Glipizide
Generic name: glipizide · Brand names: Glucotrol, Glucotrol XL
Quick facts
Drug class
Source
Apotex label (set ID dcf426b8-bcdc-8214-a1b6-6388bd3399a0), Description; MedlinePlus: 'Glipizide is in a class of medications called sulfonylureas.' openFDA pharm_class_epc not queried
Source text (exact source wording)
Glipizide is an oral blood-glucose-lowering drug of the sulfonylurea class.
Rx or otc
Rx ('Rx Only' on label)
Forms and strengths
- Glipizide Tablets, USP 5 mg and 10 mg: white to off-white, round, scored tablets, imprinted as follows: 5 mg- “APO” on the side and “GLP” over bisect “5” on the other side; 10 mg- “APO” on one side and “GLP” over bisect “10” on the other side.
Generic available
Value
yes
Source
DailyMed: Apotex label marketing category ANDA (ANDA075795); other ANDA labels: ANI ANDA074497, Oxford ANDA074378, Advagen ANDA214874, Actavis ANDA074223
Common use one line
Glipizide tablets are indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.
What it is used for
Glipizide is used along with diet and exercise to improve blood sugar control in adults with type 2 diabetes mellitus.
Section
INDICATIONS AND USAGE
Source
Apotex label (set ID dcf426b8-bcdc-8214-a1b6-6388bd3399a0)
Source text (exact source wording)
Glipizide tablets are indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.
How it works
Glipizide appears to lower blood sugar by stimulating the pancreas to release insulin. This depends on working beta cells in the pancreas. How it works during long-term use has not been clearly established.
Section
CLINICAL PHARMACOLOGY: Mechanism of Action
Source
Apotex label (set ID dcf426b8-bcdc-8214-a1b6-6388bd3399a0)
Source text (exact source wording)
The primary mode of action of glipizide in experimental animals appears to be the stimulation of insulin secretion from the beta cells of pancreatic islet tissue and is thus dependent on functioning beta cells in the pancreatic islets. In humans, glipizide appears to lower the blood glucose acutely by stimulating the release of insulin from the pancreas, an effect dependent upon functioning beta cells in the pancreatic islets. The mechanism by which glipizide lowers blood glucose during long-term administration has not been clearly established.
Dosage: adults
Glipizide tablets are generally given about 30 minutes before a meal. The recommended starting dose is 5 mg before breakfast. Dose changes are usually in steps of 2.5 to 5 mg, with at least several days between steps. The maximum recommended once daily dose is 15 mg, doses above 15 mg are ordinarily divided and given before meals, and the maximum recommended total daily dose is 40 mg.
Section
DOSAGE AND ADMINISTRATION
Source
Apotex label (set ID dcf426b8-bcdc-8214-a1b6-6388bd3399a0)
Source text (exact source wording)
In general, glipizide tablets should be given approximately 30 minutes before a meal to achieve the greatest reduction in postprandial hyperglycemia.
Initial Dose
The recommended starting dose is 5 mg, given before breakfast. Geriatric patients or those with liver disease may be started on 2.5 mg.
Titration
Dosage adjustments should ordinarily be in increments of 2.5 to 5 mg, as determined by blood glucose response. At least several days should elapse between titration steps. If response to a single dose is not satisfactory, dividing that dose may prove effective. The maximum recommended once daily dose is 15 mg. Doses above 15 mg should ordinarily be divided and given before meals of adequate caloric content. The maximum recommended total daily dose is 40 mg.
Maintenance
Some patients may be effectively controlled on a once-a-day regimen, while others show better response with divided dosing. Total daily doses above 15 mg should ordinarily be divided. Total daily doses above 30 mg have been safely given on a b.i.d. basis to long-term patients.
Initial Dose
The recommended starting dose is 5 mg, given before breakfast. Geriatric patients or those with liver disease may be started on 2.5 mg.
Titration
Dosage adjustments should ordinarily be in increments of 2.5 to 5 mg, as determined by blood glucose response. At least several days should elapse between titration steps. If response to a single dose is not satisfactory, dividing that dose may prove effective. The maximum recommended once daily dose is 15 mg. Doses above 15 mg should ordinarily be divided and given before meals of adequate caloric content. The maximum recommended total daily dose is 40 mg.
