: 2.5 mg PO qDay initially (immediate release); extended release not studied

Renal impairment: Not studied; if GFR <50 mL/min, may decrease dose by 50% (suggested)

Safety and efficacy not established

Diabetes

2.5 mg PO qDay initially; increase by 2.5-5 mg/day every 1-2 weeks as determined by blood glucose response at intervals of several days

May switch to extended release once daily tablets at the nearest equivalent total daily dose or lower end of recommended range; not to exceed 20 mg/day

Dosing considerations

Because elderly patients are susceptible to the hypoglycemic effects of glucose-lowering drugs, the question of how tightly glucose levels should be controlled in the elderly is controversial

Recognizing hypoglycemia in elderly patients may be challenging

Monitoring other parameters associated with cardiovascular disease, such as blood pressure and cholesterol, may be more important than normalized glycemic control

Initial and maintenance dosing should be conservative

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Interactions

Interaction Checker

and glipizide

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              Serious - Use Alternative (6)

              • aminolevulinic acid oral

                aminolevulinic acid oral, glipizide. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid administering other phototoxic drugs with aminolevulinic acid oral for 24 hr during perioperative period.

              • aminolevulinic acid topical

                glipizide increases toxicity of aminolevulinic acid topical by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration of photosensitizing drugs may enhance the phototoxic reaction to photodynamic therapy with aminolevulinic acid.

              • ethanol

                ethanol, glipizide. Other (see comment). Contraindicated. Comment: Excessive EtOH consumption may alter glycemic control. Some sulfonylureas may produce a disulfiram like rxn.

              • ivosidenib

                ivosidenib will decrease the level or effect of glipizide by affecting hepatic enzyme CYP2C9/10 metabolism. Avoid or Use Alternate Drug. Avoid coadministration of sensitive CYP2C9 substrates with ivosidenib or replace with alternate therapies. If coadministration is unavoidable, monitor patients for loss of therapeutic effect of these drugs.

              • lumacaftor/ivacaftor

                lumacaftor/ivacaftor will decrease the level or effect of glipizide by affecting hepatic enzyme CYP2C9/10 metabolism. Avoid or Use Alternate Drug. Sulfonylureas are CYP2C9 substrates. Lumacaftor/ivacaftor has the potential to induce CYP2C9.

              • methyl aminolevulinate

                glipizide, methyl aminolevulinate. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Each drug may increase the photosensitizing effect of the other.

              Monitor Closely (161)

              • aceclofenac

                aceclofenac increases effects of glipizide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

              • acemetacin

                acemetacin increases effects of glipizide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

              • albiglutide

                albiglutide, glipizide. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Serious hypoglycemia may occur when insulin secretagogues and GLP-1 agonists are concurrently administered. Consider lowering the dose of insulin secretagogue to reduce the risk of hypoglycemia. .

              • alogliptin

                alogliptin, glipizide. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration of alogliptin with insulin and/or insulin secretagogues (eg, sulfonylureas, meglitinide derivatives) may increase risk for hypoglycemia; may require lower dose of insulin or insulin secretagogue .

              • alpelisib

                alpelisib will decrease the level or effect of glipizide by affecting hepatic enzyme CYP2C9/10 metabolism. Modify Therapy/Monitor Closely.

              • aluminum hydroxide

                aluminum hydroxide will increase the level or effect of glipizide by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • apalutamide

                apalutamide will decrease the level or effect of glipizide by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Coadministration of apalutamide, a weak CYP2C9 inducer, with drugs that are CYP2C9 substrates can result in lower exposure to these medications. Evaluate for loss of therapeutic effect if medication must be coadministered.

              • aripiprazole

                aripiprazole, glipizide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

              • asenapine

                asenapine, glipizide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

              • aspirin

                aspirin increases effects of glipizide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

              • aspirin rectal

                aspirin rectal increases effects of glipizide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

              • aspirin/citric acid/sodium bicarbonate

                aspirin/citric acid/sodium bicarbonate increases effects of glipizide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

              • atazanavir

                atazanavir decreases effects of glipizide by Other (see comment). Use Caution/Monitor. Comment: Reports of hyperglycemia due to insulin resistance with protease inhibitors. .

              • benazepril

                benazepril increases effects of glipizide by pharmacodynamic synergism. Use Caution/Monitor. Additive hypogylcemic effects.

              • bexarotene

                bexarotene increases effects of glipizide by pharmacodynamic synergism. Use Caution/Monitor. Based on the mechanism of action, bexarotene capsules may increase the action of insulin enhancing agents, resulting in hypoglycemia. Hypoglycemia has not been associated with bexarotene monotherapy.

              • bitter melon

                bitter melon increases effects of glipizide by pharmacodynamic synergism. Use Caution/Monitor. Risk of hypoglycemia.

              • calcium carbonate

                calcium carbonate will increase the level or effect of glipizide by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • canagliflozin

                glipizide, canagliflozin. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Consider a lower dose of insulin or insulin secretagogue to avoid hypoglycemia when coadministered with canagliflozin.

              • cannabidiol

                cannabidiol will increase the level or effect of glipizide by decreasing metabolism. Modify Therapy/Monitor Closely. Cannabidiol may potentially inhibit CYP2C9 activity. Consider reducing the dose when concomitantly using CYP2C9 substrates.

              • captopril

                captopril increases effects of glipizide by pharmacodynamic synergism. Use Caution/Monitor. Both drugs lower blood glucose. Monitor blood glucose.

              • celecoxib

                celecoxib increases effects of glipizide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

              • choline magnesium trisalicylate

                choline magnesium trisalicylate increases effects of glipizide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

              • cimetidine

                cimetidine will increase the level or effect of glipizide by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • cinnamon

                cinnamon increases effects of glipizide by pharmacodynamic synergism. Use Caution/Monitor. Potential for hypoglycemia.

              • ciprofibrate

                ciprofibrate increases effects of glipizide by plasma protein binding competition. Use Caution/Monitor. Hypoglycemia; increased risk in hypoalbuminemia.

