Glipizide and metformin together

Glipizide-Metformin

Glipizide and metformin is a combination of two oral diabetes medicines that help control blood sugar levels.

Glipizide and metformin is used together with diet and exercise to improve blood sugar control in adults with type 2 diabetes. This medicine is not for treating type 1 diabetes.

Glipizide and metformin may also be used for purposes not listed in this medication guide.

You should not use glipizide and metformin if you have severe kidney disease or diabetic ketoacidosis (call your doctor for treatment).

If you need to have any type of x-ray or CT scan using a dye that is injected into your veins, you will need to temporarily stop taking glipizide and metformin.

You may develop lactic acidosis, a dangerous build-up of lactic acid in your blood. Call your doctor or get emergency medical help if you have unusual muscle pain, trouble breathing, stomach pain, dizziness, feeling cold, or feeling very weak or tired.

You should not use this medicine if you are allergic to glipizide or metformin, or if you have:

  • severe kidney disease; or
  • metabolic acidosis or diabetic ketoacidosis (call your doctor for treatment).

If you need to have any type of x-ray or CT scan using a dye that is injected into your veins, you will need to temporarily stop taking glipizide and metformin.

Tell your doctor if you have ever had:

  • kidney disease;
  • congestive heart failure, especially if you take digoxin (Lanoxin) or furosemide (Lasix);
  • a genetic enzyme deficiency called glucose-6-phosphate dehydrogenase (G6PD) deficiency;
  • liver disease;
  • heart disease; or
  • if you are over 80 years old and have not recently had your kidney function checked.

You may develop lactic acidosis, a dangerous build-up of lactic acid in your blood. This may be more likely if you have other medical conditions, a severe infection, chronic alcoholism, or if you are 65 or older. Ask your doctor about your risk.

It is not known whether glipizide and metformin will harm an unborn baby. Similar diabetes medications have caused severe hypoglycemia in newborn babies whose mothers had used the medication near the time of delivery. Tell your doctor if you are pregnant or plan to become pregnant while using this medicine.

Metformin may stimulate ovulation in a premenopausal woman and may increase the risk of unintended pregnancy. Talk to your doctor about your risk.

You should not breast-feed while you are taking this medicine.

Some diabetes drugs are better than others, according to new study

Insulin secretagogues (ISs),* such as glimepiride, glibenclamide (known as glyburide in the USA and Canada), gliclazide and tolbutamide, have been used to treat type 2 diabetes since the 1950-1970s, Nevertheless, the long-term risk associated with these drugs has largely been unknown. Metformin is the first drug of choice in type 2 diabetes, but, until now, there have not been studies investigating the long-term risk of individual ISs compared with metformin.

A study published online April 6 in the European Heart Journal followed a large, unselected group of everyone living in Denmark, aged over 20, who had been treated with either an IS or metformin (monotherapy) between 1997 and 2006 — a total of 107,806 people. It found that, compared to metformin treatment, monotherapy with most ISs, including glimepiride, glibenclamide, glipizide and tolbutamide, was associated with a greater risk of death from any cause, and a greater risk of heart attacks, stroke or death from cardiovascular diseases. This was the case both for patients who had already suffered a heart attack and for patients who had not. Two other ISs, gliclazide and repaglinide, showed no significant difference to metformin in their effectiveness in patients with and without a history of heart attacks.

Compared to metformin, patients who had not suffered a heart attack had approximately a fifth to a third higher risk of death from any cause if they were taking glimepiride, glibenclamide, glipizide or tolbutamide. In patients with a history of heart attacks, the risk was approximately a third to a half higher.

The researchers, led by Dr Tina Ken Schramm, a senior resident doctor at the Heart Centre at the Rigshospitalet Copenhagen University Hospital (Copenhagen, Denmark), stress that the findings may not mean that these ISs actually cause harm, but only that they appear to be less effective than metformin.

“Previous studies have shown that ISs, in particular sulphonylureas, are associated with a reduction in long-term risk. Therefore, the increased risk from ISs shown in our study presumably has more to do with the beneficial effects of metformin, gliclazide and repaglinide, than the detrimental effect of the other ISs,” explained Dr Schramm. “This is the first study to compare all ISs with metformin despite a wide debate on the possible cardiovascular risk associated with ISs for about three decades. Our findings emphasise how important it is to conduct long-term follow up studies of glucose-lowering medications.”

In an accompanying editorial, Drs Odette Gore and Darren McGuire of the University of Texas Southwestern Medical Center (Dallas, Texas, USA), write that the study’s findings are “among the most robust published,” and continue: “It is of key importance to note that the observation of less benefit with most sulphonylureas in the study compared with metformin should not be interpreted as causing harm.”

Dr McGuire explained: “Patients taking metformin had the best outcomes, supporting prior evidence of metformin benefit and making it the first-line drug recommended for almost all patients with type 2 diabetes. Compared against this beneficial drug, most of the ISs were associated with worse outcomes, but they would almost certainly be similar to, or better, had the comparison been made against placebo treatment, with the added benefit on kidney, eye, and nerve disease of the glucose control they yield. So patients should not stop their medications based on this study, but certainly should discuss any concerns with their doctor.”

He added: “It’s important to remember that these are observational analyses and not randomised comparisons, so it is impossible to tease out what if any of the difference in outcomes is due to the drugs compared versus differences in the patients — those taking ISs might have an increased risk to begin with.”

Dr Schramm and her colleagues say that the mechanisms underlying the effects of different ISs and metformin are not fully understood and require further research.