Maintenance
Some patients may be effectively controlled on a once-a-day regimen, while others show better response with divided dosing. Total daily doses above 15 mg should ordinarily be divided. Total daily doses above 30 mg have been safely given on a b.i.d. basis to long-term patients.
Dosage: children
Safety and effectiveness in children have not been established. No pediatric dosing is given.
Section
PRECAUTIONS: Pediatric Use
Source
Apotex label (set ID dcf426b8-bcdc-8214-a1b6-6388bd3399a0)
Source text (exact source wording)
Safety and effectiveness in children have not been established.
Dosage adjustments
Drug interaction caps
Take glipizide at least 4 hours before colesevelam. No dose cap tied to an interacting drug is given.
Section
DOSAGE AND ADMINISTRATION
Source
Apotex label (set ID dcf426b8-bcdc-8214-a1b6-6388bd3399a0)
Source text (exact source wording)
When colesevelam is coadministered with glipizide ER, maximum plasma concentration and total exposure to glipizide is reduced. Therefore, glipizide should be administered at least 4 hours prior to colesevelam.
Kidney
In people with kidney problems, initial and maintenance dosing should be conservative. Hypoglycemia may be prolonged. No specific kidney dose is given.
Section
DOSAGE AND ADMINISTRATION; PRECAUTIONS: Renal and Hepatic Disease
Source
Apotex label (set ID dcf426b8-bcdc-8214-a1b6-6388bd3399a0)
Source text (exact source wording)
In elderly patients, debilitated or malnourished patients, and patients with impaired renal or hepatic function, the initial and maintenance dosing should be conservative to avoid hypoglycemic reactions (see PRECAUTIONS section). / The metabolism and excretion of glipizide may be slowed in patients with impaired renal and/or hepatic function. If hypoglycemia should occur in such patients, it may be prolonged and appropriate management should be instituted.
Liver
People with liver disease may be started on 2.5 mg, and dosing should be conservative.
Section
DOSAGE AND ADMINISTRATION
Source
Apotex label (set ID dcf426b8-bcdc-8214-a1b6-6388bd3399a0)
Source text (exact source wording)
Geriatric patients or those with liver disease may be started on 2.5 mg. / In elderly patients, debilitated or malnourished patients, and patients with impaired renal or hepatic function, the initial and maintenance dosing should be conservative to avoid hypoglycemic reactions (see PRECAUTIONS section).
Elderly
Older patients may be started on 2.5 mg. Dose selection should be cautious, usually starting at the low end of the range.
Section
DOSAGE AND ADMINISTRATION; PRECAUTIONS: Geriatric Use
Source
Apotex label (set ID dcf426b8-bcdc-8214-a1b6-6388bd3399a0)
Source text (exact source wording)
Geriatric patients or those with liver disease may be started on 2.5 mg. ... In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.
Missed dose
MedlinePlus says to ask your doctor what to do about a missed dose. As a general rule, take it as soon as you remember. If it is almost time for the next dose, skip the missed dose. Do not take a double dose.
Section
What should I do if I forget a dose?
Source
MedlinePlus glipizide page (Last Revised - 10/15/2017)
Medlineplus source text (exact source wording)
Before you start to take glipizide, ask you doctor what you should do if you forget to take a dose. Write these directions down so that you can refer to them later. As a general rule, take the missed dose as soon as you remember it. If it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.
Overdose
Overdose can cause low blood sugar. Mild symptoms are treated with oral glucose and adjustments to dose or meals. Severe reactions with coma, seizure, or other neurological problems are medical emergencies needing immediate hospitalization. Patients should be monitored for a minimum of 24 to 48 hours because low blood sugar may recur. Call poison control at 1-800-222-1222, or 911 if the person has collapsed, had a seizure, has trouble breathing, or can't be awakened.