              • ciprofloxacin

                ciprofloxacin increases effects of glipizide by pharmacodynamic synergism. Use Caution/Monitor. Hyper and hypoglycemia have been reported in patients treated concomitantly with quinolones and antidiabetic agents. Careful monitoring of blood glucose is recommended.

              • clarithromycin

                clarithromycin increases levels of glipizide by plasma protein binding competition. Use Caution/Monitor. Risk of hypoglycemia.

              • clotrimazole

                clotrimazole increases levels of glipizide by decreasing metabolism. Use Caution/Monitor.

              • clozapine

                clozapine, glipizide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

              • colesevelam

                colesevelam decreases levels of glipizide by drug binding in GI tract. Use Caution/Monitor. Concomitant administration decreases glipizide absorption; however, absorption is not reduced when glipizide is administered 4 hr before colesevelam.

              • cyclosporine

                glipizide, cyclosporine. unknown mechanism. Use Caution/Monitor. Cyclosporine may decrease the effects of sulfonylureas. Sulfonylureas may increase the effects of cyclosporine.

              • dapagliflozin

                glipizide, dapagliflozin. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Consider a lower dose of insulin or insulin secretagogue to avoid hypoglycemia when coadministered with dapagliflozin.

              • darunavir

                darunavir, glipizide. Other (see comment). Use Caution/Monitor. Comment: Darunavir may increase or decrease levels of glipizide. Use alternatives if available. Reports of hyperglycemia due to insulin resistance with protease inhibitors. .

              • diclofenac

                diclofenac increases effects of glipizide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

              • diflunisal

                diflunisal increases effects of glipizide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

              • disopyramide

                disopyramide increases effects of glipizide by unspecified interaction mechanism. Use Caution/Monitor. Risk of hypoglycemia.

              • dulaglutide

                dulaglutide, glipizide. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

              • elvitegravir/cobicistat/emtricitabine/tenofovir DF

                elvitegravir/cobicistat/emtricitabine/tenofovir DF decreases levels of glipizide by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Elvitegravir is a moderate CYP2C9 inducer.

              • empagliflozin

                empagliflozin, glipizide. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Consider a lower dose of insulin or insulin secretagogue to avoid hypoglycemia when coadministered with SGLT2 inhibitors.

              • enalapril

                enalapril increases effects of glipizide by pharmacodynamic synergism. Use Caution/Monitor.

              • ertugliflozin

                ertugliflozin, glipizide. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Consider a lower dose of insulin or insulin secretagogue to avoid hypoglycemia when coadministered with ertugliflozin.

              • esomeprazole

                esomeprazole will increase the level or effect of glipizide by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • etodolac

                etodolac increases effects of glipizide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

              • exenatide injectable solution

                exenatide injectable solution, glipizide. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of hypoglycemia when exenatide is used in combination with agents that induce hypoglycemia. Consider lowering dose of sulfonylureas to reduce risk of hypoglycemia. .

              • exenatide injectable suspension

                exenatide injectable suspension, glipizide. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of hypoglycemia when exenatide is used in combination with agents that induce hypoglycemia. Consider lowering dose of sulfonylureas to reduce risk of hypoglycemia.

              • famotidine

                famotidine will increase the level or effect of glipizide by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • fenofibrate

                fenofibrate increases effects of glipizide by plasma protein binding competition. Use Caution/Monitor. Hypoglycemia; increased risk in hypoalbuminemia.

              • fenofibrate micronized

                fenofibrate micronized increases effects of glipizide by plasma protein binding competition. Use Caution/Monitor. Hypoglycemia; increased risk in hypoalbuminemia.

              • fenofibric acid

                fenofibric acid increases effects of glipizide by plasma protein binding competition. Use Caution/Monitor. Hypoglycemia; increased risk in hypoalbuminemia.

              • fenoprofen

                fenoprofen increases effects of glipizide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

              • fleroxacin

                fleroxacin increases effects of glipizide by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.

              • fluconazole

                fluconazole increases levels of glipizide by decreasing metabolism. Use Caution/Monitor.

              • fluoxetine

                fluoxetine increases effects of glipizide by unspecified interaction mechanism. Use Caution/Monitor. Risk of hypoglycemia.

              • flurbiprofen

                flurbiprofen increases effects of glipizide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

              • fosamprenavir

                fosamprenavir, glipizide. Other (see comment). Use Caution/Monitor. Comment: Fosamprenavir may increase or decrease levels of glipizide. Use alternatives if available. Reports of hyperglycemia due to insulin resistance with protease inhibitors. .

              • fosinopril

                fosinopril increases effects of glipizide by pharmacodynamic synergism. Use Caution/Monitor.

              • gemfibrozil

                gemfibrozil increases effects of glipizide by plasma protein binding competition. Use Caution/Monitor. Hypoglycemia; increased risk in hypoalbuminemia.

              • gemifloxacin

                gemifloxacin increases effects of glipizide by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.

              • ibuprofen

                ibuprofen increases effects of glipizide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

              • ibuprofen IV

                ibuprofen IV increases effects of glipizide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

              • ibuprofen/famotidine

                ibuprofen/famotidine will increase the level or effect of glipizide by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • iloperidone

                iloperidone, glipizide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

              • imidapril

                imidapril increases effects of glipizide by pharmacodynamic synergism. Use Caution/Monitor.

              • indinavir

                indinavir decreases effects of glipizide by Other (see comment). Use Caution/Monitor. Comment: Reports of hyperglycemia due to insulin resistance with protease inhibitors. .