She concluded: “Our study supports previous studies demonstrating that metformin may be less hazardous or more beneficial than most ISs. This suggests that metformin should be the first drug of choice in type 2 diabetes in most patients. The study shows there are important differences in the risk associated with different ISs, suggesting that gliclazide and maybe repaglinide are preferable, although in patients who have had a previous heart attack the most beneficial agents are metformin and gliclazide. As a result of our findings it is important now that there should be randomised studies focusing on patients at low and high cardiovascular risk.”

*ISs act by causing insulin to be released, thereby dealing with the problem of insufficient insulin production seen in type 2 diabetes. Metformin combats insulin resistance — one of the characteristics of diabetes — by increasing the action of insulin on insulin receptors, thereby reducing blood glucose in the liver, muscles and fat. During the period of the study, about 50-60% of those receiving glucose-lowering medications received monotherapy with metformin or ISs in Denmark. The initial treatment for diabetes patients is usually monotherapy with either metformin or ISs, and then later, when the diabetes becomes more advanced, insulin treatment or a combination of treatments becomes an option.

Alogliptin compared to Glipizide with Metformin in Type 2 Diabetes

For patients with type 2 diabetes mellitus (T2DM), metformin is the usual first-line oral therapy in addition to diet control and exercise. If metformin does not adequately control the diabetes or if there are serious side effects, sulphonylurea is a popular second-line choice of oral anti-diabetic treatment. Alogliptin is an investigational medicine being developed to improve blood glucose control in people with T2DM. Alogliptin controls blood glucose by making the good effects of GLP-1 last longer. GLP-1 is a natural substance released by the body from the gut after meals. This leads to more insulin release.Alogliptin has already been tested in a large number of T2DM patients and has so far been safe, effective and did not lead to weight gain. This research study will assess the safety and effectiveness of alogliptin plus metformin, as compared with glipizide (sulphonylurea) plus metformin over a longer treatment period.Adults aged 18-80 years inclusive, currently taking metformin with inadequate glucose control, will be invited to participate. Depending on their metformin dose and blood glucose control, they will enter a screening period of 6-16 weeks. Eligible participants will then be randomised to receive either glipizide 5 mg/day, alogliptin 12.5mg/day or alogliptin 25mg/day in addition to metformin. The study is double-blind, meaning that neither the participant nor the doctor will know which treatment group has been assigned. Participants will receive study medication for 2 years.Participants will complete between 21 and 32 visits. Procedures that participants will undergo include: physical examination, vital signs, electrocardiogram, blood and urine collection, complete diaries and questionnaires and measure blood sugar levels using a glucometer.This study is sponsored by Takeda; a maximum of 2691 participants will be enrolled worldwide.

Glipizide and metformin

Generic Name: glipizide and metformin (GLIP ih zyd and met FOR min)
Brand Name: Metaglip

Medically reviewed by Drugs.com on Sep 10, 2019 – Written by Cerner Multum

  • Overview
  • Side Effects
  • Dosage
  • Professional
  • Interactions
  • More

What is glipizide and metformin?

Glipizide and metformin is a combination of two oral diabetes medicines that help control blood sugar levels.

Glipizide and metformin is used together with diet and exercise to improve blood sugar control in adults with type 2 diabetes. glipizide and metformin is not for treating type 1 diabetes.

Glipizide and metformin may also be used for purposes not listed in this medication guide.

Important Information

You should not use glipizide and metformin if you have severe kidney disease or diabetic ketoacidosis (call your doctor for treatment).

If you need to have any type of x-ray or CT scan using a dye that is injected into your veins, you may need to temporarily stop taking glipizide and metformin.

You may develop lactic acidosis, a dangerous build-up of lactic acid in your blood. Call your doctor or get emergency medical help if you have unusual muscle pain, trouble breathing, stomach pain, dizziness, feeling cold, or feeling very weak or tired.

How should I take glipizide and metformin?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

Take glipizide and metformin with meals.

Call your doctor if you are sick with vomiting, diarrhea, or a fever. These conditions can lead to severe dehydration, which could be dangerous while you are taking glipizide and metformin.

Drink plenty of liquids while you are taking glipizide and metformin.

You may have low blood sugar (hypoglycemia) and feel very hungry, dizzy, irritable, confused, anxious, or shaky. To quickly treat hypoglycemia, eat or drink a fast-acting source of sugar (fruit juice, hard candy, crackers, raisins, or non-diet soda).

Your doctor may prescribe a glucagon injection kit in case you have severe hypoglycemia. Be sure your family or close friends know how to give you this injection in an emergency.

Also watch for signs of high blood sugar (hyperglycemia) such as increased thirst or urination.

Blood sugar levels can be affected by stress, illness, surgery, exercise, alcohol use, or skipping meals. Ask your doctor before changing your dose or medication schedule.

Glipizide and metformin is only part of a complete treatment program that may also include diet, exercise, weight control, blood sugar testing, and special medical care. Follow your doctor’s instructions very closely.

Store at room temperature away from moisture and heat.

Your doctor may have you take extra vitamin B12 while you are taking glipizide and metformin. Take only the amount of vitamin B12 that your doctor has prescribed.

What happens if I miss a dose?

Take your dose as soon as you can, but only if you are getting ready to eat a meal. If you skip a meal, skip the missed dose and wait until your next meal.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose can cause severe hypoglycemia or lactic acidosis.

What should I avoid while taking glipizide and metformin?

Avoid drinking alcohol. It lowers blood sugar and may increase your risk of lactic acidosis.

If you also take colesevelam, avoid taking it within 4 hours after you take glipizide and metformin.

