Glipizide 5mg Tablets
It is used to help control blood sugar in people with type 2 diabetes.
Drug Class
Antidiabetic Agent
Pharmacologic Class
Sulfonylurea
Pregnancy Category
Category C
FDA Approved
Jun 1984
DEA Schedule
Not Controlled
Overview
What is this medicine?
Glipizide is a medication used to treat type 2 diabetes. It helps your body make more insulin, a hormone that lowers blood sugar. It works best when taken before a meal.
How to Use This Medicine
Taking Your Medication
To use this medication correctly, follow your doctor's instructions and read all the information provided. Take this medication 30 minutes before meals. If you are taking it once a day, take it 30 minutes before your first meal of the day. It's essential to understand what to do if you don't eat as much as usual or if you skip a meal.
Storing and Disposing of Your Medication
Store your medication at room temperature in a dry place, avoiding the bathroom. Keep all medications in a safe location, out of the reach of children and pets. Dispose of unused or expired medications properly. Do not flush them down the toilet or pour them down the drain unless instructed to do so. If you have questions about disposing of your medication, consult your pharmacist. You may also want to check if there are drug take-back programs in your area.
Missing a Dose
If you miss a dose, take it as soon as you remember. However, if it's close to the time for your next dose, skip the missed dose and resume your regular schedule. Do not take two doses at the same time or take extra doses.
To use this medication correctly, follow your doctor's instructions and read all the information provided. Take this medication 30 minutes before meals. If you are taking it once a day, take it 30 minutes before your first meal of the day. It's essential to understand what to do if you don't eat as much as usual or if you skip a meal.
Storing and Disposing of Your Medication
Store your medication at room temperature in a dry place, avoiding the bathroom. Keep all medications in a safe location, out of the reach of children and pets. Dispose of unused or expired medications properly. Do not flush them down the toilet or pour them down the drain unless instructed to do so. If you have questions about disposing of your medication, consult your pharmacist. You may also want to check if there are drug take-back programs in your area.
Missing a Dose
If you miss a dose, take it as soon as you remember. However, if it's close to the time for your next dose, skip the missed dose and resume your regular schedule. Do not take two doses at the same time or take extra doses.
Lifestyle & Tips
- Take Glipizide 30 minutes before your first meal of the day (or before breakfast and dinner if taking twice daily).
- Maintain a consistent meal plan and regular exercise routine as advised by your doctor or dietitian.
- Monitor your blood sugar levels regularly as instructed by your healthcare provider.
- Carry a source of fast-acting sugar (e.g., glucose tablets, hard candy, fruit juice) to treat low blood sugar (hypoglycemia) if it occurs.
- Avoid or limit alcohol consumption, as it can increase the risk of low blood sugar.
Available Forms & Alternatives
Dosing & Administration
Adult Dosing
Standard Dose:
Initial: 5 mg orally once daily, 30 minutes before breakfast. Titrate in increments of 2.5-5 mg/day. Max: 40 mg/day (immediate release). Doses >15 mg/day should be divided.
Dose Range:
2.5 - 40 mg
Condition-Specific Dosing:
Type 2 Diabetes Mellitus:
Initial: 5 mg orally once daily, 30 minutes before breakfast. Titrate in increments of 2.5-5 mg/day based on blood glucose response. Max: 40 mg/day (immediate release). Doses >15 mg/day should be divided and given before meals.
Pediatric Dosing
Neonatal:
Not established
Infant:
Not established
Child:
Not established
Adolescent:
Not established
Dose Adjustments
Renal Impairment:
Mild:
No specific adjustment, monitor closely.
Moderate:
Initial dose should be 2.5 mg/day. Titrate cautiously.
Severe:
Initial dose should be 2.5 mg/day. Titrate cautiously, increased risk of hypoglycemia.
Dialysis:
Use with caution; consider alternative agents. Initial dose 2.5 mg/day, monitor closely for hypoglycemia.
Hepatic Impairment:
Mild:
Initial dose should be 2.5 mg/day. Titrate cautiously.
Moderate:
Initial dose should be 2.5 mg/day. Titrate cautiously, increased risk of hypoglycemia.
Severe:
Initial dose should be 2.5 mg/day. Titrate cautiously, increased risk of hypoglycemia. Avoid if possible.