Section
OVERDOSAGE; MedlinePlus
Source
Apotex label (set ID dcf426b8-bcdc-8214-a1b6-6388bd3399a0)
Source text (exact source wording)
There is no well documented experience with glipizide overdosage. ... Overdosage of sulfonylureas, including glipizide, can produce hypoglycemia. Mild hypoglycemic symptoms without loss of consciousness or neurologic findings should be treated aggressively with oral glucose and adjustments in drug dosage and/or meal patterns. ... Severe hypoglycemic reactions with coma, seizure, or other neurological impairment occur infrequently, but constitute medical emergencies requiring immediate hospitalization. ... Patients should be closely monitored for a minimum of 24 to 48 hours since hypoglycemia may recur after apparent clinical recovery.
[MedlinePlus] In case of overdose, call the poison control helpline at 1-800-222-1222. ... If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.
[MedlinePlus] In case of overdose, call the poison control helpline at 1-800-222-1222. ... If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.
Storage
Store at 20˚C to 25˚C (68˚F to 77˚F) in a tight, light-resistant container.
Section
RECOMMENDED STORAGE (Apotex-specific)
Source
Apotex label (set ID dcf426b8-bcdc-8214-a1b6-6388bd3399a0)
Source text (exact source wording)
Store at 20˚C to 25˚C (68˚F to 77˚F) [see USP Controlled Room Temperature]. Dispense in a tight, light-resistant container [see USP].
Boxed warning
There is no boxed warning in this label. Its WARNINGS section carries a special warning: oral diabetes drugs have been reported to be associated with increased cardiovascular mortality compared with diet alone or diet plus insulin. This is based on the UGDP study of 823 patients, in which patients treated for 5 to 8 years with diet plus a fixed dose of tolbutamide (1.5 grams per day) had a cardiovascular mortality rate approximately 21/2 times that of patients treated with diet alone. The label says this warning may also apply to other drugs in this class.
Section
WARNINGS
Source
Apotex label (set ID dcf426b8-bcdc-8214-a1b6-6388bd3399a0)
Source text (exact source wording)
NONE (the Apotex SPL has no BOXED WARNING section). The label's WARNINGS section opens with a bolded special warning, recorded here for completeness: SPECIAL WARNING ON INCREASED RISK OF CARDIOVASCULAR MORTALITY. The administration of oral hypoglycemic drugs has been reported to be associated with increased cardiovascular mortality as compared to treatment with diet alone or diet plus insulin. This warning is based on the study conducted by the University Group Diabetes Program (UGDP), a long-term prospective clinical trial designed to evaluate the effectiveness of glucose-lowering drugs in preventing or delaying vascular complications in patients with non-insulin-dependent diabetes. The study involved 823 patients who were randomly assigned to one of four treatment groups (Diabetes, 19, supp. 2: 747-830, 1970). UGDP reported that patients treated for 5 to 8 years with diet plus a fixed dose of tolbutamide (1.5 grams per day) had a rate of cardiovascular mortality approximately 21/2 times that of patients treated with diet alone. A significant increase in total mortality was not observed, but the use of tolbutamide was discontinued based on the increase in cardiovascular mortality, thus limiting the opportunity for the study to show an increase in overall mortality. Despite controversy regarding the interpretation of these results, the findings of the UGDP study provide an adequate basis for this warning. The patient should be informed of the potential risks and advantages of glipizide and of alternative modes of therapy.
Contraindications
Do not use glipizide if you are allergic to it, or if you have type 1 diabetes or diabetic ketoacidosis (with or without coma). That condition should be treated with insulin.
Section
CONTRAINDICATIONS
Source
Apotex label (set ID dcf426b8-bcdc-8214-a1b6-6388bd3399a0)
Source text (exact source wording)
Glipizide is contraindicated in patients with: 1. Known hypersensitivity to the drug. 2. Type 1 diabetes mellitus, diabetic ketoacidosis, with or without coma. This condition should be treated with insulin.
Warnings and precautions
The label says this cardiovascular mortality warning may also apply to other oral hypoglycemic drugs in this class.