              • indomethacin

                indomethacin increases effects of glipizide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

              • insulin aspart

                glipizide, insulin aspart. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

              • insulin aspart protamine/insulin aspart

                glipizide, insulin aspart protamine/insulin aspart. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

              • insulin degludec

                glipizide, insulin degludec. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

              • insulin degludec/insulin aspart

                glipizide, insulin degludec/insulin aspart. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

              • insulin detemir

                glipizide, insulin detemir. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

              • insulin glargine

                glipizide, insulin glargine. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

              • insulin glulisine

                glipizide, insulin glulisine. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

              • insulin inhaled

                glipizide, insulin inhaled. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

              • insulin isophane human/insulin regular human

                glipizide, insulin isophane human/insulin regular human. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

              • insulin lispro

                glipizide, insulin lispro. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

              • insulin lispro protamine/insulin lispro

                glipizide, insulin lispro protamine/insulin lispro. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

              • insulin NPH

                glipizide, insulin NPH. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

              • insulin regular human

                glipizide, insulin regular human. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Antidiabetic agents are often used in combination; dosage adjustments may be required when initiating or discontinuing antidiabetic agents.

              • isocarboxazid

                isocarboxazid increases effects of glipizide by unknown mechanism. Use Caution/Monitor.

              • ketoconazole

                ketoconazole increases levels of glipizide by decreasing metabolism. Use Caution/Monitor.

              • ketoprofen

                ketoprofen increases effects of glipizide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

              • ketorolac

                ketorolac increases effects of glipizide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

              • ketorolac intranasal

                ketorolac intranasal increases effects of glipizide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

              • ketotifen, ophthalmic

                ketotifen, ophthalmic, glipizide. Other (see comment). Use Caution/Monitor. Comment: Combination may result in thrombocytopenia (rare). Monitor CBC.

              • levofloxacin

                levofloxacin increases effects of glipizide by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.

              • linagliptin

                glipizide, linagliptin. Other (see comment). Use Caution/Monitor. Comment: When linagliptin is used in combination with sulfonylureas, a lower dose of the sulfonylurea may be required to reduce risk of hypoglycemia.

              • linezolid

                linezolid increases effects of glipizide by unknown mechanism. Use Caution/Monitor.

              • liraglutide

                liraglutide, glipizide. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Serious hypoglycemia may occur when insulin secretagogues and GLP-1 agonists are concurrently administered. Consider lowering the dose of insulin secretagogue to reduce the risk of hypoglycemia. .

              • lisinopril

                lisinopril increases effects of glipizide by pharmacodynamic synergism. Use Caution/Monitor.

              • lixisenatide

                lixisenatide, glipizide. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Risk of hypoglycemia increased when coadministered with sulfonylureas. Sulfonylurea dosage reduction may be required.

              • lopinavir

                lopinavir, glipizide. Other (see comment). Use Caution/Monitor. Comment: Lopinavir may increase or decrease levels of glipizide. Reports of hyperglycemia due to insulin resistance with protease inhibitors. .

              • lornoxicam

                lornoxicam increases effects of glipizide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

              • lurasidone

                lurasidone, glipizide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

              • marijuana

                marijuana decreases effects of glipizide by pharmacodynamic antagonism. Use Caution/Monitor.

              • mecasermin

                mecasermin increases effects of glipizide by pharmacodynamic synergism. Use Caution/Monitor. Additive hypoglycemic effects.

              • meclofenamate

                meclofenamate increases effects of glipizide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

              • mefenamic acid

                mefenamic acid increases effects of glipizide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

              • meloxicam

                meloxicam increases effects of glipizide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

              • metreleptin

                glipizide, metreleptin. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration of metreleptin with insulin and/or insulin secretagogues (eg, sulfonylureas, meglitinide derivatives) may increase risk for hypoglycemia; may require lower dose of insulin or insulin secretagogue.

              • miconazole vaginal

                miconazole vaginal increases levels of glipizide by decreasing metabolism. Use Caution/Monitor.

              • mipomersen

                mipomersen, glipizide. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Both drugs have potential to increase hepatic enzymes; monitor LFTs.

              • moexipril

                moexipril increases effects of glipizide by pharmacodynamic synergism. Use Caution/Monitor.

              • moxifloxacin

                moxifloxacin increases effects of glipizide by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.

              • nabumetone

                nabumetone increases effects of glipizide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

              • nadolol

                nadolol decreases effects of glipizide by pharmacodynamic antagonism. Use Caution/Monitor. Non selective beta blockers may also mask the symptoms of hypoglycemia.

              • naproxen

                naproxen increases effects of glipizide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

              • nelfinavir

                nelfinavir decreases effects of glipizide by Other (see comment). Use Caution/Monitor. Comment: Reports of hyperglycemia due to insulin resistance with protease inhibitors. .

              • nitazoxanide

                nitazoxanide, glipizide. Either increases levels of the other by Mechanism: plasma protein binding competition. Use Caution/Monitor.

              • nitisinone

                nitisinone will increase the level or effect of glipizide by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. Nitisinone inhibits CYP2C9. Caution if CYP2C9 substrate coadministered, particularly those with a narrow therapeutic index.

              • ofloxacin

                ofloxacin increases effects of glipizide by pharmacodynamic synergism. Use Caution/Monitor. Quinolone antibiotic administration may result in hyper- or hypoglycemia. Gatifloxacin is most likely to produce dysglycemia; moxifloxacin is least likely.

              • olanzapine

                olanzapine, glipizide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

              • opuntia ficus indica

                opuntia ficus indica increases effects of glipizide by pharmacodynamic synergism. Use Caution/Monitor.

              • ospemifene

                glipizide, ospemifene. Either increases levels of the other by plasma protein binding competition. Modify Therapy/Monitor Closely.

              • oxaprozin

                oxaprozin increases effects of glipizide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

              • paliperidone

                paliperidone, glipizide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

              • parecoxib

                parecoxib increases effects of glipizide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

              • peginterferon alfa 2b

                peginterferon alfa 2b decreases levels of glipizide by affecting hepatic enzyme CYP2C9/10 metabolism. Use Caution/Monitor. When patients are administered peginterferon alpha-2b with CYP2C9 substrates, the therapeutic effect of these drugs may be altered. .

