Dangerous Drug: glipiZIDE(glip’ i zide)
Glucotrol, Glucotrol XLDNC
PREGNANCY CATEGORY C
Drug Classes
Antidiabetic
Sulfonylurea (second generation)
Therapeutic Actions
Stimulates insulin release from functioning beta cells in the pancreas; may improve binding between insulin and insulin receptors or increase the number of insulin receptors; more potent in effect than first-generation sulfonylureas.
Indications
Adjunct to diet and exercise to lower blood glucose with type 2 diabetes mellitus
Contraindications and Cautions
Contraindicated with allergy to sulfonylureas, diabetes with ketoacidosis, sole therapy of type 1 diabetes or diabetes complicated by pregnancy; diabetes complicated by fever, severe infections, severe trauma, major surgery, ketosis, acidosis, coma (insulin is indicated); type 1 diabetes, serious hepatic impairment, serious renal impairment.
Use cautiously with uremia, thyroid or endocrine impairment, glycosuria, hyperglycemia associated with primary renal disease; labor and delivery (if glipizide is used during pregnancy, discontinue drug at least 1 mo before delivery); lactation; pregnancy.
Available Forms
Tablets—5, 10 mg; ER tabletsDNC—2.5, 5, 10 mg
Dosages
Dose conservatively in elderly patients, debilitated or malnourished patients, and patients with renal or hepatic impairment.
Give approximately 30 min before breakfast to achieve greatest reduction in postprandial hyperglycemia; if using extended-release form, give with breakfast.
Adults
Initial therapy: 5 mg PO before breakfast. Adjust dosage in increments of 2.5–5 mg as determined by blood glucose response. At least several days should elapse between adjustments. Maximum once-daily dose should not exceed 15 mg; above 15 mg, divide dose, and administer before meals. Do not exceed 40 mg/day. ER tablets:
5 mg/day. Adjust dosage in 5-mg increments every 3 mo; maximum dose—20 mg/day.
Maintenance therapy: Total daily doses above 15 mg PO should be divided; total daily doses above 30 mg are given in divided doses bid.
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