Glipizide

Medically Reviewed by Dr. Harshi Dhingra, M.D.

Last Reviewed: Oct 30, 2023

Warnings

Glipizide Risks, Warnings, and Complications

Glipizide can cause or worsen health problems in some people. Talk to your doctor or pharmacist about other treatments for type 2 diabetes mellitus if you are at an increased risk of adverse reactions or complications from this medication. Some of the risks of taking glipizide include:

HYPOGLYCEMIA: Glipizide and other sulfonylureas can cause severe hypoglycemia (very low blood sugar levels). Elderly patients, people who are malnourished or debilitated, and people who have pituitary or adrenal insufficiency are at a particularly high risk of hypoglycemic reactions after taking a glipizide tablet or other glucose-lowering medicines. In addition, it can be difficult to recognize hypoglycemia (low blood sugar) in elderly patients and people taking beta blockers. The risk of hypoglycemia is higher when you have low caloric intake, after prolonged or severe exercise, if you drink alcohol, or when you are on more than one drug to lower blood sugar or are taking a combination of glucose-lowering agents.
Low blood sugar can impair your ability to react and put you at risk of accidents, for example, while driving a motor vehicle or operating machinery. Severe hypoglycemia can lead to loss of consciousness, seizures, temporary or permanent brain damage, and even death.
Talk with your doctor about recognizing the signs and symptoms of low blood sugar and how to manage it. Your doctor may tell you to take glucose tablets, eat hard candy, or drink fruit juice or regular (non-diet) soda if your blood sugar level falls below a particular level (usually between 50-70 mg/dL).
SEVERE ALLERGIC REACTION: Rarely, glipizide can cause allergic reactions, including serious reactions such as anaphylaxis (throat closing), angioedema (swelling), and severe skin reactions. Stop taking glipizide and seek emergency medical attention if you develop a severe skin rash, hives, itching, swelling of the face or throat, or difficulty breathing or swallowing.
INCREASED RISK OF DEATH FROM CARDIOVASCULAR DISEASE: In a study conducted by the University Group Diabetes Program, an oral anti-diabetes drug called tolbutamide, which is also a sulfonylurea like glipizide, was found to increase the risk of death due to cardiovascular disease by 2.5 times compared to diet alone or diet and insulin therapy. Talk with your doctor about the risks versus benefits of taking glipizide and alternative diabetes treatments if this is a concern for you.
HEMOLYTIC ANEMIA: In people with a medical condition called glucose 6-phosphate dehydrogenase (G6PD) deficiency, glipizide can cause hemolytic anemia (anemia due to the abnormally fast breakdown of red blood cells). This complication can occur even in patients who do not have G6PD deficiency. Tell your doctor without delay if you develop tiredness, weakness, dizziness, yellowing of the skin or eyes, stomach pains, light-colored stool, or dark-colored urine after starting glipizide.

Precautions Before Starting Glipizide

Tell your doctor if you have ever had an allergic reaction to glipizide, any of the active or inactive ingredients in glipizide tablets, other sulfonylureas, or any other medications. Your pharmacy can give you a list of ingredients.

Give your doctor and pharmacist a complete list of your medications, including prescription medications, over-the-counter medicines, vitamins, dietary supplements, and herbal products. This can help avoid possible interactions between glipizide and your other drugs.

Give your doctor a complete medical history. Glipizide may not be right for people with certain medical conditions, such as G6PD deficiency (an inherited enzyme deficiency that causes hemolytic anemia with premature destruction of red blood cells), heart disease, kidney problems, liver disease, or endocrine disorders involving the pituitary gland, adrenal glands, or thyroid gland.

If you are taking the extended-release glipizide tablets, tell your doctor if you have short bowel syndrome, narrowing or blockage of the intestines, other intestinal problems, intestinal surgery in the past, or ongoing diarrhea.

Tell your healthcare professional if you are pregnant, could be pregnant, plan to get pregnant, or are nursing an infant with breast milk.

Precautions During Use of Glipizide

Keep all your healthcare appointments during glipizide treatment. Your doctor may want to order blood tests and adjust your glipizide dose and/or the doses of your other medications based on the results. For example, they may increase or decrease your glipizide or insulin dose based on glycemic control.

Glipizide can increase the sensitivity of your skin to sunlight. Avoid unnecessary sun exposure and the use of tanning beds. Wear protective clothing and sunscreen to protect your skin.

Avoid drinking alcohol while on glipizide. Alcohol can make the side effects of this medication worse and cause symptoms such as flushing, headache, blurred vision, weakness, nausea, vomiting, confusion, chest pain, sweating, anxiety, choking, and breathing difficulties.

Talk with your doctor about what to do if you are under emotional stress, sick with an infection or fever, or have suffered injuries. These conditions can affect your blood glucose levels and the amount of glipizide you need to take. If you have low blood sugar due to these conditions, your provider may ask you to discontinue insulin or other diabetes medications.

Tell your doctor if you become pregnant while taking glipizide.

Tell all your healthcare providers you are on glipizide, especially before any surgery, including dental procedures.

Glipizide Drug Interactions

Taking glipizide along with other drugs can affect how the medications work. A drug combination can also increase the risk of severe adverse reactions.

The following medications may have interactions with glipizide:

Anticoagulants or blood thinners such as warfarin (Coumadin)
Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen (Advil, Motrin), and naproxen (Aleve, Naprosyn)
Beta blockers such as propranolol (Inderal), metoprolol (Lopressor, Toprol XL), labetalol (Normodyne), atenolol (Tenormin), and nadolol (Corgard)
Calcium channel blockers such as diltiazem (Dilacor, Cardizem, Tiazac, others), amlodipine (Norvasc), felodipine (Plendil), nicardipine (Cardene), isradipine (DynaCirc), nifedipine (Procardia, Adalat), nisoldipine (Sular), nimodipine (Nimotop), and verapamil (Isoptin, Calan, Verelan)
Antibiotics such as chloramphenicol
Sulfa antibiotics such as co-trimoxazole (Bactrim, Septra) and sulfasalazine (Azulfidine)
H2 blockers such as cimetidine (Tagamet)
Diuretics or water pills
Antifungal agents such as fluconazole (Diflucan) and miconazole (Monistat)
Hormonal contraceptives (birth control pills) and hormone replacement therapy
Other medications used to treat diabetes or high blood sugar levels, including insulin
Tuberculosis medications such as isoniazid (INH)
Antidepressants called monoamine oxidase inhibitors, including tranylcypromine (Parnate), phenelzine (Nardil), isocarboxazid (Marplan), and selegiline (Emsam, Eldepryl, Zelapar)
Medications used to treat the common cold, nausea, asthma, and mental illnesses
Oral steroids such as methylprednisolone (Medrol), prednisone (Deltasone), and dexamethasone (Dexone, Decadron)
Vitamin B3 (niacin)
Anticonvulsants such as phenytoin (Dilantin)
Salicylate pain relievers such as magnesium salicylate (Doan's, others), choline salicylate (Arthropan), choline magnesium trisalicylate, diflunisal (Dolobid), and salsalate (Argesic, Disalcid, Salgesic)
Gout medications such as probenecid (Benemid)
Thyroid medications

Give your doctor or pharmacist a complete list of your medications, including prescription drugs, nonprescription drugs, dietary supplements, and herbal remedies. Also, tell your healthcare professional if you smoke, drink alcohol, or use recreational drugs because some of these substances can cause serious health complications when used with prescription medications.

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