              • perindopril

                perindopril increases effects of glipizide by pharmacodynamic synergism. Use Caution/Monitor.

              • phenelzine

                phenelzine increases effects of glipizide by unknown mechanism. Use Caution/Monitor.

              • pindolol

                pindolol decreases effects of glipizide by pharmacodynamic antagonism. Use Caution/Monitor. Non selective beta blockers may also mask the symptoms of hypoglycemia.

              • piroxicam

                piroxicam increases effects of glipizide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

              • posaconazole

                posaconazole increases levels of glipizide by decreasing metabolism. Use Caution/Monitor.

              • probenecid

                probenecid increases levels of glipizide by unspecified interaction mechanism. Use Caution/Monitor. Risk of hypoglycemia.

              • propranolol

                propranolol decreases effects of glipizide by pharmacodynamic antagonism. Use Caution/Monitor. Non selective beta blockers may also mask the symptoms of hypoglycemia.

              • quetiapine

                quetiapine, glipizide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

              • quinapril

                quinapril increases effects of glipizide by pharmacodynamic synergism. Use Caution/Monitor.

              • ramipril

                ramipril increases effects of glipizide by pharmacodynamic synergism. Use Caution/Monitor.

              • rasagiline

                rasagiline increases effects of glipizide by unknown mechanism. Use Caution/Monitor.

              • rifabutin

                rifabutin decreases levels of glipizide by increasing metabolism. Use Caution/Monitor.

              • rifampin

                rifampin decreases levels of glipizide by increasing metabolism. Use Caution/Monitor.

              • rifapentine

                rifapentine decreases levels of glipizide by increasing metabolism. Use Caution/Monitor.

              • risperidone

                risperidone, glipizide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

              • ritonavir

                ritonavir, glipizide. Other (see comment). Use Caution/Monitor. Comment: Ritonavir may increase or decrease levels of glipizide. Reports of hyperglycemia due to insulin resistance with protease inhibitors. .

              • rucaparib

                rucaparib will increase the level or effect of glipizide by affecting hepatic enzyme CYP2C9/10 metabolism. Modify Therapy/Monitor Closely. Adjust dosage of CYP2C9 substrates, if clinically indicated.

              • salicylates (non-asa)

                salicylates (non-asa) increases effects of glipizide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

              • salsalate

                salsalate increases effects of glipizide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

              • saquinavir

                saquinavir decreases effects of glipizide by Other (see comment). Use Caution/Monitor. Comment: Reports of hyperglycemia due to insulin resistance with protease inhibitors. .

              • selegiline

                selegiline increases effects of glipizide by unknown mechanism. Use Caution/Monitor. Serum glucose should be monitored closely when MAOIs are added to any regimen containing antidiabetic medications. Hypoglycemic effects may be increased.

              • selegiline transdermal

                selegiline transdermal increases effects of glipizide by unknown mechanism. Use Caution/Monitor.

              • semaglutide

                semaglutide, glipizide. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of insulin secretagogues with GLP-1 agonists may increase hypoglycemia risk. Lowering the insulin secretagogue dose may reduce hypoglycemia risk. .

              • shark cartilage

                shark cartilage increases effects of glipizide by pharmacodynamic synergism. Use Caution/Monitor. Theoretical interaction.

              • sodium bicarbonate

                sodium bicarbonate will increase the level or effect of glipizide by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • sodium citrate/citric acid

                sodium citrate/citric acid will increase the level or effect of glipizide by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.

              • somapacitan

                somapacitan decreases effects of glipizide by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Growth hormone products may decrease insulin sensitivity, particularly at higher doses. Antidiabetic agents may require dose adjustment after initiating somapacitan. .

              • sulfadiazine

                sulfadiazine increases levels of glipizide by plasma protein binding competition. Use Caution/Monitor.

              • sulfamethoxazole

                sulfamethoxazole increases levels of glipizide by plasma protein binding competition. Use Caution/Monitor.

              • sulfamethoxypyridazine

                sulfamethoxypyridazine increases effects of glipizide by unspecified interaction mechanism. Use Caution/Monitor. Risk of hypoglycemia.

              • sulfasalazine

                sulfasalazine increases effects of glipizide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

              • sulfisoxazole

                sulfisoxazole increases levels of glipizide by plasma protein binding competition. Use Caution/Monitor.

              • sulindac

                sulindac increases effects of glipizide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

              • timolol

                timolol decreases effects of glipizide by pharmacodynamic antagonism. Use Caution/Monitor. Non selective beta blockers may also mask the symptoms of hypoglycemia.

              • tipranavir

                tipranavir decreases effects of glipizide by Other (see comment). Use Caution/Monitor. Comment: Reports of hyperglycemia due to insulin resistance with protease inhibitors. .

              • tolfenamic acid

                tolfenamic acid increases effects of glipizide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

              • tolmetin

                tolmetin increases effects of glipizide by unknown mechanism. Use Caution/Monitor. Risk of hypoglycemia.

              • trandolapril

                trandolapril increases effects of glipizide by pharmacodynamic synergism. Use Caution/Monitor.

              • tranylcypromine

                tranylcypromine increases effects of glipizide by unknown mechanism. Use Caution/Monitor.

              • triamcinolone acetonide injectable suspension

                triamcinolone acetonide injectable suspension decreases effects of glipizide by pharmacodynamic antagonism. Use Caution/Monitor. Corticosteroids may diminish hypoglycemic effect of antidiabetic agents. Monitor blood glucose levels carefully.

              • trimagnesium citrate anhydrous

                trimagnesium citrate anhydrous increases levels of glipizide by enhancing GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.

              • voriconazole

                voriconazole increases levels of glipizide by decreasing metabolism. Use Caution/Monitor.

              • xipamide

                xipamide decreases levels of glipizide by increasing renal clearance. Use Caution/Monitor.

              • ziprasidone

                ziprasidone, glipizide. Other (see comment). Use Caution/Monitor. Comment: Atypical antipsychotics have been associated with hyperglycemia that may alter blood glucose control; monitor glucose levels closely.

