Diaplus

Indications

Glipizide is used to control blood sugar in adults with type 2 diabetes, together with diet and exercise. It can be used alone or with other diabetes medicines; combination tablets with Metformin are also available.

How It Works

It belongs to the sulfonylurea group. It makes the pancreas release more insulin, which lowers blood sugar. It needs a pancreas that can still make some insulin, so it is not used in type 1 diabetes. It acts for a shorter time than some older sulfonylureas.

Dosage and Administration

Adults: usually started at 2.5 to 5 mg once a day, about 30 minutes before breakfast. The doctor may increase the dose slowly, based on blood sugar tests, usually up to a maximum of 20 mg a day; larger doses are often split into two doses before meals. Extended-release tablets are taken once a day with breakfast and must be swallowed whole. Older people and those with kidney or liver problems start on a low dose. Combination tablets with Metformin: as prescribed, with meals.

Interactions

• Insulin and other diabetes medicines increase the risk of low blood sugar.
• Fluconazole, Miconazole, Clarithromycin, sulfonamide antibiotics and some painkillers can increase its effect.
• Corticosteroids, thiazide diuretics and some hormone medicines can raise blood sugar.
• Beta-blockers such as Propranolol can hide the warning signs of low blood sugar.
• Alcohol increases the risk of low blood sugar.

Contraindications

• Type 1 diabetes or diabetic ketoacidosis.
• Severe kidney or liver disease.
• Allergy to glipizide, other sulfonylureas or sulfonamide medicines.
• Porphyria.

Side Effects

The most important side effect is low blood sugar: sweating, shaking, hunger, fast heartbeat, headache, confusion or blurred vision. Take something sugary straight away if this happens. Other effects include nausea, diarrhoea, stomach upset, weight gain, dizziness and skin rash.

Get urgent medical help if low blood sugar does not improve after taking sugar, or if there is fainting, fits or unusual drowsiness; also for yellow skin or eyes, a blistering or peeling rash, or unusual bruising or bleeding.

Pregnancy and Lactation

Not recommended in pregnancy; women with diabetes who are pregnant or planning pregnancy are usually switched to insulin, so speak to the doctor early. Not recommended while breastfeeding because it may lower the baby's blood sugar.

Precautions and Warnings

• Eat regular meals and take extra care with exercise, fasting (including Ramadan), illness or alcohol.
• Older people and those with kidney or liver problems have a higher risk of low blood sugar.
• People with G6PD deficiency may develop anaemia.
• The empty shell of some extended-release tablets may be seen in the stool; this is normal.
• Check blood sugar regularly and carry a sugary snack.

Overdose

An overdose can cause severe low blood sugar. If the person is awake, give sugar or a sweet drink and go to hospital straight away, as low sugar can return. If the person is drowsy or unconscious, do not put food in the mouth; call for emergency help.

Therapeutic Class

Sulfonylurea (oral antidiabetic medicine).

Storage

Store below 30°C in a dry place, away from light and out of the reach of children.