Heading
Special warning on increased risk of cardiovascular mortality
Section
WARNINGS
Source
Apotex label (set ID dcf426b8-bcdc-8214-a1b6-6388bd3399a0)
Source text (exact source wording)
Although only one drug in the sulfonylurea class (tolbutamide) was included in this study, it is prudent from a safety standpoint to consider that this warning may also apply to other oral hypoglycemic drugs in this class, in view of their close similarities in mode of action and chemical structure.
No clinical studies have established conclusive evidence that glipizide reduces macrovascular risk.
Heading
Macrovascular Outcomes
Section
PRECAUTIONS
Source
Apotex label (set ID dcf426b8-bcdc-8214-a1b6-6388bd3399a0)
Source text (exact source wording)
There have been no clinical studies establishing conclusive evidence of macrovascular risk reduction with glipizide or any other anti-diabetic drug.
With kidney or liver problems, glipizide may be cleared more slowly and low blood sugar may be prolonged.
Heading
Renal and Hepatic Disease
Section
PRECAUTIONS
Source
Apotex label (set ID dcf426b8-bcdc-8214-a1b6-6388bd3399a0)
Source text (exact source wording)
The metabolism and excretion of glipizide may be slowed in patients with impaired renal and/or hepatic function. If hypoglycemia should occur in such patients, it may be prolonged and appropriate management should be instituted.
Glipizide can cause severe low blood sugar. Older, weakened, or malnourished people, and those with adrenal or pituitary insufficiency, are more susceptible. Low blood sugar may be hard to recognize in the elderly and in people taking beta blockers. It is more likely with too little food, severe or prolonged exercise, alcohol, or more than one glucose-lowering drug.
Heading
Hypoglycemia
Section
PRECAUTIONS
Source
Apotex label (set ID dcf426b8-bcdc-8214-a1b6-6388bd3399a0)
Source text (exact source wording)
All sulfonylurea drugs are capable of producing severe hypoglycemia. Proper patient selection, dosage, and instructions are important to avoid hypoglycemic episodes. ... Elderly, debilitated or malnourished patients, and those with adrenal or pituitary insufficiency, are particularly susceptible to the hypoglycemic action of glucose-lowering drugs. Hypoglycemia may be difficult to recognize in the elderly, and in people who are taking beta-adrenergic blocking drugs. Hypoglycemia is more likely to occur when caloric intake is deficient, after severe or prolonged exercise, when alcohol is ingested, or when more than one glucose-lowering drug is used.
Stress such as fever, trauma, infection, or surgery can cause loss of blood sugar control, and it may be necessary to stop glipizide and give insulin.
Heading
Loss of Control of Blood Glucose
Section
PRECAUTIONS
Source
Apotex label (set ID dcf426b8-bcdc-8214-a1b6-6388bd3399a0)
Source text (exact source wording)
When a patient stabilized on any diabetic regimen is exposed to stress such as fever, trauma, infection, or surgery, a loss of control may occur. At such times, it may be necessary to discontinue glipizide and administer insulin.
In people with G6PD deficiency, sulfonylureas can lead to hemolytic anemia, so caution is needed and a non-sulfonylurea alternative should be considered. Hemolytic anemia has also been reported in people without known G6PD deficiency.
Heading
Hemolytic Anemia
Section
PRECAUTIONS
Source
Apotex label (set ID dcf426b8-bcdc-8214-a1b6-6388bd3399a0)
Source text (exact source wording)
Treatment of patients with glucose 6-phosphate dehydrogenase (G6PD) deficiency with sulfonylurea agents can lead to hemolytic anemia. Because glipizide belongs to the class of sulfonylurea agents, caution should be used in patients with G6PD deficiency and a non-sulfonylurea alternative should be considered. In post-marketing reports, hemolytic anemia has also been reported in patients who did not have known G6PD deficiency.
Blood and urine glucose should be checked periodically. Measuring glycosylated hemoglobin may be useful.
Heading
Laboratory Tests
Section
PRECAUTIONS
Source
Apotex label (set ID dcf426b8-bcdc-8214-a1b6-6388bd3399a0)
Source text (exact source wording)
Blood and urine glucose should be monitored periodically. Measurement of glycosylated hemoglobin may be useful.