              Minor (85)

              • agrimony

                agrimony increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown.

              • American ginseng

                American ginseng increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown.

              • amitriptyline

                amitriptyline increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown.

              • amoxapine

                amoxapine increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown.

              • anamu

                anamu increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown. Theoretical interaction.

              • aspirin

                aspirin increases effects of glipizide by plasma protein binding competition. Minor/Significance Unknown. Large dose of salicylate.

              • aspirin rectal

                aspirin rectal increases effects of glipizide by plasma protein binding competition. Minor/Significance Unknown. Large dose of salicylate.

              • aspirin/citric acid/sodium bicarbonate

                aspirin/citric acid/sodium bicarbonate increases effects of glipizide by plasma protein binding competition. Minor/Significance Unknown. Large dose of salicylate.

              • balsalazide

                balsalazide increases effects of glipizide by plasma protein binding competition. Minor/Significance Unknown. Large dose of salicylate.

              • bendroflumethiazide

                bendroflumethiazide decreases effects of glipizide by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.

              • budesonide

                budesonide decreases effects of glipizide by pharmacodynamic antagonism. Minor/Significance Unknown.

              • chloramphenicol

                chloramphenicol increases levels of glipizide by decreasing metabolism. Minor/Significance Unknown.

              • chlorothiazide

                chlorothiazide decreases effects of glipizide by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.

              • chlorthalidone

                chlorthalidone decreases effects of glipizide by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.

              • choline magnesium trisalicylate

                choline magnesium trisalicylate increases effects of glipizide by plasma protein binding competition. Minor/Significance Unknown. Large dose of salicylate.

              • chromium

                chromium increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown.

              • clomipramine

                clomipramine increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown.

              • clonidine

                clonidine decreases effects of glipizide by pharmacodynamic antagonism. Minor/Significance Unknown. Diminished symptoms of hypoglycemia.

                clonidine, glipizide. Other (see comment). Minor/Significance Unknown. Comment: Decreased symptoms of hypoglycemia. Mechanism: decreased hypoglycemia induced catecholamine production.

              • cornsilk

                cornsilk increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of hypoglycemia (theoretical interaction).

              • cortisone

                cortisone decreases effects of glipizide by pharmacodynamic antagonism. Minor/Significance Unknown.

              • cyclopenthiazide

                cyclopenthiazide decreases effects of glipizide by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.

              • damiana

                damiana decreases effects of glipizide by pharmacodynamic antagonism. Minor/Significance Unknown. Theoretical interaction.

              • danazol

                danazol increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown.

              • deflazacort

                deflazacort decreases effects of glipizide by pharmacodynamic antagonism. Minor/Significance Unknown.

              • desipramine

                desipramine increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown.

              • devil's claw

                devil's claw increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown.

              • dexamethasone

                dexamethasone decreases effects of glipizide by pharmacodynamic antagonism. Minor/Significance Unknown.

              • diflunisal

                diflunisal increases effects of glipizide by plasma protein binding competition. Minor/Significance Unknown. Large dose of salicylate.

              • doxepin

                doxepin increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown.

              • elderberry

                elderberry increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of hypoglycemia (in vitro research).

              • eucalyptus

                eucalyptus increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown. Theoretical interaction.

              • fludrocortisone

                fludrocortisone decreases effects of glipizide by pharmacodynamic antagonism. Minor/Significance Unknown.

              • fluoxymesterone

                fluoxymesterone increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown.

              • fo-ti

                fo-ti increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown.

              • forskolin

                forskolin increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown. Colenol, a compound found in Coleus root, may stimulate insulin release.

              • gotu kola

                gotu kola increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown. (Theoretical interaction).

              • guanfacine

                guanfacine decreases effects of glipizide by pharmacodynamic antagonism. Minor/Significance Unknown. Diminished symptoms of hypoglycemia.

                guanfacine, glipizide. Other (see comment). Minor/Significance Unknown. Comment: Decreased symptoms of hypoglycemia. Mechanism: decreased hypoglycemia induced catecholamine production.

              • gymnema

                gymnema increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown.

              • horse chestnut seed

                horse chestnut seed increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown.

              • hydrochlorothiazide

                hydrochlorothiazide decreases effects of glipizide by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.

              • hydrocortisone

                hydrocortisone decreases effects of glipizide by pharmacodynamic antagonism. Minor/Significance Unknown.

              • imipramine

                imipramine increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown.

              • indapamide

                indapamide decreases effects of glipizide by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.

              • isoniazid

                isoniazid decreases effects of glipizide by unspecified interaction mechanism. Minor/Significance Unknown.

              • juniper

                juniper increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of hypoglycemia (theoretical interaction).

              • lofepramine

                lofepramine increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown.

              • lycopus

                lycopus increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of hypoglycemia (theoretical interaction).

              • maitake

                maitake increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of hypoglycemia (animal research).

              • maprotiline

                maprotiline increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown.

              • mesalamine

                mesalamine increases effects of glipizide by plasma protein binding competition. Minor/Significance Unknown. Large dose of salicylate.

              • mesterolone

                mesterolone increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown.

              • methyclothiazide

                methyclothiazide decreases effects of glipizide by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.

              • methylprednisolone

                methylprednisolone decreases effects of glipizide by pharmacodynamic antagonism. Minor/Significance Unknown.

              • methyltestosterone

                methyltestosterone increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown.

              • metolazone

                metolazone decreases effects of glipizide by pharmacodynamic antagonism. Minor/Significance Unknown. Thiazide dosage >50 mg/day may increase blood glucose.

              • nettle

                nettle increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown. (Theoretical interaction).

              • nizatidine

                nizatidine will increase the level or effect of glipizide by increasing gastric pH. Applies only to oral form of both agents. Minor/Significance Unknown.