Glipizide and metformin side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Stop using glipizide and metformin and call your doctor at once if you have:

  • heart problems– swelling, rapid weight gain, feeling short of breath;

  • severe hypoglycemia–extreme weakness, blurred vision, sweating, trouble speaking, tremors, stomach pain, confusion, seizure; or

  • lactic acidosis–unusual muscle pain, trouble breathing, stomach pain, vomiting, irregular heart rate, dizziness, feeling cold, or feeling very weak or tired.

Common side effects may include:

  • upset stomach, nausea, diarrhea;

  • headache; or

  • cold symptoms such as stuffy nose, sneezing, sore throat.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Glipizide and metformin dosing information

Usual Adult Dose for Diabetes Type 2:

Doses provided as glipizide-metformin
Patients with Inadequate Glycemic Control on Diet and Exercise Alone:
-Initial dose: 2.5 mg-250 mg orally once a day
Patients with Fasting Blood Glucose (FBG) between 280 and 320 mg/dL:
-Initial dose: 2.5 mg-500 mg orally twice a day
Maintenance Dose: Increase in increments of 2.5 mg-500 mg per day every 2 weeks to the minimum effective dose to achieve adequate blood glucose control
Maximum Initial Dose: 10 mg-1000 mg or 10 mg-2000 mg per day in divided doses
Patients with Inadequate Glycemic Control on Glipizide (or another Sulfonylurea) and /or Metformin:
Initial dose: 2.5 mg-500 mg or 5 mg-500 mg orally twice a day
Maintenance Dose: Increase in increments of no more than 5 mg-500 mg to the minimum effective dose to achieve adequate blood glucose control
Maximum Dose: 20 mg-2000 mg per day

-Give with meals; initial doses should be conservative to avoid hypoglycemia largely due to glipizide and gastrointestinal side effects largely due to metformin.
-For patients who are switching to combination therapy, initial doses should not exceed the daily dose of glipizide (or equivalent sulfonylurea) and metformin already being taken; the decision to switch to the nearest equivalent dose should be based on clinical judgement.
-Monitor patients closely for signs and symptoms of hypoglycemia.
Use: As an adjunct to diet and exercise to improve glycemic control in patients with type 2 diabetes mellitus.

What other drugs will affect glipizide and metformin?

Many drugs can affect glipizide and metformin, making this medicine less effective or increasing your risk of lactic acidosis. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here. Tell your doctor about all your current medicines and any medicine you start or stop using.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Copyright 1996-2018 Cerner Multum, Inc. Version: 11.01.

Medical Disclaimer

More about glipizide / metformin

  • Side Effects
  • During Pregnancy
  • Dosage Information
  • Drug Images
  • Drug Interactions
  • Pricing & Coupons
  • En Español
  • 2 Reviews
  • Drug class: antidiabetic combinations
  • FDA Alerts (1)

Consumer resources

  • Glipizide and Metformin
  • Glipizide and metformin (Advanced Reading)

Other brands: Metaglip

Professional resources

  • Glipizide and Metformin (Wolters Kluwer)
  • … +1 more

Related treatment guides

  • Diabetes, Type 2

Glipizide and metformin (Oral)

GLIP-i-zide, met-FOR-min hye-droe-KLOR-ide

Oral route(Tablet)

Lactic acidosis is a rare, but serious, metabolic complication that can occur due to metformin accumulation during treatment with glipiZIDE/metformin hydrochloride; when it occurs, it is fatal in approximately 50% of cases. The risk of lactic acidosis increases with renal impairment, increased age, diabetes mellitus, congestive heart failure, hepatic insufficiency, and other conditions whenever there is significant tissue hypoperfusion and hypoxemia. Treatment with glipiZIDE/metformin hydrochloride should not be initiated in patients 80 years of age or older unless measurement of creatinine clearance demonstrates that renal function is normal. Therapy should temporarily be discontinued prior to any intravascular radiocontrast study or surgical procedure. Avoid excessive alcohol use since alcohol potentiates the effects of metformin on lactate metabolism. Discontinue therapy immediately and institute supportive measures promptly for suspected lactic acidosis .

Medically reviewed by Drugs.com. Last updated on Jan 28, 2019.

  • Overview
  • Side Effects
  • Dosage
  • Professional
  • Interactions
  • More

Commonly used brand name(s)

In the U.S.

  • Metaglip

Available Dosage Forms:

  • Tablet

Therapeutic Class: Antidiabetic

Chemical Class: 2nd Generation Sulfonylurea

Uses for glipizide and metformin

Glipizide and Metformin combination is used to treat high blood sugar levels that are caused by a type of diabetes mellitus or sugar diabetes called type 2 diabetes. Normally, after you eat, your pancreas releases insulin to help your body store excess sugar for later use. This process occurs during normal digestion of food. In type 2 diabetes, your body does not work properly to store the excess sugar and the sugar remains in your bloodstream. Chronic high blood sugar can lead to serious health problems in the future. Proper diet is the first step in managing type 2 diabetes but often medicines are needed to help your body. With two actions, the combination of glipizide and metformin helps your body cope with high blood sugar. Glipizide stimulates the release of insulin from the pancreas, directing your body to store blood sugar. Metformin has three different actions: it slows the absorption of sugar in your small intestine; it also stops your liver from converting stored sugar into blood sugar; and it helps your body use your natural insulin more efficiently.

Glipizide and metformin is available only with your doctor’s prescription.

Before using glipizide and metformin

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For glipizide and metformin, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to glipizide and metformin or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Studies on glipizide and metformin have been done only in adult patients, and there is no specific information comparing use of glipizide and metformin in children with use in other age groups.

