Glipizide 2.5mg Tablets

Glipizide is a second-generation sulfonylurea that lowers blood glucose by stimulating the release of insulin from the beta cells of the pancreatic islets. It binds to the sulfonylurea receptor (SUR1) on the beta-cell membrane, leading to the closure of ATP-sensitive potassium channels, depolarization of the membrane, opening of voltage-gated calcium channels, and subsequent influx of calcium, which triggers insulin exocytosis.

Urgent Side Effects: Seek Medical Help Right Away

While rare, some people may experience severe and potentially life-threatening side effects when taking this medication. If you notice any of the following symptoms, contact your doctor or seek medical attention immediately:

Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Changes in eyesight
Slurred speech
Tingling
Fever, chills, or sore throat
Unexplained bruising or bleeding
Feeling extremely tired or weak

Additionally, low blood sugar (hypoglycemia) can occur, especially when this medication is used with other diabetes medications. If you experience any of the following symptoms, contact your doctor right away:

Dizziness
Headache
Feeling sleepy or weak
Shaking
Fast heartbeat
Confusion
Hunger
Sweating

Follow your doctor's instructions for managing low blood sugar, which may include taking glucose tablets, liquid glucose, or consuming certain fruit juices.

Other Possible Side Effects

Most people do not experience significant side effects, but some may occur. If you notice any of the following side effects or any other unusual symptoms, contact your doctor or seek medical attention if they bother you or do not go away:

Dizziness
Diarrhea
Feeling nervous and excitable
* Gas

This is not an exhaustive list of possible side effects. If you have questions or concerns about side effects, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.

Before Taking This Medication: Important Information to Share with Your Doctor

It is essential to inform your doctor about the following:

Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction you experienced.
A known sulfa allergy.
Acidic blood problems, such as acidosis.
Type 1 diabetes, as this medication is not intended to treat this condition.

This list is not exhaustive, and it is crucial to discuss all your medications (prescription, over-the-counter, natural products, and vitamins) and health issues with your doctor and pharmacist. They will help determine if it is safe to take this medication with your existing treatments and health conditions. Never start, stop, or adjust the dosage of any medication without first consulting your doctor.

It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication. Before engaging in activities that require alertness, such as driving, wait until you understand how this drug affects you. Monitor your blood sugar levels as instructed by your doctor.

Regular blood work is crucial, so follow your doctor's recommendations for checking your blood and discuss the results with them. Be aware that this medication may interfere with certain lab tests, so notify all your healthcare providers and lab personnel that you are taking this drug.

Adhere to the diet and exercise plan outlined by your doctor. If you experience low blood sugar, avoid driving, as it increases the risk of accidents. Additionally, refrain from consuming alcohol while taking this medication. If you are also taking colesevelam, take it at least 4 hours after taking this drug.

Be mindful that stress, such as fever, infection, injury, or surgery, can affect blood sugar control. Changes in physical activity, exercise, or diet may also impact blood sugar levels. If you have low levels of the enzyme G6PD, use caution, as you may be more prone to anemia. This enzyme deficiency is more common in individuals of African, South Asian, Middle Eastern, and Mediterranean descent.

This medication may increase the risk of heart disease-related death, so discuss this with your doctor. Be aware that low blood sugar can occur, and severe cases can lead to seizures, loss of consciousness, long-term brain damage, and even death. Consult your doctor about this risk.

If you are 65 or older, use this medication with caution, as you may be more susceptible to side effects. Inform your doctor if you are pregnant, plan to become pregnant, or are breastfeeding, as you will need to discuss the benefits and risks to you and your baby. Note that low blood sugar has occurred in infants born to mothers who took a similar medication until the birth date. If you take this medication during pregnancy, you may need to stop taking it before your due date, so consult your doctor.