Pharmacology
Mechanism of Action
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. This depolarizes the membrane, opening voltage-gated calcium channels, and the influx of calcium triggers insulin secretion. It also may increase peripheral glucose utilization and decrease hepatic glucose production.
Pharmacokinetics
Absorption:
Bioavailability:
90-100%
Tmax:
2-4 hours
FoodEffect:
Food delays absorption and reduces peak plasma concentrations. Should be taken 30 minutes before a meal.
Distribution:
Vd:
10-13 L
ProteinBinding:
>98% (primarily to albumin)
CnssPenetration:
Limited
Elimination:
HalfLife:
2-5 hours
Clearance:
Not available
ExcretionRoute:
Urine (80%), Feces (10%)
Unchanged:
<10% (in urine)
Pharmacodynamics
OnsetOfAction:
~30 minutes
PeakEffect:
1-2 hours
DurationOfAction:
10-24 hours (immediate release)
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Attention Immediately
Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek medical help right away:
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
Low blood sugar (hypoglycemia), which may be more likely when this medication is used with other diabetes medications. Symptoms of low blood sugar may include:
+ Dizziness
+ Headache
+ Feeling sleepy or weak
+ Shaking
+ Fast heartbeat
+ Confusion
+ Hunger
+ Sweating
If you experience any of these symptoms, contact your doctor immediately. Follow your doctor's instructions for managing low blood sugar, which may include taking glucose tablets, liquid glucose, or some fruit juices.
Other Possible Side Effects
Like all medications, this drug can cause side effects. Many people may not experience any side effects or may only have mild side effects. However, if you notice any of the following side effects or any other unusual symptoms, contact your doctor or seek medical help:
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, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek medical help right away:
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
Low blood sugar (hypoglycemia), which may be more likely when this medication is used with other diabetes medications. Symptoms of low blood sugar may include:
+ Dizziness
+ Headache
+ Feeling sleepy or weak
+ Shaking
+ Fast heartbeat
+ Confusion
+ Hunger
+ Sweating
If you experience any of these symptoms, contact your doctor immediately. Follow your doctor's instructions for managing low blood sugar, which may include taking glucose tablets, liquid glucose, or some fruit juices.
Other Possible Side Effects
Like all medications, this drug can cause side effects. Many people may not experience any side effects or may only have mild side effects. However, if you notice any of the following side effects or any other unusual symptoms, contact your doctor or seek medical help:
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, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Seek Immediate Medical Attention If You Experience:
- Symptoms of low blood sugar (hypoglycemia): sweating, shaking, dizziness, confusion, hunger, irritability, headache, blurred vision, rapid heartbeat. If these occur, treat immediately with fast-acting sugar.
- Symptoms of high blood sugar (hyperglycemia): increased thirst, frequent urination, fatigue, blurred vision. Report these to your doctor.
- Signs of allergic reaction: rash, itching, hives, swelling of the face/lips/tongue/throat, difficulty breathing. Seek immediate medical attention.
Before Using This Medicine
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 symptoms you experienced.
A known sulfa allergy.
Acidic blood conditions, such as those that affect your blood's acid-base balance.
If you have 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 other treatments and health conditions. Never start, stop, or adjust the dosage of any medication without first consulting 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 symptoms you experienced.
A known sulfa allergy.
Acidic blood conditions, such as those that affect your blood's acid-base balance.
If you have 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 other treatments and health conditions. Never start, stop, or adjust the dosage of any medication without first consulting your doctor.
Precautions & Cautions
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 and undergo blood tests as recommended by your healthcare provider. Discuss any concerns or questions with your doctor.
This medication may interfere with certain laboratory tests, so it is crucial to 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 to maintain optimal health.
Avoid driving if you have experienced low blood sugar, as it increases the risk of accidents. Refrain from consuming alcohol while taking this medication. If you are also taking colesevelam, take it at least 4 hours after taking this drug to minimize potential interactions.
Be aware 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 a deficiency of the enzyme G6PD, use caution, as you may be more susceptible to anemia. This 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; discuss this with your doctor to understand the potential risks and benefits. Low blood sugar is a possible side effect, and severe cases can lead to seizures, loss of consciousness, long-term brain damage, and even death. Consult your doctor to learn more about managing low blood sugar.
