Glipizide

Sulfonylurea (second-generation), Insulin secretagogue, Antihyperglycemic agent

Glipizide

Glucotrol, Glucotrol XL

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Summary

Classes

Sulfonylurea (second-generation), Insulin secretagogue, Antihyperglycemic agent

Common uses

Type 2 diabetes mellitus▲0▼

Pharmacy

Starting dose

5 mg PO once daily, 30 minutes before breakfast; XL: 5 mg with breakfast

Preparations

5 mg, 10 mg immediate-release tablets; 2.5 mg, 5 mg, 10 mg extended-release tablets

US FDA Max

40 mg/d (IR; doses >15 mg given as divided BID); 20 mg/d (XL)

Pharmacology

Routes

Oral

Onset

Within 30 minutes (IR)

Duration

~12-24 hours

Half-life

2-5 hours

Bioavailability

~100% (oral; food delays absorption, hence pre-meal dosing for IR)

Pregnancy

Avoid; switch to insulin. Hypoglycemia in newborn reported.^{[citation needed]}

Legal status

Rx-only in US

Purported mechanism

Glipizide binds the SUR1 regulatory subunit of pancreatic β-cell ATP-sensitive potassium channels, closing the channel and producing membrane depolarization, voltage-gated calcium entry, and glucose-independent insulin release.▲0▼ Hypoglycemia is the central risk, especially in elderly and renally impaired patients (glipizide has shorter half-life than glyburide, which is one reason it is preferred in older adults). CYP2C9 substrate; weight gain typical.