Glucotrol (Glipizide)

Description

Glucotrol is an oral medication classified as a sulfonylurea. It’s used to manage type 2 diabetes and works by stimulating the release of insulin from the pancreas. As a result, it lowers blood sugar levels in peoples whose bodies can produce insulin naturally. Glipizide is given as an oral tablet.

Directions

Glucotrol is taken once daily with breakfast or the first substantial meal of the day. The standard initial dosage typically starts at 5 mg. The dosage can then be gradually increased to a maximum of 40 mg per day in divided doses. For certain populations, such as older adults or individuals with liver conditions, starting at 2.5 mg is recommended. Monitor blood sugar levels regularly when using Glucotrol. Adjustments to the dosage may be needed based on individual responses.

Ingredients

The active ingredient in Glucotrol is glipizide.

Contraindications

Avoid taking Glucotrol if any of the following apply:

• Known hypersensitivity to glipizide or any of its ingredients
• Type 1 diabetes mellitus
• Diabetic ketoacidosis, with or without coma

Cautions

• Before taking Glucotrol, you may want to consult a healthcare provider about the following:
• Any existing health conditions
• Any allergies
• A list of all medications you are currently taking
• Whether you are pregnant or breastfeeding

• Some older studies have linked certain diabetes pills, including drugs like glipizide, to a higher risk of death from heart problems compared to people treated with diet alone or insulin. Although this was seen with a similar medication called tolbutamide, glipizide works in a similar way, so it’s important to talk with your doctor about the risks and benefits before starting.
• Glipizide can cause blood sugar to drop too low, especially in older adults or those with liver or kidney problems. Skipping meals, intense exercise, drinking alcohol, or using other diabetes medications can make low blood sugar more likely. Signs include shakiness, sweating, confusion, and dizziness. Severe cases may need emergency treatment.
• If you have liver or kidney problems, glipizide may stay in your body longer and increase the risk of side effects. Your doctor may adjust your dose or monitor you more closely.
• Stress, illness, infection, or surgery may make glipizide less effective, and insulin may be needed temporarily. Also, over time, glipizide may stop working as well, which is called “secondary failure.”
• Glipizide may rarely cause serious allergic reactions or skin rashes. Stop taking it and seek medical help if you have swelling, itching, or trouble breathing.
• Rare cases of a type of anemia have been reported, especially in people with a condition called G6PD deficiency. Your doctor may suggest a different medication if you're at risk.
• Many drugs can interact with glipizide. Some may increase the risk of low blood sugar, such as NSAIDs, certain antibiotics, and blood thinners. Others, like steroids, water pills, and birth control pills, may raise your blood sugar and reduce glipizide’s effect.
• Glipizide may not be safe to use during pregnancy or breastfeeding. It can cause low blood sugar in newborns if taken close to delivery. Insulin is usually preferred during pregnancy. If you're nursing, talk to your doctor about whether to stop the medication or stop breastfeeding.
• Glipizide has not been proven safe or effective in children.
• Seniors may be more sensitive to the effects of glipizide. Doctors often start with a lower dose and watch for side effects more carefully.

Side Effects

The most commonly reported side effects of glipizide include mild gastrointestinal problems such as nausea, diarrhea, constipation, or stomach discomfort. Skin reactions like rash, itching, or hives may also occur but are typically mild and temporary. Dizziness, drowsiness, and headache have been reported in some patients, though they rarely require stopping the medication.

More serious side effects, though rare, include low blood sugar (hypoglycemia), allergic skin reactions, and blood-related disorders like anemia or low white cell counts. Liver problems such as cholestatic jaundice have also been reported and should prompt immediate discontinuation. In rare cases, glipizide has been linked to low sodium levels (hyponatremia) and symptoms resembling disulfiram-like reactions, though these are uncommon. Routine monitoring may show mild changes in liver or kidney function tests without clear clinical symptoms.

References

1. Glucotrol (glipizide) Product Monograph. New York, NY: Pfizer; 2016.
2. Glipizide tablet Drug Label Information. Parsippany, NJ: Actavis Pharma, Inc.; 2023.

About Dr. Gerardo Sison (Page Author)

An honors graduate of the University of Florida, Dr. Sison started his pharmacy career in a community setting, extending his services to hospitals and clinics over time. He has also worked in medication therapy management, advising patients on proper medication use for their chronic health conditions. Read More....