Geriatric

Some older adults may be more sensitive than younger adults to the effects of these medicines. The first signs of low or high blood sugar are not easily seen or do not occur at all in older adults. This may increase the chance of low blood sugar developing during treatment. Older adults are more likely to have age-related problems and glipizide and metformin should be used carefully as age increases. Glipizide and metformin should not be started in adults over 80 years of age unless kidney function is not reduced.

Pregnancy

Pregnancy Category Explanation
All Trimesters C Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breastfeeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking glipizide and metformin, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using glipizide and metformin with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Acetrizoic Acid
  • Diatrizoate
  • Ethiodized Oil
  • Iobenzamic Acid
  • Iobitridol
  • Iocarmic Acid
  • Iocetamic Acid
  • Iodamide
  • Iodipamide
  • Iodixanol
  • Iodohippuric Acid
  • Iodopyracet
  • Iodoxamic Acid
  • Ioglicic Acid
  • Ioglycamic Acid
  • Iohexol
  • Iomeprol
  • Iopamidol
  • Iopanoic Acid
  • Iopentol
  • Iophendylate
  • Iopromide
  • Iopronic Acid
  • Ioseric Acid
  • Iosimide
  • Iotasul
  • Iothalamate
  • Iotrolan
  • Iotroxic Acid
  • Ioxaglate
  • Ioxitalamic Acid
  • Ipodate
  • Metrizamide
  • Metrizoic Acid
  • Tyropanoate Sodium

Using glipizide and metformin with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Acarbose
  • Aspirin
  • Balofloxacin
  • Besifloxacin
  • Bupropion
  • Ceritinib
  • Ciprofloxacin
  • Dasabuvir
  • Desmopressin
  • Disopyramide
  • Dofetilide
  • Dolutegravir
  • Dulaglutide
  • Enoxacin
  • Entacapone
  • Fleroxacin
  • Flumequine
  • Gatifloxacin
  • Gemifloxacin
  • Ioversol
  • Lanreotide
  • Levofloxacin
  • Lixisenatide
  • Lomefloxacin
  • Metreleptin
  • Moxifloxacin
  • Nadifloxacin
  • Norfloxacin
  • Octreotide
  • Ofloxacin
  • Ombitasvir
  • Paritaprevir
  • Pasireotide
  • Pazufloxacin
  • Pefloxacin
  • Pioglitazone
  • Prulifloxacin
  • Ritonavir
  • Rufloxacin
  • Sitagliptin
  • Sparfloxacin
  • Tafenoquine
  • Thioctic Acid
  • Tosufloxacin
  • Vandetanib

Using glipizide and metformin with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Acebutolol
  • Aminolevulinic Acid
  • Atenolol
  • Betaxolol
  • Bisoprolol
  • Bitter Melon
  • Carteolol
  • Carvedilol
  • Celiprolol
  • Cimetidine
  • Clarithromycin
  • Colesevelam
  • Cyclosporine
  • Esmolol
  • Fenugreek
  • Furazolidone
  • Glucomannan
  • Guar Gum
  • Iproniazid
  • Isocarboxazid
  • Labetalol
  • Levobunolol
  • Linezolid
  • Methylene Blue
  • Metipranolol
  • Metoprolol
  • Moclobemide
  • Nadolol
  • Nebivolol
  • Nialamide
  • Oxprenolol
  • Patiromer
  • Penbutolol
  • Phenelzine
  • Pindolol
  • Practolol
  • Procarbazine
  • Propranolol
  • Psyllium
  • Ranitidine
  • Ranolazine
  • Rasagiline
  • Rifampin
  • Safinamide
  • Saxagliptin
  • Selegiline
  • Sotalol
  • Timolol
  • Tranylcypromine
  • Verapamil
  • Voriconazole

Interactions with food/tobacco/alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using glipizide and metformin with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use glipizide and metformin, or give you special instructions about the use of food, alcohol, or tobacco.

  • Ethanol

Other medical problems

The presence of other medical problems may affect the use of glipizide and metformin. Make sure you tell your doctor if you have any other medical problems, especially:

  • Acid in the blood (acidosis or ketoacidosis) or
  • Surgery (major)—Use of insulin is best to help control diabetes in patients with these conditions.
  • Blood poisoning or
  • Dehydration (severe) or
  • Heart or blood vessel disorders or
  • Kidney disease or
  • Liver disease—Lactic acidosis can occur in these conditions and chances of it occurring are even greater with a medicine that contains metformin.
  • Congestive Heart Failure—Glipizide and metformin should not be used in patients who have this medical condition.

  • Kidney, heart, or other problems that require medical tests or examinations that use certain medicines called contrast agents, with x-ray exams—Because glipizide and metformin contains metformin, your doctor should advise you to stop taking it before you have any medical exams or diagnostic tests that might cause less urine output than usual; you may be advised to start taking the medicine again 48 hours after the exams or tests if your kidney function is tested and found to be normal.
  • Alcohol intoxication or
  • Strenuous exercise not accompanied by adequate intake of food or
  • Underactive adrenal gland, not properly controlled or
  • Underactive pituitary gland, not properly controlled or
  • Undernourished condition or
  • Weakened physical condition or
  • Any other condition that causes low blood sugar—Patients with these conditions may be more likely to develop low blood sugar while taking a medication that contains glipizide and metformin.
  • Vitamin B12 deficiency—This condition may be made worse by this medication.

