Glipizide
Regulatory sources consulted
- AEMPS CIMA FT_51293 (https://cima.aemps.es/cima/dochtml/ft/51293/FT_51293.html)
- Flockhart Table (CYP2C9 substrate)
- Clinical Pharmacology Professional Knowledge
- AEMPS CIMA · nº registro 51293 ↗
- RxNorm rxcui 4821 ↗
Approved indications
- Type 2 diabetes mellitus (non-insulin-dependent), when diet and physical exercise are not sufficient to control glycemia.
Contraindications
Absolute
- Hypersensitivity to glipizide, other sulfonylureas, or sulfonamides.
- Type 1 diabetes, diabetic ketoacidosis, diabetic pre-coma and coma.
- Severe renal or hepatic impairment.
- Pregnancy and lactation.
- Concomitant treatment with miconazole.
Clinical warnings
- Major warning · Hypoglycemia: This is the most significant adverse effect. The risk is increased in the elderly, debilitated patients, those with irregular caloric intake, and in renal or hepatic impairment. — AEMPS CIMA
Drug interactions
- HighMiconazoleJ02AB01
Mechanism: Potent inhibition of glipizide metabolism via CYP2C9, which can lead to a marked increase in plasma levels and risk of severe and prolonged hypoglycemia.
Recommendation: Concomitant use is contraindicated.
AEMPS CIMA
- ModerateAlcoholV03AB16
Mechanism: Potentiates the hypoglycemic effect. May occasionally cause a disulfiram-like reaction (antabuse) with flushing, nausea, and vomiting.
Recommendation: Avoid or limit alcohol consumption. Warn the patient about both possible reactions (hypoglycemia and disulfiram effect).
AEMPS CIMA
Adverse events
Common (≥1%)
hypoglycemia · nausea · diarrhea · abdominal pain · rash · pruritus
Rare but serious
severe hypoglycemia · hematologic reactions (leukopenia, agranulocytosis, thrombocytopenia) · hemolytic anemia · hepatotoxicity (cholestatic jaundice) · SIADH · disulfiram-like reaction
Pregnancy and lactation
FDA category: C
Contraindicated during pregnancy and lactation. May cause prolonged neonatal hypoglycemia if used near delivery.