Pregnancy and breastfeeding
Glipizide was mildly fetotoxic in rat studies, and there are no adequate studies in pregnant women. It should be used in pregnancy only if the potential benefit justifies the potential risk. Prolonged severe low blood sugar (4 to 10 days) has been reported in newborns of mothers taking a sulfonylurea at delivery, and glipizide should be discontinued at least one month before the expected delivery date. It is not known whether glipizide is in breast milk, but some sulfonylureas are, and nursing infants could have low blood sugar.
Section
PRECAUTIONS: Pregnancy; Nursing Mothers (ellipses mark omitted text)
Source
Apotex label (set ID dcf426b8-bcdc-8214-a1b6-6388bd3399a0)
Source text (exact source wording)
Pregnancy Category C. Glipizide was found to be mildly fetotoxic in rat reproductive studies at all dose levels (5 to 50 mg/kg). ... There are no adequate and well controlled studies in pregnant women. Glipizide should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. ... Prolonged severe hypoglycemia (4 to 10 days) has been reported in neonates born to mothers who were receiving a sulfonylurea drug at the time of delivery. ... If glipizide is used during pregnancy, it should be discontinued at least one month before the expected delivery date.
Nursing Mothers: Although it is not known whether glipizide is excreted in human milk, some sulfonylurea drugs are known to be excreted in human milk. Because the potential for hypoglycemia in nursing infants may exist, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
Nursing Mothers: Although it is not known whether glipizide is excreted in human milk, some sulfonylurea drugs are known to be excreted in human milk. Because the potential for hypoglycemia in nursing infants may exist, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
Side effects
Common
The label says gastrointestinal disturbances are the most common reactions: nausea and diarrhea (about one in seventy) and constipation and gastralgia (about one in one hundred). These appear dose-related and may disappear when the dose is divided or reduced.
Threshold
The label gives no percentage threshold for 'common'. It states: 'Gastrointestinal disturbances are the most common reactions.' Incidences are given as fractions.
Section
ADVERSE REACTIONS: Gastrointestinal
Source
Apotex label (set ID dcf426b8-bcdc-8214-a1b6-6388bd3399a0)
Source text (exact source wording)
Gastrointestinal disturbances are the most common reactions. Gastrointestinal complaints were reported with the following approximate incidence: nausea and diarrhea, one in seventy; constipation and gastralgia, one in one hundred. They appear to be dose-related and may disappear on division or reduction of dosage.
Less common
Allergic skin reactions have been reported in about one in seventy patients. Dizziness, drowsiness, and headache have each been reported in about one in fifty patients and are usually transient. The label has no placebo-controlled table with percentages.
Section
ADVERSE REACTIONS: Dermatologic; Miscellaneous
Source
Apotex label (set ID dcf426b8-bcdc-8214-a1b6-6388bd3399a0)
Source text (exact source wording)
Allergic skin reactions including erythema, morbilliform or maculopapular eruptions, urticaria, pruritus, and eczema have been reported in about one in seventy patients. ... Dizziness, drowsiness, and headache have each been reported in about one in fifty patients treated with glipizide. They are usually transient and seldom require discontinuance of therapy. (No placebo-controlled table with percentages is in the label.)
Serious
Label
Serious problems named in the label include severe low blood sugar, rare liver injury with jaundice, blood cell problems (leukopenia, agranulocytosis, thrombocytopenia, hemolytic anemia, aplastic anemia, pancytopenia), hepatic porphyria, low sodium with SIADH, and disulfiram-like reactions.
Source
Apotex label (set ID dcf426b8-bcdc-8214-a1b6-6388bd3399a0)
Source text (exact source wording)
All sulfonylurea drugs are capable of producing severe hypoglycemia. (PRECAUTIONS) ... Cholestatic jaundice may occur rarely with sulfonylureas: glipizide should be discontinued if this occurs. ... Leukopenia, agranulocytosis, thrombocytopenia, hemolytic anemia (see PRECAUTIONS), aplastic anemia, and pancytopenia have been reported with sulfonylureas. ... Hepatic porphyria and disulfiram-like reactions have been reported with sulfonylureas. ... Cases of hyponatremia and the syndrome of inappropriate antidiuretic hormone (SIADH) secretion have been reported with this and other sulfonylureas. ... Cholestatic and hepatocellular forms of liver injury accompanied by jaundice have been reported rarely in association with glipizide; glipizide should be discontinued if this occurs. (Post-Marketing Experience)
Medlineplus
MedlinePlus says to call your doctor immediately for yellowing of the skin or eyes, light-colored stools, dark urine, pain in the upper right part of the stomach, unusual bruising or bleeding, fever, or sore throat.
