Top 300 Pharmacy Drug Cards

GLIPIZIDE: Glucotrol, Various

Class: Second-Generation Sulfonylurea, Antidiabetic

Dosage Forms. Tablet: 5 mg, 10 mg; Tablet, Extended Release: 2.5 mg, 5 mg, 10 mg

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Common FDA Label Indication, Dosing, and Titration.

1. Diabetes mellitus: Immediate release, 5-10 mg po daily, may titrate to max of 40 mg daily, divide bid if doses >15 mg; Extended release, 5-10 mg po daily, may titrate to max of 20 mg daily

Off-Label Uses. None

MOA. Sulfonylureas enhance insulin secretion from pancreatic β-cells and potentiate insulin action on several extrahepatic tissues. Long-term sulfonylureas increase peripheral utilization of glucose, suppress hepatic gluconeogenesis, and possibly increase the sensitivity and/or number of peripheral insulin receptors.

Drug Characteristics: Glipizide

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Medication Safety Issues: Glipizide

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Drug Interactions: Glipizide

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Adverse Reactions: Glipizide

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Efficacy Monitoring Parameters. Preprandial blood glucose between 70 and 130 mg/dL, HbA1c <7%.

Toxicity Monitoring Parameters. Symptoms of hypoglycemia include nausea, sweating, and loss of consciousness. Seek medical attention if yellowing of skin or eyes, severe skin rash, unusual bruising, or bleeding.

Key Patient Counseling Points. Monitor blood glucose in frequent intervals (2-4 times per day); if <70 mg/dL, eat candy or sugar and contact prescriber. Use a sunscreen and avoid sunlamps and tanning beds. Do not drink alcohol, may cause a disulfiram reaction. Take 30 min before morning meal. Do not chew or crush extended-release formulation.

Clinical Pearls. Metformin is first-line therapy for Type II diabetes. A sulfonylurea may be added if HbA1c goals are not achieved with metformin alone. Not for use in children. Hemolytic anemia is most likely to occur in patients with G6PD deficiency. Patients on insulin: when starting glipizide, reduce insulin dose by 50%, or discontinue if <20 units per day.