glipizide: clinical use

Prescribing considerations

• Confirm functioning endogenous insulin secretion and use only for adult type 2 diabetes.
• Assess hypoglycaemia risk, including irregular nutrition, strenuous exercise, alcohol use, endocrine insufficiency and concurrent glucose-lowering treatment.
• Older, debilitated or malnourished people and those with renal or hepatic impairment are more susceptible to severe or prolonged hypoglycaemia.
• Consider a non-sulfonylurea option in G6PD deficiency because haemolytic anaemia can occur.
• Acute infection, trauma, fever or surgery may disrupt glycaemic control and require treatment reassessment.
• Review adherence, lifestyle factors and disease progression if glycaemic response deteriorates.

Contraindications and cautions

• Hypersensitivity to glipizide, other sulfonylureas, sulfonamides or product excipients
• Type 1 diabetes, diabetic ketoacidosis or diabetic coma
• Severe renal or hepatic insufficiency
• Concurrent miconazole treatment
• Pregnancy or breastfeeding

Monitoring

• Glycaemic response using appropriate glucose measurements and glycated haemoglobin
• Frequency, severity and awareness of hypoglycaemia
• Renal and hepatic function where clinically indicated
• Glucose control when interacting medicines are introduced or withdrawn
• Ongoing effectiveness, because secondary loss of response may occur

Clinical pharmacology

Glipizide is rapidly and almost completely absorbed, highly protein bound and extensively metabolised in the liver to mainly inactive products eliminated largely in urine. Its principal action is meal-related stimulation of pancreatic beta-cell insulin secretion.

Formulation and product differences

• The selected product is an immediate-release oral tablet.
• The tablet contains lactose.
• Although scored on both sides, the score line is not intended for dividing the tablet.

Tablet

Route: Oral

Strengths: 5 mg