Source
MedlinePlus glipizide page (Last Revised - 10/15/2017)
Source text (exact source wording)
Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately: yellowing of the skin or eyes; light-colored stools; dark urine; pain in the upper right part of the stomach; unusual bruising or bleeding; fever; sore throat
Led to discontinuation
Of 702 patients in U.S. and foreign controlled studies, 11.8% reported adverse reactions and in only 1.5% was glipizide discontinued.
Section
ADVERSE REACTIONS
Source
Apotex label (set ID dcf426b8-bcdc-8214-a1b6-6388bd3399a0)
Source text (exact source wording)
In U.S. and foreign controlled studies, the frequency of serious adverse reactions reported was very low. Of 702 patients, 11.8% reported adverse reactions and in only 1.5% was glipizide discontinued.
Interactions
Drugs
NSAIDs, some azoles, salicylates, sulfonamides, chloramphenicol, probenecid, coumarins, MAOIs, quinolones, and beta blockers may increase the low-blood-sugar effect. Watch closely for hypoglycemia when they are added and for loss of control when they are stopped.
Name
Drugs that may increase the hypoglycemic action
Section
PRECAUTIONS: Drug Interactions
Source text (exact source wording)
The hypoglycemic action of sulfonylureas may be potentiated by certain drugs including nonsteroidal anti-inflammatory agents, some azoles, and other drugs that are highly protein bound, salicylates, sulfonamides, chloramphenicol, probenecid, coumarins, monoamine oxidase inhibitors, quinolones and beta adrenergic blocking agents. When such drugs are administered to a patient receiving glipizide, the patient should be observed closely for hypoglycemia. When such drugs are withdrawn from a patient receiving glipizide, the patient should be observed closely for loss of control.
Thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, and isoniazid may raise blood sugar and lead to loss of control.
Name
Drugs that tend to produce hyperglycemia
Section
PRECAUTIONS: Drug Interactions
Source text (exact source wording)
Certain drugs tend to produce hyperglycemia and may lead to loss of control. These drugs include the thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blocking drugs, and isoniazid. When such drugs are administered to a patient receiving glipizide, the patient should be closely observed for loss of control. When such drugs are withdrawn from a patient receiving glipizide, the patient should be observed closely for hypoglycemia.
Oral miconazole has been reported to interact with oral hypoglycemic agents, leading to severe hypoglycemia. Fluconazole increased the glipizide AUC by a mean of 56.9% (range: 35 to 81).
Name
Miconazole and fluconazole
Section
PRECAUTIONS: Drug Interactions
Source text (exact source wording)
A potential interaction between oral miconazole and oral hypoglycemic agents leading to severe hypoglycemia has been reported. ... The mean percentage increase in the glipizide AUC after fluconazole administration was 56.9% (range: 35 to 81).
Take glipizide at least 4 hours before colesevelam.
Name
Colesevelam
Section
PRECAUTIONS: Drug Interactions
Source text (exact source wording)
Therefore, glipizide should be administered at least 4 hours prior to colesevelam to ensure that colesevelam does not reduce the absorption of glipizide.
Food and alcohol
Alcohol can make low blood sugar more likely. The label says glipizide has an extremely low incidence of disulfiram-like alcohol reactions. MedlinePlus says to ask your doctor about safe use of alcohol.
Name
Alcohol
Section
PRECAUTIONS: Hypoglycemia; ADVERSE REACTIONS: Metabolic; MedlinePlus
Source text (exact source wording)
Hypoglycemia is more likely to occur when caloric intake is deficient, after severe or prolonged exercise, when alcohol is ingested, or when more than one glucose-lowering drug is used. ... Clinical experience to date has shown that glipizide has an extremely low incidence of disulfiram-like alcohol reactions. [MedlinePlus] ask your doctor about the safe use of alcoholic beverages while you are taking glipizide. Alcohol may make the side effects of glipizide worse.
