Known brand names include Glucotrol.
A sulfonylurea pill for type 2 diabetes, taken about 30 minutes before a meal along with diet and exercise. It lowers blood sugar by making the pancreas release more insulin, so low blood sugar is its main risk.
An inexpensive second-line oral agent added to metformin when cost matters. Among sulfonylureas, glipizide's short half-life and inactive metabolites make it safer in older adults and kidney disease than glyburide. SGLT2 inhibitors and GLP-1 agonists are preferred when heart or kidney protection, weight loss, or low hypoglycemia risk is the priority.
A sulfonylurea that lowers glucose mainly by stimulating insulin release from pancreatic beta cells, so it depends on functioning beta cells. The meal-time insulin response stays enhanced with long-term use, while fasting insulin does not rise. Extrapancreatic effects may contribute. Peak levels come 1 to 3 hours after a dose and the half-life is 2 to 4 hours, though glucose control can last up to 24 hours; the liver metabolizes it to inactive products.
The label does not describe a narrow therapeutic index or direct dosing by measured blood levels of the drug.
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Doses come from the FDA label. Study tool, not for clinical decisions.
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No set adjustment. Clearance may be slowed and hypoglycemia can be prolonged, so start and maintain conservatively.
None on the current label. A special warning in the Warnings section describes possible increased cardiovascular mortality with oral sulfonylureas.
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Hypoglycemia: oral glucose for mild episodes without loss of consciousness. Coma or seizures: rapid IV 50% glucose, then a continuous 10% glucose infusion to keep glucose above 100 mg/dL. Monitor for at least 24 to 48 hours, because hypoglycemia can recur. Dialysis is unlikely to help because the drug is highly protein bound.
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No adequate human studies; use only if the benefit justifies the fetal risk, and many experts prefer insulin in pregnancy. If used, stop at least one month before the expected delivery date, because newborns of mothers on sulfonylureas have had prolonged severe hypoglycemia.
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Not known whether it enters milk, but some sulfonylureas do, and infant hypoglycemia is possible. Decide whether to stop nursing or the drug; if the drug is stopped and diet is not enough, consider insulin.
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