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Glipizide/Metformin: Diabetes Drug Side Effects & Dosage

What is glipizide/metformin? What is glipizide/metformin used for?

  • Glipizide/metformin is a
    combination antidiabetic medication that contains two commonly used glucose
    lowering agents, glipizide (Glucotrol) and metformin (Glucophage). These agents
    work in different, yet complementary ways to improve
    blood glucose control in
    patients with
    type 2 diabetes.

    • Glipizide is a second generation oral sulfonylurea that lowers blood glucose
      by stimulating the production of
      insulin from the pancreas. It is the major
      hormone responsible for regulating
      blood sugar.
    • Metformin is
      an oral biguanide antidiabetic medication that decreases the production of
      glucose in the
      liver, decreases the absorption of glucose by the
      intestines, and
      increases response to insulin.
  • In clinical studies, glipizide/metformin therapy was superior in improving
    fasting plasma glucose, postprandial plasma glucose (blood glucose levels after
    a meal), and
    HbA1c versus treatment with either agent alone.
  • Combination glipizide and metformin
    was approved by the FDA in October 2002.

What brand names are available for glipizide/metformin?

  • There are no brand names available for glipizide/metformin in the US.
  • Metaglip is a discontinued brand name for glipizide/metformin.

Do I need a prescription for glipizide/metformin?


What are the uses for glipizide/metformin?

What are the side effects of glipizide/metformin?

The most common side effects associated with glipizide/metformin treatment are:

Side effects related to the stomach were most commonly reported by patients
who newly started treatment with glipizide/metformin and included:

Other less common but potentially serious side effects include:

Metformin can cause a rare but serious condition known as lactic acidosis, a
build-up of acid in the blood. Lactic acidosis can cause death and requires
immediate treatment.

Symptoms of lactic acidosis include:

Patients suspected of presenting with signs or symptoms of lactic acidosis
must seek emergency medical help.

What is the dosage for glipizide/metformin?

  • For patients inadequately controlled on diet and exercise alone: Generally,
    the recommended starting dose of glipizide/metformin is 2.5/250 mg administered
    once or twice daily. A starting dose of 2.5/500 mg twice daily may be considered
    for patients with fasting plasma glucose (FPG) of 280-320 mg/dL. If necessary,
    dosage may be increased by 1 tablet daily every 2 weeks to achieve adequate
    blood glucose control. The maximum daily dose is 20/2000 mg. Avoid starting
    treatment with the 5/500 mg strength due to the risk of hypoglycemia (low blood
    glucose levels).
  • For patients inadequately controlled on glipizide or metformin monotherapy:
    Treatment may be started with either 2.5/500 mg or 5/500 mg administered by
    mouth twice daily with meals. To avoid hypoglycemia, the starting dose must not
    exceed the current dose of glipizide or metformin that the patient has been
    already taking.
  • For patients who are already taking a combination of sulfonylurea/metformin
    who desire to switch to a combination pill:
    To avoid hypoglycemia, avoid
    exceeding the current dose of sulfonylurea and metformin. If necessary, the dose may
    be increased gradually to the minimum dosage required to achieve adequate blood
    glucose control.
  • Patients with liver disease: Use of glipizide/metformin in patients with
    liver disease is generally not recommended. Liver disease increases the risk of
    metformin associated lactic acidosis, a rare but potentially fatal condition
    which causes an accumulation of acid in the body.
  • Patients with kidney disease: Metformin should not be used in females with
    serum creatinine concentration > 1.4 mg/dL or in males with serum creatinine
    concentration > 1.5 mg/dL.
  • Pediatrics: The safety and efficacy of glipizide/metformin has not been
    established in pediatric patients. Therefore, use of glipizide/metformin in this
    patient population is not recommended.

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Which drugs or supplements interact with glipizide/metformin?

  • Drugs which cause blood glucose levels to increase may diminish the
    effectiveness of glipizide/metformin therapy. These drugs include:

  • Cimetidine (Tagamet), by decreasing the elimination of metformin from the
    body, can increase the amount of metformin in the blood by 40%. This may
    increase the frequency of side effects from metformin.
  • Alcohol consumption increases the effect of metformin on lactate production,
    increasing the risk of lactic acidosis.
  • Due to the risk of lactic acidosis, metformin containing products must be
    temporarily discontinued prior to the administration of radiopaque contrast
  • Metformin should be held for at least 48 hours after contrast dye
    administration and should not be restarted until patient’s kidney function
    returns back to normal.
  • Beta blockers may increase the blood glucose lowering actions of
    sulfonylureas. Cardio-selective beta blockers such as
    acebutolol (Sectral),
    atenolol (Tenormin),
    metoprolol (Lopressor or Toprol XL), and penbutolol
    (Levatol) may be safer than their nonselective counterparts.
  • Colesevelam (Welchol) may reduce blood levels of glipizide. Patients are
    advised to take glipizide 1 hour before or 4 hours after colesevelam
    administration to minimize the risk of their interaction.
  • Concomitant use of systemic antifungals such as
    fluconazole (Diflucan),
    itraconazole (Sporanox),
    ketoconazole (Nizoral),
    miconazole, and
    (VFEND) with glipizide may cause hypoglycemia.


______________ is another term for type 2 diabetes.
See Answer

Is glipizide/metformin safe to use during pregnancy or while breastfeeding?

  • Glipizide/metformin has not been adequately evaluated in
    women. Due to the lack of conclusive safety data, glipizide/metformin should be
    during pregnancy if possible. Glipizide/metformin is classified as FDA
    pregnancy risk category C (animal reproduction studies have shown an adverse
    effect on the fetus and there are no adequate and well-controlled studies in
    humans, but potential benefits may warrant use of the drug in pregnant women
    despite potential risks).
  • It is not known if glipizide/metformin is excreted in breast
    milk. Due to the lack of safety data and the potential risk for hypoglycemia in
    the nursing infant, use of glipizide/metformin during
    breastfeeding is not

What else should I know about glipizide/metformin?

What preparations of glipizide/metformin are available?
  • Oral tablets (glipizide/metformin): 2.5/250, 2.5/500 or 5/500 mg
How should I keep glipizide/metformin stored?
  • Tablets should be stored at room temperature between 15 C and 30 C
    (59 F and 86 F).

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