Proper use of glipizide and metformin

Follow carefully the special meal plan your doctor gave you. This is the most important part of controlling your condition, and is necessary if the medicine is to work properly. Also, exercise regularly and test for sugar in your blood or urine as directed.

Glipizide and metformin combination should be taken with meals to help reduce the gastrointestinal side effects that may occur during treatment.

Dosing

The dose of glipizide and metformin will be different for different patients. Follow your doctor’s orders or the directions on the label. The following information includes only the average doses of glipizide and metformin. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):
    • For type 2 diabetes:
      • For first-time treatment:
        • Adults: At first, 2.5 milligrams (mg) of glipizide and 250 milligrams (mg) of metformin once a day with a meal. Then, your doctor may increase your dose a little at a time every two weeks until your blood sugar is controlled.
        • Children: Use and dose must be determined by your doctor.
      • As second-line therapy:
        • Oral, 2.5 milligrams (mg) of glipizide and 500 milligrams (mg) of metformin or 5 milligrams (mg) of glipizide and 500 milligrams (mg) of metformin two times a day, with the morning and evening meals. Then, your doctor may increase your dose a little at a time until your blood sugar is controlled. The starting dose should not exceed the daily dose of glipizide or metformin already being taken.
        • Children: Use and dose must be determined by your doctor.
      • For patients previously treated with a sulfonylurea antidiabetic agent and/or metformin:
        • Adults: When switching patients from a sulfonylurea plus metformin to the glipizide and metformin combination, the initial dose should not exceed the daily dose of glipizide (or equivalent dose of another sulfonylurea) and metformin that was being taken.
        • Children: Use and dose must be determined by your doctor.

Missed dose

If you miss a dose of glipizide and metformin, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions while using glipizide and metformin

Your doctor will want to check your progress at regular visits , especially during the first few weeks that you take glipizide and metformin.

Under certain conditions, too much glipizide and metformin can cause lactic acidosis. Symptoms of lactic acidosis are severe and quick to appear and usually occur when other health problems not related to the medicine are present and are very severe, such as a heart attack or kidney failure. Symptoms of lactic acidosis include abdominal or stomach discomfort; decreased appetite; diarrhea; fast, shallow breathing; general feeling of discomfort; muscle pain or cramping; and unusual sleepiness, tiredness, or weakness.

If symptoms of lactic acidosis occur, you should get immediate emergency medical help.

It is very important to follow carefully any instructions from your health care team about:

  • Alcohol—Drinking alcohol may cause severe low blood sugar. Discuss this with your health care team.
  • Other medicines—Do not take other medicines unless they have been discussed with your doctor.
  • Counseling—Other family members need to learn how to prevent side effects or help with side effects if they occur. Also, patients with diabetes may need special counseling about diabetes medicine dosing changes that might occur because of lifestyle changes, such as changes in exercise and diet. Furthermore, counseling on contraception and pregnancy may be needed because of the problems that can occur in patients with diabetes during pregnancy.
  • Travel—Keep a recent prescription and your medical history with you. Be prepared for an emergency as you would normally. Make allowances for changing time zones and keep your meal times as close as possible to your usual meal times.

In case of emergency—There may be a time when you need emergency help for a problem caused by your diabetes. You need to be prepared for these emergencies. It is a good idea to wear a medical identification (ID) bracelet or neck chain at all times. Also, carry an ID card in your wallet or purse that says that you have diabetes and a list of all your medicines.

Symptoms of hypoglycemia (low blood sugar) include anxiety; behavior change similar to being drunk; blurred vision; cold sweats; confusion; cool, pale skin; difficulty in thinking; drowsiness; excessive hunger; fast heartbeat; headache (continuing); nausea; nervousness; nightmares; restless sleep; shakiness; slurred speech; or unusual tiredness or weakness.

Glipizide and metformin combination can cause low blood sugar. However, it also can occur if you delay or miss a meal or snack, drink alcohol, exercise more than usual, cannot eat because of nausea or vomiting, take certain medicines, or take glipizide and metformin with another type of diabetes medicine. Symptoms of low blood sugar must be treated before they lead to unconsciousness (passing out). Different people feel different symptoms of low blood sugar. It is important that you learn which symptoms of low blood sugar you usually have so that you can treat it quickly.

If symptoms of low blood sugar occur, eat glucose tablets or gel, corn syrup, honey, or sugar cubes; or drink fruit juice, nondiet soft drink, or sugar dissolved in water. Also, check your blood for low blood sugar. Glucagon is used in emergency situations when severe symptoms such as seizures (convulsions) or unconsciousness occur. Have a glucagon kit available, along with a syringe or needle, and know how to use it. Members of your household also should know how to use it.

Symptoms of hyperglycemia (high blood sugar) include blurred vision; drowsiness; dry mouth; flushed, dry skin; fruit-like breath odor; increased urination (frequency and volume); ketones in urine; loss of appetite; sleepiness; stomachache, nausea, or vomiting; tiredness; troubled breathing (rapid and deep); unconsciousness; or unusual thirst.

High blood sugar may occur if you do not exercise as much as usual, have a fever or infection, do not take enough or skip a dose of your diabetes medicine, or overeat or do not follow your meal plan.