• Bosentan (increased risk of hepatotoxicity)
• Miconazole (oral, increased risk of hypoglycemia)

• Alcohol (disulfiram-like reaction, increased hypoglycemia)
• Beta-blockers (mask hypoglycemia symptoms, impair glucose counter-regulation)
• Fluconazole (increased glipizide levels, hypoglycemia)
• NSAIDs (e.g., ibuprofen, naproxen - increased glipizide levels, hypoglycemia)
• Sulfonamides (e.g., sulfamethoxazole/trimethoprim - increased glipizide levels, hypoglycemia)
• Chloramphenicol (increased glipizide levels, hypoglycemia)
• Warfarin (potential for altered INR, increased bleeding risk)

• Corticosteroids (decreased hypoglycemic effect)
• Thiazide diuretics (decreased hypoglycemic effect)
• Thyroid hormones (decreased hypoglycemic effect)
• Oral contraceptives (decreased hypoglycemic effect)
• Phenytoin (decreased hypoglycemic effect)
• Rifampin (decreased glipizide levels, reduced efficacy)
• Cimetidine (increased glipizide levels, hypoglycemia)
• MAO inhibitors (increased glipizide levels, hypoglycemia)

• Chromium supplements (potential additive effect on glucose lowering)
• Garlic supplements (potential additive effect on glucose lowering)

• Sweating
• Tremor
• Palpitations
• Anxiety
• Hunger
• Confusion
• Dizziness
• Headache
• Irritability
• Blurred vision
• Slurred speech
• Seizures
• Loss of consciousness

Glipizide is Pregnancy Category C. It is generally not recommended for use during pregnancy due to potential for fetal hyperinsulinemia and neonatal hypoglycemia. Insulin is the preferred treatment for diabetes during pregnancy.

Glipizide is excreted into breast milk. Due to the potential for hypoglycemia in the nursing infant, it is generally not recommended during breastfeeding. Insulin is usually preferred.

Safety and efficacy have not been established in pediatric patients. Use is not recommended.

Elderly patients are more susceptible to the hypoglycemic effects of glipizide due to decreased renal and hepatic function, and often have less robust counter-regulatory responses. Start with a lower dose (e.5 mg or 2.5 mg) and titrate slowly. Monitor blood glucose closely and educate on hypoglycemia symptoms.

• Glipizide should be taken 30 minutes before a meal to ensure optimal absorption and reduce the risk of post-meal hyperglycemia. Taking it with food can delay absorption and blunt its peak effect.
• The 2.5 mg tablet is often used as a starting dose for elderly patients, those with mild renal or hepatic impairment, or patients who are very sensitive to hypoglycemic agents.
• Patients should be thoroughly educated on the symptoms of hypoglycemia and how to treat it, as sulfonylureas carry a significant risk of this adverse effect.
• Alcohol consumption should be limited or avoided due to increased risk of hypoglycemia and potential disulfiram-like reactions.
• Regular monitoring of blood glucose and HbA1c is crucial to assess efficacy and safety.
• Consider discontinuing glipizide if the patient develops severe renal or hepatic impairment, or if they are NPO for an extended period, to prevent severe hypoglycemia.

• Metformin (first-line for most Type 2 DM patients)
• DPP-4 inhibitors (e.g., sitagliptin, saxagliptin)
• SGLT2 inhibitors (e.g., empagliflozin, canagliflozin)
• GLP-1 receptor agonists (e.g., liraglutide, semaglutide)
• Thiazolidinediones (e.g., pioglitazone)
• Insulin (various formulations)
• Meglitinides (e.g., repaglinide, nateglinide - shorter acting insulin secretagogues)

If your symptoms or health issues persist or worsen, it is essential to contact your doctor for further guidance. To ensure your safety, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so it's a good idea to check with your pharmacist for more information. If you have any questions or concerns about your medication, don't hesitate to reach out to your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek medical attention. When seeking help, be prepared to provide details about the medication, including the amount taken and the time it happened, to ensure you receive the best possible care.