              • nortriptyline

                nortriptyline increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown.

              • ofloxacin

                ofloxacin, glipizide. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Potential dysglycemia.

              • omeprazole

                omeprazole will increase the level or effect of glipizide by affecting hepatic enzyme CYP2C19 metabolism. Minor/Significance Unknown.

              • orlistat

                orlistat increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown.

              • oxandrolone

                oxandrolone increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown.

              • oxymetholone

                oxymetholone increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown.

              • pegvisomant

                pegvisomant increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown.

              • potassium acid phosphate

                potassium acid phosphate increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown. Interaction especially seen in the treatment of hypokalemia.

              • potassium chloride

                potassium chloride increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown. Interaction especially seen in the treatment of hypokalemia.

              • potassium citrate

                potassium citrate increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown. Interaction especially seen in the treatment of hypokalemia.

              • prednisolone

                prednisolone decreases effects of glipizide by pharmacodynamic antagonism. Minor/Significance Unknown.

              • prednisone

                prednisone decreases effects of glipizide by pharmacodynamic antagonism. Minor/Significance Unknown.

              • protriptyline

                protriptyline increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown.

              • sage

                sage increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown.

              • salicylates (non-asa)

                salicylates (non-asa) increases effects of glipizide by plasma protein binding competition. Minor/Significance Unknown. Large dose of salicylate.

              • salsalate

                salsalate increases effects of glipizide by plasma protein binding competition. Minor/Significance Unknown. Large dose of salicylate.

              • sitagliptin

                sitagliptin, glipizide. Either increases effects of the other by pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypoglycemia with combination is unknown.

              • stevia

                stevia increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown.

              • sulfasalazine

                sulfasalazine increases effects of glipizide by plasma protein binding competition. Minor/Significance Unknown. Large dose of salicylate.

              • tacrolimus

                glipizide increases levels of tacrolimus by unknown mechanism. Minor/Significance Unknown.

              • testosterone

                testosterone increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown.

              • testosterone buccal system

                testosterone buccal system increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown.

              • testosterone topical

                testosterone topical increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown.

              • tongkat ali

                tongkat ali increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown. Risk of hypoglycemia.

              • trazodone

                trazodone increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown.

              • trimipramine

                trimipramine increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown.

              • vanadium

                vanadium increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown.

              • willow bark

                willow bark increases effects of glipizide by plasma protein binding competition. Minor/Significance Unknown. Large dose of salicylate.

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              Adverse Effects

              Frequency Not Defined

              Dermatologic reactions

              Abdominal pain

              Diarrhea

              Syncope

              Constipation

              Flatulence

              Dizziness

              Nervousness

              Headache

              Anxiety

              Depression

              Drowsiness

              Erythema

              Heartburn

              Maculopapular eruptions

              Hypoglycemia

              Morbilliform eruptions

              Nausea/vomiting

              Urticaria

              Cholestatic jaundice and hepatitis occur rarely but may progress to liver failure

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              Warnings

              Contraindications

              Hypersensitivity; sulfa allergy

              Type 1 diabetes

              Diabetic ketoacidosis with or without coma

              Cautions

              Patients with risk of severe hypoglycemia include the elderly, debilitated, or malnourished; adrenal or pituitary insufficiency; stress due to infection, fever, trauma, or surgery; concomitant use with beta-blockers or other sympatholytic agents may impair the patient's ability to recognize the signs and symptoms of hypoglycemia; use with caution

              If patient is exposed to stress (fever, trauma, infection, surgery), it may be necessary to discontinue glipizide and initiate insulin

              Use caution in hepatic/renal impairment

              Use with caution in pregnancy and lactation

              Increased risk of cardiovascular mortality suggested by product labeling but data is limited

              FDA-approved product labeling for many medications have included a broad contraindication in patients with a prior allregic reaction to sulfonamides; however, recent studies have suggested that crossreactivity between antibiotic sulfonamides and nonantibiotic sulfonamides is unlikely to occur; increase in cardiovascular mortality suggested by product labeling but data is limited

              Hypoglycemia is more likely to occur when caloric intake is deficient, after severe or prolonged exercise, when alcohol is ingested, or when more than one glucose-lowering drug is used

              Hypoglycemia may be difficult to recognize in patients with autonomic neuropathy

              Hemolytic anemia may occur with glucose 6-phosphate dehydrogenase (G6PD) deficiency when treated with sulfonylurea agents; consider a nonsulfonylurea alternative

              Avoid using the extended-release tablets in patients with severe gastrointestinal narrowing of esophageal dysmotility

              Clinical studies have not found conclusive evidence that anti-diabetic drugs reduce macrovascular risk

              Loss of efficacy following prolonged use possible; if no contributing factors, to explain loss of efficacy identified, consider discontinuing therapy; additional antidiabetic therapy will be required

              Drug interactions overview

              • The hypoglycemic action of sulfonylureas may be potentiated by certain drugs including nonsteroidal anti-inflammatory agents, some azoles, and other drugs that are highly protein bound, salicylates, sulfonamides, chloramphenicol, probenecid, coumarins, monoamine oxidase inhibitors, quinolones and beta adrenergic blocking agents; conversely, certain drugs tend to produce hyperglycemia and may lead to loss of control, including thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blocking drugs, and isoniazid; when coadministering glipizide with such drugs, patient should be observed closely for hypoglycemia or hyperglycemia; when such drugs are withdrawn, observe patient closely for loss of control
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              Pregnancy & Lactation

              Pregnancy

              Available data from a small number of published studies and postmarketing experience with in pregnancy over decades have not identified any drug associated risks for major birth defects, miscarriage, or adverse maternal outcomes

              However, sulfonylureas (including glipizide) cross the placenta and have been associated with neonatal adverse reactions such as hypoglycemia; therefore, therapy should be discontinued at least two weeks before expected delivery; poorly-controlled diabetes in pregnancy increases maternal risk for diabetic ketoacidosis, pre-eclampsia, miscarriage, preterm delivery, stillbirth, and delivery complications; poorly controlled diabetes increases fetal risk for major birth defects, stillbirth, and macrosomia related morbidity

