Indications for: GLUCOTROL
Adjunct to diet and exercise in type 2 diabetes mellitus. Limitations of use: not for treating type 1 diabetes or diabetic ketoacidosis.
Limitations of Use:
Not for treating type 1 diabetes or diabetic ketoacidosis.
Give 30 mins before a meal. Initially 5mg daily. Elderly or hepatic disease: initially 2.5mg daily. Increase by 2.5–5mg every few days based on blood glucose response. Max once daily dose: 15mg. Max total daily dose: 40mg. Give in divided doses if >15mg. Transferring from other hypoglycemics to Glucotrol: see full labeling.
Type 1 diabetes, diabetic ketoacidosis, with or without coma. Sulfonamide allergy.
Increased risk of cardiovascular mortality. Adrenal or pituitary insufficiency. Stress. Secondary failure may occur with extended therapy. Risk of hemolytic anemia in G6PD deficiency; consider non-sulfonylurea alternative. Monitor urine and blood glucose. Impaired GI function or GI narrowing (XL); avoid. Discontinue if jaundice occurs or skin reactions persist. Elderly, debilitated, uncompensated strenuous exercise, malnourished or deficient caloric intake, adrenal or pituitary insufficiency, or alcohol intoxication: increased risk of hypoglycemia. Renal or hepatic impairment (see Adults). Neonates. Pregnancy: discontinue at least 2 weeks before expected delivery. Nursing mothers: monitor infants for hypoglycemia.
Sulfonylurea (2nd generation).
May be potentiated by concomitant oral miconazole, fluconazole, or drugs affecting glucose metabolism (eg, ACEIs, ARBs, NSAIDs, salicylates, sulfonamides, chloramphenicol, probenecid, coumarins, MAOIs, quinolones); monitor closely for hypoglycemia with co-administration and for worsening glycemic control upon withdrawal (see full labeling). May be antagonized by atypical antipsychotics, diuretics, steroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, niacin, sympathomimetics, calcium channel blockers, isoniazid, protease inhibitors; monitor. May be antagonized by colesevelam; administer glipizide ≥4hrs prior to colesevelam. β-blockers, clonidine, guanethidine, reserpine may mask hypoglycemia. Disulfiram-like reaction with alcohol (rare). Monitor for 1–2 weeks if transferring from long-acting sulfonylureas.
Hypoglycemia, tremor, asthenia, diarrhea, flatulence, allergic skin reactions, photosensitivity, blood dyscrasias, hyponatremia, dizziness, drowsiness, headache; rare: cholestatic jaundice, hepatic porphyria.
Generic Drug Availability:
XL tabs 2.5mg—30; 5mg, 10mg—100, 500; Tabs—100