Name
Food and meal timing
Section
DOSAGE AND ADMINISTRATION; CLINICAL PHARMACOLOGY
Source text (exact source wording)
In general, glipizide tablets should be given approximately 30 minutes before a meal to achieve the greatest reduction in postprandial hyperglycemia. ... Total absorption and disposition of an oral dose was unaffected by food in normal volunteers, but absorption was delayed by about 40 minutes.
Other
Salicylate pain relievers, niacin, cimetidine, aspirin, and NSAIDs such as ibuprofen and naproxen may interact with glipizide.
Name
Nonprescription products (MedlinePlus)
Section
MedlinePlus
Source text (exact source wording)
the following nonprescription products may interact with glipizide: salicylate pain relievers ...; niacin; cimetidine (Tagamet); aspirin and other nonsteroidal anti-inflammatory medications (NSAIDs) such as ibuprofen (Advil, Motrin) and naproxen (Aleve).
Patient tips
Label
Patients should follow diet instructions, exercise regularly, and test blood or urine glucose regularly. Patients and family members should be taught the risks, symptoms, and treatment of low blood sugar and what makes it more likely.
Source
Apotex label (set ID dcf426b8-bcdc-8214-a1b6-6388bd3399a0) PRECAUTIONS: Information for Patients
Source text (exact source wording)
Patients should be informed of the potential risks and advantages of glipizide and of alternative modes of therapy. They should also be informed about the importance of adhering to dietary instructions, of a regular exercise program, and of regular testing of urine and/or blood glucose. The risks of hypoglycemia, its symptoms and treatment, and conditions that predispose to its development should be explained to patients and responsible family members. Primary and secondary failure should also be explained. (The Apotex label has no separate Medication Guide.)
Medlineplus
Glipizide helps control blood sugar but does not cure diabetes. Keep taking it even if you feel well, and do not stop without talking to your doctor. The regular tablet is usually taken 30 minutes before breakfast or meals. Wear a diabetic identification bracelet. Avoid unnecessary or prolonged sun exposure, because it may make skin sensitive to sunlight.
Source
MedlinePlus glipizide page (Last Revised - 10/15/2017)
Source text (exact source wording)
Glipizide helps control blood sugar but does not cure diabetes. Continue to take glipizide even if you feel well. Do not stop taking glipizide without talking to your doctor. ... The regular tablet is usually taken one or more times a day, 30 minutes before breakfast or meals. ... You should always wear a diabetic identification bracelet to be sure you get proper treatment in an emergency. ... plan to avoid unnecessary or prolonged exposure to sunlight and to wear protective clothing, sunglasses, and sunscreen. Glipizide may make your skin sensitive to sunlight.
Alternatives
Class
sulfonylurea class
Class source
Apotex label (set ID dcf426b8-bcdc-8214-a1b6-6388bd3399a0) Description: 'Glipizide is an oral blood-glucose-lowering drug of the sulfonylurea class.'
Indication source
Apotex label: adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus
Note
No recommendation made.
Frequently asked questions
Question
What is glipizide used for?
Answer
Glipizide tablets are indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.
Source section
INDICATIONS AND USAGE
Source
Apotex label
Question
Should I take glipizide with food?
Answer
The label says glipizide tablets should generally be given approximately 30 minutes before a meal for the greatest reduction in blood sugar after meals. The recommended starting dose is 5 mg, given before breakfast. MedlinePlus says the regular tablet is usually taken 30 minutes before breakfast or meals.
Source section
DOSAGE AND ADMINISTRATION; MedlinePlus
Source
Apotex label; MedlinePlus
Question
What should I do if I miss a dose?
Answer
MedlinePlus says to ask your doctor what to do about a missed dose. As a general rule, take it as soon as you remember. If it is almost time for the next dose, skip the missed dose. Do not take a double dose.
Source section
What should I do if I forget a dose?