If you are 65 or older, use this medication with caution, as you may be more prone to side effects. Inform your doctor if you are pregnant, plan to become pregnant, or are breastfeeding, as the benefits and risks of this medication need to be carefully evaluated. Additionally, be aware that low blood sugar has occurred in infants born to mothers who took similar medications during pregnancy. If you are taking this medication and become pregnant, your doctor may advise you to stop taking it before your due date.
This medication may interfere with certain laboratory tests, so it is crucial to 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 to maintain optimal health.
Avoid driving if you have experienced low blood sugar, as it increases the risk of accidents. Refrain from consuming alcohol while taking this medication. If you are also taking colesevelam, take it at least 4 hours after taking this drug to minimize potential interactions.
Be aware 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 a deficiency of the enzyme G6PD, use caution, as you may be more susceptible to anemia. This 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; discuss this with your doctor to understand the potential risks and benefits. Low blood sugar is a possible side effect, and severe cases can lead to seizures, loss of consciousness, long-term brain damage, and even death. Consult your doctor to learn more about managing low blood sugar.
If you are 65 or older, use this medication with caution, as you may be more prone to side effects. Inform your doctor if you are pregnant, plan to become pregnant, or are breastfeeding, as the benefits and risks of this medication need to be carefully evaluated. Additionally, be aware that low blood sugar has occurred in infants born to mothers who took similar medications during pregnancy. If you are taking this medication and become pregnant, your doctor may advise you to stop taking it before your due date.
Overdose Information
Overdose Symptoms:
- Severe hypoglycemia (extremely low blood sugar)
- Confusion
- Seizures
- Loss of consciousness
- Coma
What to Do:
Immediately consume a source of fast-acting sugar (e.g., glucose tablets, juice, regular soda). If the person is unconscious or having seizures, do NOT give anything by mouth. Call 911 or emergency medical services immediately. Inform them of the medication taken. Call 1-800-222-1222 (Poison Control Center) for further guidance.
Drug Interactions
Major Interactions
- Bosentan (increased risk of hepatotoxicity)
- Miconazole (oral, IV, topical) (potentiates hypoglycemic effect)
Moderate Interactions
- Alcohol (disulfiram-like reaction, increased hypoglycemia)
- Beta-blockers (mask hypoglycemia symptoms, potentiate hypoglycemia)
- NSAIDs (potentiate hypoglycemic effect)
- Sulfonamides (potentiate hypoglycemic effect)
- Chloramphenicol (potentiates hypoglycemic effect)
- Coumarin derivatives (potentiate hypoglycemic effect)
- MAOIs (potentiate hypoglycemic effect)
- Probenecid (potentiate hypoglycemic effect)
- Fluconazole (potentiates hypoglycemic effect)
- Corticosteroids (decrease hypoglycemic effect)
- Thiazide diuretics (decrease hypoglycemic effect)
- Phenothiazines (decrease hypoglycemic effect)
- Thyroid products (decrease hypoglycemic effect)
- Estrogens/Oral Contraceptives (decrease hypoglycemic effect)
- Phenytoin (decrease hypoglycemic effect)
- Nicotinic acid (decrease hypoglycemic effect)
- Sympathomimetics (decrease hypoglycemic effect)
- Calcium channel blockers (decrease hypoglycemic effect)
- Isoniazid (decrease hypoglycemic effect)
- Colesevelam (decreased glipizide absorption; administer glipizide at least 4 hours before colesevelam)
Monitoring
Baseline Monitoring
HbA1c
Rationale: To establish baseline glycemic control and guide initial therapy.
Timing: Prior to initiation of therapy.
Fasting Plasma Glucose (FPG)
Rationale: To establish baseline glycemic control and guide initial therapy.
Timing: Prior to initiation of therapy.
Renal Function (SCr, eGFR)
Rationale: To assess kidney function, as glipizide is primarily renally excreted and dose adjustments may be needed in impairment.
Timing: Prior to initiation of therapy.
Hepatic Function (ALT, AST, Bilirubin)
Rationale: To assess liver function, as glipizide is metabolized in the liver and dose adjustments may be needed in impairment.
Timing: Prior to initiation of therapy.
