glipizide (Glucotrol, Glucotrol XL)
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Introduction
Tradename: Glucotrol, Glucotrol XL. 2nd generation sulfonylurea.
Indications
management of diabetes mellitus type 2*
* may be preferred agent in patients with renal insufficiency
Dosage
- start: 2.5-5 mg PO QD
- increase: 2.5-5 mg QD weekly
- max** 40 mg/day
- divide dose BID if >15 mg/day
- geriatrics: begin 2.5 mg QD, QD dosing
Tabs: 5 & 10 mg.
**Doses > 10 mg/day may not provide additional benefit.
Pharmacokinetics
- onset of action 1.5 hours
- food delays absorption[3]
- protein binding: 92-99%
- metabolized in the liver (91-97%)
- elimination 1/2life of 2-4 hours
- duration of action: up to 24 hours
- 60-80% of metabolites eliminated in the urine, 11% in the feces
elimination via liver
elimination via kidney
protein binding = 92-99 %
1/2life = 7 hours
Adverse effects
- common (> 10%)
- less common (1-10%)
- uncommon (< 1%)
- produces less hypoglycemia following a prolonged fast than does glyburide[5]
Drug interactions
- alcohol
- beta adrenergic receptor antagonists
- non-steroidal anti-inflammatory agents
- hypoglycemia may occur in combination with clarithromycin[7]
- drug interaction(s) of sulfonylureas with warfarin
- drug interaction(s) of beta-adrenergic receptor antagonists with sulfonylureas
- drug interaction(s) of fluroquinolones with sulfonylureas
- drug interaction(s) of macrolides with sulfonylureas
- drug interaction(s) of salicylates with sulfonylureas
- drug interaction(s) of gliptins with sulfonylureas
- drug interaction(s) of fluoroquinolones with hypoglycemic agents
Laboratory
More general terms
Additional terms
Component of
References
- ↑ The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
- ↑ Kaiser Permanente Northern California Regional Drug Formulary, 1998
- ↑ 3.0 3.1 Harrison's Principles of Internal Medicine, 14th ed. Fauci et al (eds), McGraw-Hill Inc. NY, 1998, pg 470
- ↑ Geriatric Dosage Handbook, 6th edition, Selma et al eds, Lexi-Comp, Cleveland, 2001
- ↑ 5.0 5.1 Shorr RI, JAMA 279(18):1441-a, 1998 http://jama.ama-assn.org/cgi/content/full/279/18/1441-a
- ↑ Department of Veterans Affairs, VA National Formulary
- ↑ 7.0 7.1 Paauw DS Dangerous and Deadly Drug Combinations Medscape. June 30, 2016 http://www.medscape.com/features/slideshow/dangerous-drug-combinations