If symptoms of high blood sugar occur, check your blood sugar level and then call your health care professional for instructions.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

  • Anxiety
  • blurred vision
  • chills
  • cold sweats
  • coma
  • confusion
  • cool pale skin
  • cough
  • depression
  • dizziness
  • fast heartbeat
  • fever
  • headache
  • increased hunger
  • nausea
  • nervousness
  • nightmares
  • seizures
  • shakiness
  • slurred speech
  • sneezing
  • sore throat
  • unusual tiredness or weakness

Less common

  • Bladder pain
  • bloody or cloudy urine
  • difficult, burning, or painful urination
  • frequent urge to urinate
  • lower back or side pain
  • pounding in the ears
  • slow heartbeat

Rare

  • Abdominal discomfort
  • decreased appetite
  • diarrhea
  • fainting spells
  • fast, shallow breathing
  • general feeling of discomfort
  • muscle pain or cramping
  • shortness of breath
  • sleepiness

Symptoms of Overdose

Get emergency help immediately if any of the following symptoms of overdose occur:

  • Abdominal discomfort
  • anxiety
  • behavior change, similar to drunkenness
  • blurred vision
  • cold sweats
  • coma
  • confusion
  • cool, pale skin
  • decreased appetite
  • diarrhea
  • difficulty in concentrating
  • drowsiness
  • excessive hunger
  • fast heartbeat
  • fast, shallow breathing
  • general feeling of discomfort
  • headache
  • muscle pain or cramping
  • nausea
  • nervousness
  • nightmares
  • restless sleep
  • seizures
  • shakiness
  • slurred speech
  • unusual sleepiness
  • unusual tiredness or weakness

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More Common

  • Muscle or bone pain
  • stomach pain
  • vomiting

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Copyright 2019 Truven Health Analytics, Inc. All Rights Reserved.

Medical Disclaimer

Glipizide vs Metformin: Main Differences and Similarities

Glipizide and metformin are two drugs used to treat type 2 diabetes. They are both available as generic medications and are relatively cheap options compared to newer options. While both glipizide and metformin can help treat high blood sugar levels, they do have differences in how they work.

Glipizide

Glipizide is the generic name for Glucotrol. It is a sulfonylurea that works by increasing insulin secretion so that the body can use it more efficiently. The increased insulin allows the body to use excess sugar in the body and lower overall levels.

Glipizide can be administered as a 5 mg or 10 mg oral tablet. Extended-release tablets can also be taken in strengths of 2.5 mg, 5 mg, or 10 mg. It is usually recommended to be taken in combination with diet and exercise.

Those with liver or kidney impairment should be monitored when taking glipizide. Otherwise, it is generally avoided in these individuals. Glipizide can also increase the risk of hypoglycemia, or dangerously low blood sugar levels, compared to other antidiabetic drugs.

Metformin

Metformin is also known by its brand name, Glucophage. It is classified as a biguanide which works by directly controlling the amount of sugar in the blood. It does this by decreasing the production of glucose, the body’s source of sugar, in the liver. It can also decrease the absorption of glucose from food as well as enhance the function of insulin in the body.

Metformin is supplied as a 500 mg, 850 mg, or 1000 mg oral tablet. An extended-release form can also be taken as a 500 mg, 750 mg, or 1000 mg oral tablet. Metformin is also available as a 500 mg/5 mL oral solution.

Similar to glipizide, metformin should be used with caution or avoided in those with kidney and liver problems. However, metformin does not carry a high risk of hypoglycemia. Instead, the most common side effects of metformin involve abdominal cramps and diarrhea.

Glipizide vs Metformin Side by Side Comparison

Glipizide and metformin can both help lower blood sugar levels in the body. Despite these similarities, both drugs differ in several ways. They can be further compared below.

Glipizide Metformin
Prescribed For
  • Type 2 diabetes mellitus
  • Type 2 diabetes mellitus
Drug Classification
  • Sulfonylurea
  • Biguanide
Manufacturer
  • Generic
  • Generic
Common Side Effects
  • Hypoglycemia
  • Constipation
  • Diarrhea
  • Nausea
  • Flatulence
  • Dizziness
  • Nervousness
  • Headache
  • Tremor
  • Diarrhea
  • Nausea
  • Vomiting
  • Flatulence
  • Weakness
  • Indigestion
  • Abdominal pain
  • Headache
Is there a generic?
  • No generic available
  • No generic available
Is it covered by insurance?
  • Varies according to your provider
  • Varies according to your provider
Dosage Forms
  • Oral tablet
  • Oral tablet
  • Oral tablet, extended release
  • Oral solution
Average Cash Price
  • $299 (per 60 tablets)
  • $111 (per 60 tablets)
SingleCare Discount Price
  • Glipizide Price
  • Metformin Price
Drug Interactions
  • NSAIDs
  • Probenecid
  • Warfarin
  • Sulfonamides
  • Salicylates
  • MAO inhibitors (selegiline, isocarboxazid, etc.)
  • Quinolone antibiotics
  • Beta-blockers (atenolol, carvedilol, etc.)
  • Diuretics (hydrochlorothiazide, furosemide, etc.)
  • Corticosteroids
  • Phenothiazines
  • Oral contraceptives
  • Phenytoin
  • Azoles
  • Niacin
  • Isoniazid
  • Carbonic anhydrase inhibitors (acetazolamide, dichlorphenamide, topiramate)
  • Cimetidine
  • Dolutegravir
  • Alcohol
  • Insulin
  • Beta-blockers (atenolol, carvedilol, etc.)
  • Diuretics (hydrochlorothiazide, furosemide, etc.)
  • Corticosteroids
  • Phenothiazines
  • Oral contraceptives
  • Phenytoin
  • Azoles
  • Niacin
  • Isoniazid
Can I use while planning pregnancy, pregnant, or breastfeeding?
  • Glipizide is in Pregnancy Category C. Consult a physician regarding taking glipizide while pregnant or breastfeeding.
  • Metformin is in Pregnancy Category B. No fetal harm has been established in animal studies. Consult a doctor regarding steps to take if planning pregnancy or breastfeeding.