              Neonates of women with gestational diabetes who are treated with sulfonylureas during pregnancy may be at increased risk for neonatal intensive care admission and may develop respiratory distress, hypoglycemia, birth injury, and be large for gestational age; prolonged severe hypoglycemia, lasting 4-10 days, has been reported in neonates born to mothers receiving a sulfonylurea at the time of delivery and has been reported with the use of agents with a prolonged half-life; observe newborns for symptoms of hypoglycemia and respiratory distress and manage accordingly

              Due to reports of prolonged severe hypoglycemia in neonates born to mothers receiving a sulfonylurea at time of delivery, therapy should be discontinued at least two weeks before expected delivery

              Animal data

              • No effects on embryofetal development reported in animal studies following administration of drug to pregnant rats and rabbits during organogenesis at doses 833 times and 8 times the human dose based on body surface area, respectively; however, increased pup mortality was observed in rats administered glipizide from gestation day 15 throughout lactation at doses 2 times the maximum human dose based on body surface area

              Lactation

              Breastfed infants of lactating women on therapy should be monitored for symptoms of hypoglycemia; although glipizide was undetectable in human milk in one small clinical lactation study; this result is not conclusive because of limitations of assay used in the study; there are no data on effects of glipizide on milk production; the developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for therapy and any potential adverse effects on the breastfed child from therapy or from the underlying maternal condition

              Monitor breastfed infants for signs of hypoglycemia (e.g., jitters, cyanosis, apnea, hypothermia, excessive sleepiness, poor feeding, seizures)

              Pregnancy Categories

              A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

              B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

              C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

              D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

              X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

              NA: Information not available.

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              Pharmacology

              Mechanism of Action

              Initial effect to increase insulin secretion from pancreatic beta cells; may also decrease rate of hepatic glucose production and increase insulin receptor sensitivity

              Absorption

              Bioavailability: 100% (Glucotrol)

              Onset: Initial effect (30 min); max effect: (2-3 hr) (Glucotrol)

              Duration: 12-24 hr (Glucotrol)

              Peak plasma time: 1-3 hr (IR); 6-12 hr (ER)

              Distribution

              Protein bound: 99% (Glucotrol)

              Vd: 10-11 L (Glucotrol)

              Metabolism

              Extensively metabolized in liver to inactive metabolites

              Metabolites: Hydroxycyclohexyl derivatives (inactive)

              Elimination

              Half-life: 2-5 hr (Glucotrol)

              Excretion: Urine (63-90%); feces: (10%)

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              Images

              BRAND FORM. UNIT PRICE PILL IMAGE
              glipizide oral
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              10 mg tablet
              glipizide oral
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              5 mg tablet
              glipizide oral
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              2.5 mg tablet
              glipizide oral
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              2.5 mg tablet
              glipizide oral
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              5 mg tablet
              glipizide oral
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              10 mg tablet
              glipizide oral
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              5 mg tablet
              glipizide oral
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              5 mg tablet
              glipizide oral
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              10 mg tablet
              glipizide oral
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              10 mg tablet
              glipizide oral
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              5 mg tablet
              glipizide oral
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              10 mg tablet
              glipizide oral
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              10 mg tablet
              glipizide oral
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              5 mg tablet
              glipizide oral
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              10 mg tablet
              glipizide oral
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              5 mg tablet
              glipizide oral
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              10 mg tablet
              glipizide oral
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              5 mg tablet
              glipizide oral
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              5 mg tablet
              glipizide oral
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              5 mg tablet
              glipizide oral
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              5 mg tablet
              glipizide oral
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              10 mg tablet
              glipizide oral
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              10 mg tablet
              glipizide oral
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              2.5 mg tablet
              glipizide oral
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              10 mg tablet
              glipizide oral
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              5 mg tablet
              glipizide oral
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              2.5 mg tablet
              Glucotrol XL oral
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              10 mg tablet
              Glucotrol XL oral
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              5 mg tablet
              Glucotrol XL oral
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              2.5 mg tablet
              Glucotrol oral
              -
              10 mg tablet
              Glucotrol oral
              -
              5 mg tablet

              Copyright © 2010 First DataBank, Inc.

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              Patient Handout

              Patient Education
              glipizide oral

              GLIPIZIDE EXTENDED-RELEASE TABLET - ORAL

              (GLIP-i-zide)

              COMMON BRAND NAME(S): Glucotrol XL

              USES: Glipizide is used with a proper diet and exercise program to control high blood sugar in people with type 2 diabetes. It may also be used with other diabetes medications. Controlling high blood sugar helps prevent kidney damage, blindness, nerve problems, loss of limbs, and sexual function problems. Proper control of diabetes may also lessen your risk of a heart attack or stroke. Glipizide belongs to the class of drugs known as sulfonylureas. It lowers blood sugar by causing the release of your body's natural insulin.

              HOW TO USE: Read the Patient Information Leaflet if available from your pharmacist before you start taking glipizide and each time you get a refill. If you have any questions, ask your doctor or pharmacist.Take this medication by mouth with breakfast as directed by your doctor, usually once daily. The dosage is based on your medical condition and response to treatment.To reduce your risk of side effects, your doctor may direct you to start this medication at a low dose and gradually increase your dose. Follow your doctor's instructions carefully.If you are already taking another diabetes drug (such as chlorpropamide), follow your doctor's directions carefully for stopping the old drug and starting glipizide.Do not crush or chew extended-release tablets. Doing so can release all of the drug at once, increasing the risk of side effects. Also, do not split the tablets unless they have a score line and your doctor or pharmacist tells you to do so. Swallow the whole or split tablet without crushing or chewing.Colesevelam can decrease the absorption of glipizide. If you are taking colesevelam, take glipizide at least 4 hours before taking colesevelam.Use this medication regularly to get the most benefit from it. To help you remember, take it at the same time each day.Tell your doctor if your condition does not improve or if it worsens (your blood sugar is too high or too low).