Routine Monitoring
HbA1c
Frequency: Every 3-6 months (or more frequently if glycemic control is not at goal or therapy is changed).
Target: <7% (individualized based on patient factors)
Action Threshold: >7% (consider dose adjustment or addition of other agents)
Fasting Plasma Glucose (FPG)
Frequency: Daily (patient self-monitoring) or periodically in clinic.
Target: 80-130 mg/dL (individualized)
Action Threshold: <70 mg/dL (hypoglycemia, requires intervention); >130 mg/dL (hyperglycemia, consider dose adjustment)
Postprandial Glucose (PPG)
Frequency: Periodically (patient self-monitoring) or in clinic.
Target: <180 mg/dL (individualized)
Action Threshold: >180 mg/dL (consider dose adjustment)
Signs and Symptoms of Hypoglycemia
Frequency: Ongoing patient education and monitoring.
Target: N/A
Action Threshold: Any occurrence of symptoms (e.g., sweating, tremor, confusion, hunger) requires immediate action (consume fast-acting carbohydrates).
Symptom Monitoring
- Symptoms of hypoglycemia: sweating, tremor, dizziness, confusion, hunger, irritability, headache, blurred vision, rapid heartbeat, anxiety, weakness.
- Symptoms of hyperglycemia (if control is inadequate): increased thirst, increased urination, fatigue, blurred vision.
- Signs of allergic reaction: rash, itching, hives, swelling of face/lips/tongue/throat, difficulty breathing.
Special Patient Groups
Pregnancy
Generally not recommended during pregnancy. Insulin is the preferred treatment for diabetes during pregnancy due to the risk of neonatal hypoglycemia with sulfonylureas. If used, close monitoring of maternal and fetal blood glucose is essential.
Trimester-Specific Risks:
First Trimester:
Potential for teratogenicity, though data are limited and conflicting.
Second Trimester:
Risk of fetal hypoglycemia, especially if used close to delivery.
Third Trimester:
High risk of severe and prolonged neonatal hypoglycemia if used near term. Insulin is strongly preferred.
Lactation
Not recommended during breastfeeding. Glipizide is excreted into breast milk and can cause hypoglycemia in the breastfed infant. Insulin is generally preferred for managing diabetes in lactating mothers.
Infant Risk:
High risk of hypoglycemia in the infant.
Pediatric Use
Safety and efficacy have not been established in pediatric patients. Not recommended for use in children.
Geriatric Use
Use with caution in elderly patients. They may be more sensitive to the hypoglycemic effects of glipizide and are at increased risk of severe hypoglycemia. Start with a lower dose (e.g., 2.5 mg/day) and titrate slowly. Monitor renal function closely.
Clinical Information
Clinical Pearls
- Glipizide should be taken 30 minutes before a meal to optimize absorption and reduce the risk of postprandial hyperglycemia.
- The immediate-release formulation has a shorter half-life and duration of action compared to the extended-release (Glucotrol XL) formulation, which may require divided dosing for higher daily doses.
- Patients should be educated on the signs and symptoms of hypoglycemia and how to treat it promptly.
- Weight gain is a common side effect of sulfonylureas due to increased insulin levels.
- Alcohol consumption can significantly increase the risk of hypoglycemia and should be limited or avoided.
- Patients with impaired renal or hepatic function are at increased risk of hypoglycemia and require lower starting doses and careful titration.
Alternative Therapies
- Metformin (Biguanide)
- DPP-4 Inhibitors (e.g., sitagliptin, saxagliptin)
- SGLT2 Inhibitors (e.g., empagliflozin, dapagliflozin)
- GLP-1 Receptor Agonists (e.g., liraglutide, semaglutide)
- Thiazolidinediones (e.g., pioglitazone)
- Insulin
- Meglitinides (e.g., repaglinide, nateglinide)
Cost & Coverage
Average Cost:
$10 - $30 per 30 tablets (5mg generic)
Generic Available:
Yes
Insurance Coverage:
Tier 1 (Generic)
General Drug Facts
If your symptoms or health issues persist or worsen, it's 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 be sure to check with your pharmacist for more information. If you have any questions or concerns about this 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 emergency medical attention. When seeking help, be prepared to provide details about the medication, including the amount taken and the time it happened, to facilitate prompt and effective treatment.