glipizide Nursing Considerations & Management

Drug Name

Generic Name : glipizide

Brand Name: Glucotrol, Glucotrol XL

Classification: Antidiabetic, Sulfonylurea (second generation)

Pregnancy Category C

Available forms : Tablets—5, 10 mg; ER tablets—2.5, 5, 10 mg

Dosages : Give approximately 30 min before breakfast to achieve greatest reduction in postprandial hyperglycemia.

Initial therapy: 5 mg PO before breakfast. Adjust dosage in increments of 2.5–5 mg as determined by blood glucose response. At least several days should elapse between adjustments. Maximum once-daily dose should not exceed 15 mg; above 15 mg, divide dose, and administer before meals. Do not exceed 40 mg/day. ER tablets: 5 mg/day. Adjust dosage in 5-mg increments every 3 mo; maximum dose—20 mg/day.
Maintenance therapy: Total daily doses above 15 mg PO should be divided; total daily doses above 30 mg are given in divided doses bid.
Extended release: 5 mg/day with breakfast, may be increased to 10 mg/day after 3 mo if indicated.

Geriatric patients tend to be more sensitive to the drug. Start with initial dose of 2.5 mg/day PO. Monitor for 24 hr and gradually increase dose after several days as needed.

Glipizide stimulates insulin release from pancreatic β-cells and reduces gluconeogenesis in liver cells. It also increases insulin sensitivity at target sites.

Adjunct to diet and exercise to lower blood glucose with type 2 diabetes mellitus
Adjunct to insulin therapy in the stabilization of certain cases of type 1 diabetes, reducing the insulin requirement and decreasing the chance of hypoglycemic reactions

GI upsets, diarrhoea, nausea; allergic skin reactions, leucopenia, thrombocytopenia, agranulocytosis, hyponatraemia; jaundice; haemolytic anaemia, pancytopenia.
Potentially Fatal: Hypoglycaemia in presence of renal or hepatic damage and alcohol.

Hypersensitivity. Type 1 DM; ketoacidosis; severe renal or hepatic insufficiency. Pregnancy, lactation.

History: Allergy to sulfonylureas; diabetes with complications; type 1 diabetes, serious hepatic or renal impairment, uremia, thyroid or endocrine impairment, glycosuria, hyperglycemia associated with primary renal disease; pregnancy
Physical: Skin color, lesions; T; orientation, reflexes, peripheral sensation; R, adventitious sounds; liver evaluation, bowel sounds; urinalysis, BUN, serum creatinine, LFTs, blood glucose, CBC

Give drug 30 min before breakfast; if severe GI upset occurs or more than 15 mg/day is required, dose may be divided and given before meals.
Monitor urine or serum glucose levels frequently to determine drug effectiveness and dosage.
WARNING: Transfer to insulin therapy during periods of high stress (eg, infections, surgery, trauma).
WARNING: Use IV glucose if severe hypoglycemia occurs as a result of overdose.

Take this drug 30 minutes before breakfast for best results.
Do not discontinue this drug without consulting your health care provider.
Monitor urine or blood for glucose and ketones.
If taking ER tablets, swallow them whole; do not crush, chew, or divide tablets. The empty tablet may appear in your stool.
Do not use this drug during pregnancy; consult health care provider.
Avoid alcohol while using this drug.
Report fever, sore throat, unusual bleeding or bruising, rash, dark urine, light-colored stools, hypoglycemic or hyperglycemic reactions.