Summary

Glipizide and metformin are effective oral antidiabetics that can help lower blood sugar. Sometimes they are even used together for increased management of type 2 diabetes. While glipizide enhances insulin secretion, metformin decreases glucose production in the liver.

Both drugs have similar side effects although glipizide has a notably higher risk of hypoglycemia. Metformin can cause abdominal discomfort and diarrhea which usually goes away over time. Taking metformin with food can decrease these side effects as well.

Metformin is commonly prescribed as a first-line agent for type 2 diabetes. Unlike glipizide, it is not associated with weight gain. However, it is still more effective when taken alongside a routine diet and exercise regimen.

These treatment options should be reviewed by your doctor. The information provided here is meant to give a brief overview on two different medications. It is recommended to only take these medications with guidance and counseling from your doctor or healthcare provider.

How to Lose Weight While on Glipizide

Glipizide is a diabetes drug designed to help your body process sugar. In a normal person, the pancreas helps the body store excess sugar by releasing insulin in the proper amounts to give you energy. Diabetics do not store sugar properly, however, and instead, sugar remains in the bloodstream. Glipizide is one of several drugs used to treat the disease, but many patients can gain weight from using it, which is not a good situation for diabetics. Healthy diet and exercise are advised to fight the possible weight gain from this drug.

Eat a healthy diet. MayoClinic.com says a “diabetes diet” is a myth. Consume a diet rich in fruits, vegetables and whole grains, which are low in fat and calories, but high in nutritional quality. Cut back on sweets and animal products. Counting carbohydrates also helps maintain a healthy lifestyle for diabetics.

Take your glipizide tablet with food. The food you eat affects your blood sugar level, so try to eat similarly sized meals at regular times each day. Remember that your blood sugar will be higher after meals.

Get plenty of physical activity to move the sugar from your blood into the rest of your cells. Blood sugar levels drop when you are active. Consult your doctor before beginning an exercise program. Include 30 minutes of aerobic exercise for most days of the week through activities such as walking, biking or swimming.

Also get in some stretching and strength training to round out your program. Build up your exercise routine slowly and stick with it. Because exercise lowers your blood sugar, check your levels before exercising.

Avoid stress, which produces hormones that stimulate fat storage and can cause you to gain weight. Incorporate a relaxation period at least once a day to enjoy the little things in life. Get a massage, turn on classical music, read a book, take a relaxing bath, call friends or do yoga. Anything you enjoy will fight the effects of prolonged stress in your life.

Warnings

Glipizide should not be taken if certain medical conditions develop, such as kidney or liver disease, dehydration, infections, heart problems or poor circulation.

Read the drug’s warning labels for possible side effects besides weight gain.

Gaining weight or struggling to lose weight is frustrating. You might feel like you’re doing all the “right” things: eating healthful foods, exercising, keeping food records, getting enough sleep, and so on. Yet despite all of your efforts, the scale doesn’t seem to budge. What gives? There are so many factors that affect our weight, and food isn’t always the culprit. One of the factors that may, in part, be contributing to some weight gain is medication.

Advertisement

The link between medication and weight
If you have diabetes, chances are, you’re taking some form of medication. It might be medication to help you manage your blood sugars. You might also be taking medication to keep your blood pressure or your cholesterol numbers in check. And you might even be taking a medication to help you better cope with the stress of having a chronic condition. While all of these drugs are effective (or else why would you be taking them?), the reality is that, like all medications, some of them have side effects that can make it difficult to reach your weight goal or can even lead to weight gain. To be more specific, these meds might:

• Jump-start your appetite, causing you to eat more than you usually might
• Slow your metabolism so that you burn fewer calories
• Affect how glucose is stored in the body, leading to increased fat storage
• Cause fluid retention
• Make you feel tired or sluggish, which can prevent you from being as active as you might like

The likely culprits
The following drugs are those that are mostly likely to affect your weight. However, it’s important to keep in mind that not everybody will gain weight while taking them. And, as with any medication, don’t stop taking it without first talking with your health-care provider.

Diabetes medications
Insulin: Insulin is probably the most effective medicine there is to help you manage your blood sugars. The primary side effect of insulin is low blood sugar (hypoglycemia), but some people find that when they start on insulin, they gain some weight. There are two reasons for this. First, insulin is called an anabolic hormone, which means that it promotes the storage of excess glucose, fat, and protein. So any calories that you don’t burn off get stored as fat. Second, as I mentioned, hypoglycemia is a possible side effect, and having frequent low sugars can quickly lead to weight gain because to treat the low, you need to eat or drink something that contains carbohydrate. Juice, glucose tabs, candy — all of these contain calories.

Sulfonylureas: Glipizide (brand names Glucotrol, Glucotrol XL), glyburide (DiaBeta, Glynase, Micronase), and glimepiride (Amaryl) are examples of sulfonylureas. These drugs cause the pancreas to release insulin and can, in some instances, lead to weight gain. They also can cause low blood sugar.

Thiazolidinediones (TZDs): Pioglitazone (Actos) and rosiglitazone (Avandia) are TZDs, and they help increase the body’s sensitivity to insulin. Weight gain from these drugs may be attributed to an increase in fat cell production; they can also cause fluid retention.

Blood pressure medication: Not all blood pressure medications cause weight gain. But some of the older versions of beta-blockers (propranolol , metoprolol , and atenolol ) may. These drugs are also used to treat other conditions, such as heart failure, glaucoma, and anxiety. Weight gain generally isn’t much — a few pounds, perhaps. Fortunately, some of the newer forms of beta-blockers, as well as calcium channel blockers, don’t cause weight gain.

