Glipizide

Common brand name: Glucotrol

What is diabetes?
Diabetes is a disease of the pancreas, an organ behind your stomach. Normally, the pancreas releases insulin into the blood. When a person has diabetes, the pancreas either does not make insulin, does not make enough insulin or the insulin made does not work as it should. When you eat or drink, much of your food is broken down into a simple sugar called glucose. Glucose provides the energy your body needs for daily activities. Insulin helps sugar get inside the body's cells for use as energy.

Why is this drug prescribed?
Glipizide is used to treat type 2 diabetes, especially in people whose diabetes can not be controlled by diet alone. Glipizide is not used to treat type 1 diabetes. Glipizide lowers blood sugar by stimulating the pancreas to secrete insulin and helping the body use insulin efficiently. The pancreas must be capable of producing insulin for this medication to work. Glipizide is used to control high blood sugar, not to cure diabetes. Therefore, it is intended for long-term therapy.

How and when should glipizide be used?
Glipizide comes in two different tablet forms. The short-acting glipizide tablets are usually taken once a day, 30 minutes before breakfast, or twice a day, 30 minutes before breakfast and 30 minutes before supper. The extended-release tablets, Glucotrol XL, should be taken with breakfast unless otherwise recommended by your doctor. Swallow the extended-release tablets whole. Do not break, crush, or chew them. Part of the extended-release tablet may pass into your stools, this is normal and nothing to worry about. Do not skip doses or take less or more of the medication than your doctor prescribes. Ask your pharmacist any questions you have about refilling your prescription.

What special instructions should I follow while using this drug?

• Before taking this medication, tell your doctor if you have ever had any unusual or allergic reaction to sulfonylureas or to sulfonamide-type (sulfa) medicines, including thiazide diuretics (a type of water pill). Also tell your doctor if you have any other allergies.
• Before glipizide is prescribed, tell your health care provider about any other medicines you may be taking, including vitamins, herbals, dietary supplements, and other prescription and nonprescription (over-the-counter) medications, and especially if you are taking cimetidine (Tagamet), prochlorperazine (Compazine), phenytoin (Dilantin), isoniazid, niacin, estrogens, thyroid medicine, diuretics ("water pills"), heart or blood pressure medicine, birth control pills, and blood thinners (such as warfarin).
• Before taking this medication, tell your doctor if you are pregnant, think you might be pregnant or are breastfeeding. Usually, insulin is required to control diabetes during pregnancy.
• Tell your doctor if you have or have ever had kidney, liver, heart, or thyroid disease or a severe infection.
• Tell your doctor or dentist if you are having surgery, including dental surgery.
• Keep all appointments with your doctor and the laboratory so your response to the drug can be monitored. It may be necessary to adjust your dose, especially during the first few weeks while taking this medication.
• Follow other medications used to treat diabetes have been known to increase the risk of heart problems. It is not known if glipizide increases your risk. Ask your doctor if you have any questions about this.
• Follow your doctor's advice on quitting smoking and losing weight. Your doctor may prescribe a diet that restricts calories if you are overweight. A registered dietitian can work with you and your doctor to develop an appropriate eating plan.
• Follow your doctor's advice on diet and exercise. Glipizide is not a substitute for proper diet or regular physical activity -- the foods you eat and how much you exercise will determine how well glipizide works to control your diabetes. Follow a regular routine of exercising, eating your meals and taking your medications at the same time every day; try not to skip meals.
• Also maintain a regular exercise schedule -- the best time to exercise is 1/2 to 1 hour after eating. If you exercise heavily, your insulin and/or oral medication may need to be changed. Talk to your health care provider about how to do this.
• If you are sick with a cold, fever or flu, you need to take your usual dose of glipizide, even if you feel too sick to eat. If you can not eat solid foods, make sure you are drinking liquids.
• Follow your doctor's guidelines on drinking alcoholic beverages while taking this medication. Alcohol can cause low blood sugar and other side effects.
• Follow your doctor's guidelines on using proper hygiene, avoiding infections, taking medication for high blood pressure (if prescribed) and avoiding emotional stress.
• Wear a medical identification (I.D.) bracelet or chain at all times, in case of an emergency. Also carry an I.D. card in your wallet that says you have diabetes and a list of all your medications.
• Be sure that you always have enough of this medication on hand. Check your supply before vacations, holidays, and other occasions when you may be unable to obtain it.

What should I do if I forget to take a dose?
Follow your doctor's guidelines on what to do if you miss a dose. In general, take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and return to your normal schedule. Do not take a double dose.

What are the common side effects? What can I do about them?
In general, contact your doctor if any side effects occur, especially signs of high or low blood sugar.

• Hypoglycemia (low blood sugar): symptoms include headache, sweating, shakiness, anxiety, increased heart rate, weakness, numbness or tingling in your mouth or lips, fatigue, confusion, irritability or blurred vision. If you have any of these symptoms, check your blood sugar level. If your blood sugar level is less than 70 mg/dl, eat or drink something containing sugar (such as 1/2 cup of fruit juice or 4 pieces of hard candy). Always carry a quick source of sugar with you. Call your doctor to report your symptoms.
• Hyperglycemia (high blood sugar): blurred vision, drowsiness, dry mouth, flushed and dry skin, fruit-like breath odor, increased urination, loss of appetite, nausea or vomiting, unusual thirst. Call your doctor for advice on how to change your glipizide dose.
• Feeling faint. Ask someone to take you to your doctor or emergency room right away
• Skin sensitivity to light. Wear sunscreen, protective clothing, and sunglasses. Avoid prolonged exposure to sunlight, tanning beds and sun lamps.
• Drowsiness or dizziness. Use caution when performing activities that require alertness. Do not drive a car or operate machinery until you know how this medication affects you. Alcohol may add to the drowsiness caused by this drug.

When should I call my doctor?
Call your doctor right away if you:

• Have a seizure or faint.
• Have excessive thirst, hunger or frequent urination
• Notice an increase in your blood sugar levels
• Develop a skin rash, have itching or redness
• Notice a yellowing of the skin or eyes
• Have light-colored stools or dark urine
• Have unusual bleeding or bruising
• Have a fever of 101°F (38.3°C) or higher
• Have any other symptoms that cause concern

What storage conditions are necessary for this drug?

• Keep glipizide in the container it came in.
• Store tablets at room temperature.
• Store it away from heat, moisture (not in bathroom) and direct sunlight.
• Keep glipizide out of the reach of children.
• Never share your medication with anyone.
• Never take outdated medications. Some medication prescription labels list an expiration date. If such a date is not on your medication label or if you are unsure how old a medication is, call your pharmacy.

This handout summarizes information to help you understand and safely take your medication. Other information--not included in this handout--may be important for you to know because of your unique health status. Ask your doctor and/or pharmacist for more information on the medications prescribed for you and your unique health care needs.