              SIDE EFFECTS: Nausea, vomiting, loss of appetite, diarrhea, constipation, upset stomach, gas, headache, and weight gain may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.An empty tablet shell may appear in your stool. This effect is harmless because your body has already absorbed the medication.Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: signs of infection (such as persistent sore throat, fever), easy bleeding/bruising, stomach pain, yellowing eyes/skin, dark urine, unusual tiredness/weakness, unusual/sudden weight gain, mental/mood changes, swelling hands/feet, seizures.This medication can cause low blood sugar (hypoglycemia). This may occur if you do not consume enough calories from food or if you do unusually heavy exercise. Symptoms of low blood sugar include sudden sweating, shaking, fast heartbeat, hunger, blurred vision, dizziness, or tingling hands/feet. It is a good habit to carry glucose tablets or gel to treat low blood sugar. If you don't have these reliable forms of glucose, rapidly raise your blood sugar by eating a quick source of sugar such as table sugar, honey, or candy, or drink fruit juice or non-diet soda. Tell your doctor right away about the reaction and the use of this product. To help prevent low blood sugar, eat meals on a regular schedule, and do not skip meals. Check with your doctor or pharmacist to find out what you should do if you miss a meal.Symptoms of high blood sugar (hyperglycemia) include thirst, increased urination, confusion, drowsiness, flushing, rapid breathing, and fruity breath odor. If these symptoms occur, tell your doctor right away. Your dosage may need to be increased.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

              PRECAUTIONS: Before taking glipizide, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: liver disease, kidney disease, thyroid disease, certain hormonal conditions (adrenal/pituitary insufficiency, syndrome of inappropriate secretion of antidiuretic hormone-SIADH), electrolyte imbalance (hyponatremia), stomach/intestine problems (such as gastrointestinal stenosis or stricture, impaired emptying).You may experience blurred vision, dizziness, or drowsiness due to extremely low or high blood sugar. Do not drive, use machinery, or do any activity that requires alertness or clear vision until you are sure you can perform such activities safely.Limit alcohol while taking this medication because it can increase your risk of developing low blood sugar. Alcohol can rarely interact with glipizide and cause a serious reaction (disulfiram-like reaction) with symptoms such as facial flushing, nausea, vomiting, dizziness, or stomach pain. Consult your doctor or pharmacist about the safe use of alcohol.It may be harder to control your blood sugar when your body is stressed (such as due to fever, infection, injury, or surgery). Consult your doctor because this may require a change in your treatment plan, medications, or blood sugar testing.This medication may make you more sensitive to the sun. Limit your time in the sun. Avoid tanning booths and sunlamps. Use sunscreen and wear protective clothing when outdoors. Tell your doctor right away if you get sunburned or have skin blisters/redness.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Older adults may be more sensitive to the side effects of this drug, especially low blood sugar.During pregnancy, this medication should be used only when clearly needed. Pregnancy may cause or worsen diabetes. Discuss a plan with your doctor for managing your blood sugar while pregnant. Your doctor may substitute insulin for this drug during pregnancy. If glipizide is used, it may be switched to insulin at least 2 weeks before the expected delivery date because of glipizide's risk of causing low blood sugar in your newborn. Discuss the risks and benefits with your doctor.It is unknown if this medication passes into breast milk. However, similar drugs pass into breast milk. Consult your doctor before breast-feeding.

              DRUG INTERACTIONS: See also How to Use section.Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Many drugs can affect your blood sugar, making it harder to control. Before you start, stop, or change any medication, talk with your doctor or pharmacist about how the medication may affect your blood sugar. Check your blood sugar regularly as directed and share the results with your doctor. Tell your doctor right away if you have symptoms of high or low blood sugar. (See also Side Effects section.) Your doctor may need to adjust your diabetes medication, exercise program, or diet.Beta-blocker medications (including metoprolol, propranolol, glaucoma eye drops such as timolol) may prevent the fast/pounding heartbeat you would usually feel when your blood sugar falls too low (hypoglycemia). Other symptoms of low blood sugar such as dizziness, hunger, or sweating are unaffected by these drugs.Check the labels on all your medicines (such as cough-and-cold products) because they may contain ingredients that could affect your blood sugar. Ask your pharmacist about using those products safely.

              OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: shakiness, fast heartbeat, sweating, loss of consciousness.

              NOTES: Do not share this medication with others.Attend a diabetes education program to learn more about how to manage your diabetes with medications, diet, exercise, and regular medical exams.Learn the symptoms of high and low blood sugar and how to treat low blood sugar. Check your blood sugar regularly as directed.Keep all regular medical and laboratory appointments. Laboratory and/or medical tests (such as liver and kidney function tests, fasting blood glucose, hemoglobin A1c, complete blood counts) should be performed periodically to monitor your progress or check for side effects.

              MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

              STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

              MEDICAL ALERT: Your condition can cause complications in a medical emergency. For information about enrolling in MedicAlert, call 1-888-633-4298 (US) or 1-800-668-1507 (Canada).

              Information last revised August 2018. Copyright(c) 2021 First Databank, Inc.

              IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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              Formulary

              FormularyPatient Discounts

              Adding plans allows you to compare formulary status to other drugs in the same class.

              To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

              Adding plans allows you to:

              • View the formulary and any restrictions for each plan.
              • Manage and view all your plans together – even plans in different states.
              • Compare formulary status to other drugs in the same class.
              • Access your plan list on any device – mobile or desktop.

              The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

              Tier Description
              1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
              2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
              3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
              4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
              NC NOT COVERED – Drugs that are not covered by the plan.
              Code Definition
              PA Prior Authorization
              Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
              QL Quantity Limits
              Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
              ST Step Therapy
              Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
              OR Other Restrictions
              Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.