Corticosteroids: Also known as steroid hormones, these powerful drugs are prescribed for many conditions. They have an anti-inflammatory effect, making them suitable for treating conditions such as asthma, arthritis, lupus, vasculitis, and inflammatory bowel disease (such as Crohn’s disease). Prednisone and hydrocortisone are examples of corticosteroids. If you take these drugs short-term, weight gain may not be an issue. But many people need to take them for long periods of time, which can increase the chances of gaining weight. Corticosteroids cause weight gain by affecting metabolism and increasing appetite. In addition, these drugs can cause a redistribution of fat in the body, leading to extra fat in the abdomen, face, and back of the neck. Excess weight is usually lost once the drug is stopped.

Antidepressants: If you have depression, there’s a high likelihood that you’ll be prescribed medication. There are many medications used to treat depression, and they can be very effective. However, about 25% of people who take an antidepressant will gain weight (possibly 10 pounds or more). It’s thought that these drugs may slow metabolism, increase appetite, and lead to carbohydrate cravings. Here are the meds most likely to put on the pounds:

Antihistamines: If you’re one of the more than 50 million Americans who suffer from allergies, you might be taking an antihistamine. As effective as they can be, they, too, can lead to weight gain, probably because they tend to stimulate the appetite. One study found that use of antihistamines was linked with overweight and obesity. Over-the-counter allergy meds such as cetirizine (Zyrtec) and fexofenadine (Allegra), for example, may cause a weight gain of about 10 pounds.

Other drugs, such as sleep aids like diphenhydramine (Benadryl, Unisom, and others), antipsychotic medication, antiseizure medication, oral contraceptives, and hormone replacement therapy may also lead to weight gain. In addition, some of these medications can increase blood sugar levels, too.

Next steps
• If you’ve been gaining weight and you take any of the above mentioned drugs, talk with your health-care provider. There are alternatives for many of these medications, and your provider may be able to switch to a different class of drug. However, be prepared for the reality that drugs are often prescribed, in part, based on what your health plan covers.

• If switching to another type of drug isn’t possible, see if you can take a lower dose.

• Focus on choosing healthy foods and controlling portions. Talking with a dietitian can help.

• Make a point to be active. Physical activity can go a long way in helping you to manage your weight and boosting your energy level (and your mood).

• Ask questions when any new medication is prescribed. Find out what all the possible side effects are and if there are other options.

• Notify your provider if you are gaining weight quickly. This may be due to fluid retention.

Lisa Shepard is a registered nurse and mom to a daughter with Type 1 diabetes. Bookmark DiabetesSelfManagement.com and tune in tomorrow to learn more about her.

Glucotrol

SIDE EFFECTS

In U.S. and foreign controlled studies, the frequency of serious adverse reactions reported was very low. Of 702 patients, 11.8% reported adverse reactions and in only 1.5% was GLUCOTROL discontinued.

Hypoglycemia

See PRECAUTIONS and OVERDOSE sections.

Gastrointestinal

Gastrointestinal disturbances are the most common reactions. Gastrointestinal complaints were reported with the following approximate incidence: nausea and diarrhea, one in seventy; constipation and gastralgia, one in one hundred. They appear to be dose-related and may disappear on division or reduction of dosage. Cholestatic jaundice may occur rarely with sulfonylureas: GLUCOTROL should be discontinued if this occurs.

Dermatologic

Allergic skin reactions including erythema, morbilliform or maculopapular eruptions, urticaria, pruritus, and eczema have been reported in about one in seventy patients. These may be transient and may disappear despite continued use of GLUCOTROL; if skin reactions persist, the drug should be discontinued. Porphyria cutanea tarda and photosensitivity reactions have been reported with sulfonylureas.

Hematologic

Leukopenia, agranulocytosis, thrombocytopenia, hemolytic anemia (see PRECAUTIONS), aplastic anemia, and pancytopenia have been reported with sulfonylureas.

Metabolic

Hepatic porphyria and disulfiram-like reactions have been reported with sulfonylureas. In the mouse, GLUCOTROL pretreatment did not cause an accumulation of acetaldehyde after ethanol administration. Clinical experience to date has shown that GLUCOTROL has an extremely low incidence of disulfiram-like alcohol reactions.

Endocrine Reactions

Cases of hyponatremia and the syndrome of inappropriate antidiuretic hormone (SIADH) secretion have been reported with this and other sulfonylureas.

Miscellaneous

Dizziness, drowsiness, and headache have each been reported in about one in fifty patients treated with GLUCOTROL. They are usually transient and seldom require discontinuance of therapy.

Laboratory Tests

The pattern of laboratory test abnormalities observed with GLUCOTROL was similar to that for other sulfonylureas. Occasional mild to moderate elevations of SGOT, LDH, alkaline phosphatase, BUN, and creatinine were noted. One case of jaundice was reported. The relationship of these abnormalities to GLUCOTROL is uncertain, and they have rarely been associated with clinical symptoms.

Post-Marketing Experience

The Following Adverse Events Have Been Reported In Post-Marketing Surveillance

Hepatobiliary

Cholestatic and hepatocellular forms of liver injury accompanied by jaundice have been reported rarely in association with glipizide; GLUCOTROL should be discontinued if this occurs.

Read the entire FDA prescribing information for Glucotrol (Glipizide)

About the author

Leave a Reply

Your email address will not be published. Required fields are marked *