Glipizide + Metformin Hydrochloride
Generic Details
Generic Name
Glipizide-Metformin Hydrochloride
Other Names
- Glipizide-Metformin HCl
Drug Class
- Antidiabetic Combination
Chemical Formula
Molecular Weight
Mechanism of Action
- Glipizide stimulates the release of insulin from the pancreas, while metformin decreases glucose production in the liver and improves insulin sensitivity in peripheral tissue.
Indications
- Type 2 diabetes mellitus
Common Dosage Forms
- Tablet
Typical Dosage
- The typical starting dose is one tablet containing 2.5 mg glipizide/250 mg metformin twice daily with meals.
Pediatric Dosage
- Safety and efficacy not established.
Geriatric Dosage
- Dose adjustments may be necessary in the elderly population due to decreased renal function.
Side Effects
- Hypoglycemia (low blood sugar)
- Nausea
- Diarrhea
- Vomiting
- Metallic taste in mouth
Contraindications
- Severe renal impairment
- Metabolic acidosis
- Hypersensitivity to sulfonylureas or biguanides
Pregnancy Category
- Category B: Animal reproduction studies have failed to demonstrate a risk to the fetus, but there are no adequate and well-controlled studies in pregnant women.
Lactation Safety
- Not recommended during lactation as it is excreted in breast milk.
Drug Interactions
- Alcohol may potentiate the effects of glipizide-metformin and cause hypoglycemia.
- Certain medications like cimetidine, corticosteroids, and beta-blockers may interact with glipizide-metformin.
Overdose Symptoms
- Symptoms of hypoglycemia such as confusion, dizziness, sweating, and seizures
Antidote for Overdose
- Glucose or intravenous dextrose
Storage Conditions
- Store at room temperature away from moisture and heat.
Pharmacokinetics
- Absorption: Metformin is absorbed slowly with peak concentrations reached in 2-4 hours. Glipizide is rapidly absorbed.
- Distribution: Metformin distributes to erythrocytes and has a low protein binding, while glipizide is highly protein bound.
- Metabolism: Metformin does not undergo metabolism, whereas glipizide is extensively metabolized by the liver.
- Excretion: Both metformin and glipizide are primarily excreted unchanged in the urine.
Precautions
- Regular monitoring of blood glucose levels is essential during treatment.
- Caution in patients with hepatic impairment.
Warnings
- May cause lactic acidosis, a rare but serious side effect characterized by low blood pH.