Source
MedlinePlus
Question
Can I drink alcohol with glipizide?
Answer
Hypoglycemia is more likely when alcohol is ingested. MedlinePlus says to ask your doctor about safe use of alcohol, because alcohol may make side effects worse and rarely may cause symptoms such as flushing, headache, nausea, and vomiting.
Source section
PRECAUTIONS: Hypoglycemia; MedlinePlus
Source
Apotex label; MedlinePlus
Question
What are the most common side effects?
Answer
The label says gastrointestinal disturbances are the most common reactions: nausea and diarrhea (about one in seventy) and constipation and gastralgia (about one in one hundred). Dizziness, drowsiness, and headache have each been reported in about one in fifty patients. The label gives no percentage threshold for 'common'.
Source section
ADVERSE REACTIONS
Source
Apotex label
Question
Is glipizide safe during pregnancy or breastfeeding?
Answer
Glipizide should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. If used in pregnancy, it should be discontinued at least one month before the expected delivery date. It is not known whether glipizide is in human milk, but some sulfonylureas are, and nursing infants could have low blood sugar.
Source section
PRECAUTIONS: Pregnancy; Nursing Mothers
Source
Apotex label
Question
What should I not combine with glipizide?
Answer
Several drugs can raise the low-blood-sugar effect, including NSAIDs, some azoles, salicylates, sulfonamides, chloramphenicol, probenecid, coumarins, MAOIs, quinolones, and beta blockers. Others can raise blood sugar, including thiazides and other diuretics, corticosteroids, estrogens, and phenytoin. Oral miconazole has been reported to cause severe hypoglycemia. Take glipizide at least 4 hours before colesevelam.
Source section
PRECAUTIONS: Drug Interactions
Source
Apotex label
Question
Should I stop glipizide when I feel well?
Answer
MedlinePlus says glipizide helps control blood sugar but does not cure diabetes. Continue to take glipizide even if you feel well, and do not stop without talking to your doctor.
Source section
How should this medicine be used?
Source
MedlinePlus
Sources
- DailyMed Apotex Corp. glipizide tablets (PRIMARY)
Set id: dcf426b8-bcdc-8214-a1b6-6388bd3399a0 · Label effective or revised date: Revised: 9/2026 (end of label); label body also shows 'Revised: May 2017' and 'Rev. 8' · Dailymed version date: 2025-07-03 (DailyMed list publish date, earlier than the label's revised date: unexplained, see notes) · Fetched at: 2026-11-02 · Sections used: all sections of the label - DailyMed alternate: Oxford Pharmaceuticals glipizide tablets
Set id: 87cd4930-ba68-4acf-bf74-619c477b557d · Label effective or revised date: Revised: 9/2026 · Dailymed version date: 2025-05-02 · Fetched at: 2026-11-02 · Sections used: revised date, marketing category only - DailyMed alternate: ANI Pharmaceuticals glipizide tablets
Set id: 252ba4e0-8dc3-43e3-be00-32570dc095bd · Label effective or revised date: Revised: 7/2026 · Dailymed version date: 2026-07-15 · Fetched at: 2026-11-02 · Sections used: revised date, marketing category only - DailyMed other opened labels (not chosen)
Fetched at: 2026-11-02 · Sections used: Advagen e954afb8-52eb-416a-8f1b-14b0fcb3bac2 Revised 3/2026; Major d3b5677c-2265-47c8-beeb-bf12106056ba Revised 3/2026 (also May 2017); Actavis ad55dfd7-ffb5-478a-aa84-1009fa921e22 Revised 12/2023 - MedlinePlus Glipizide
Label effective or revised date: Last Revised - 10/15/2017 · Fetched at: 2026-11-02 · Sections used: all - openFDA / Drugs@FDA
Sections used: NOT FOUND (not queried for glipizide in this run) - Liverpool HIV/HEP checkers
Sections used: not applicable: the label's interaction section lists no antiviral drugs
Information is taken from the cited sources and is for general reference only. It is not medical advice. Report side effects to FDA MedWatch at 1-800-FDA-1088. For a poison emergency call 1-800-222-1222. See prices for this drug