Glipizide

CLINICAL USE

Non-insulin dependent diabetes mellitus

DOSE IN NORMAL RENAL FUNCTION

Initially 2.5–5 mg daily, adjusted according to response; maximum 20 mg daily; up to 15 mg may be given as a single dose before breakfast; higher doses divided

PHARMACOKINETICS

Molecular weight :445.5

%Protein binding :98–99

%Excreted unchanged in urine :

<10 :

Volume of distribution (L/kg) :0.13–0.16

half-life – normal/ESRD (hrs) :2–4/–

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Initially 2.5 mg daily. Titrate according to response

10 to 20 : Initially 2.5 mg daily. Titrate according to response

<10 : Initially 2.5 mg daily. Titrate according to response

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Unlikely to be dialysed. Dose as in GFR <10 mL/min

HD :Unlikely to be dialysed. Dose as in GFR <10 mL/min

HDF/high flux :Unlikely to be dialysed. Dose as in GFR <10 mL/min

CAV/VVHD :Unlikely to be dialysed. Dose as in GFR 10 to 20 mL/min

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugs

Analgesics: effects enhanced by NSAIDs

Antibacterials: effects enhanced by chloramphenicol, sulphonamides, and trimethoprim; effect reduced by rifamycins

Anticoagulants: effect possibly enhanced by coumarins; also possibly changes to INR

Antifungals: concentration increased by fluconazole, posaconazole and miconazole and possibly voriconazole – avoid with miconazole

Ciclosporin: may increase ciclosporin levelsSulfinpyrazone: enhanced effect of sulphonylureas

ADMINISTRATION

Reconstition

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Route

Oral

Rate of Administration

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Comments

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OTHER INFORMATION

Company does not recommend the use of Glibenese in patients with renal insufficiencyRenal or hepatic insufficiency may cause elevated blood levels of glipizide (increased risk of serious hypoglycaemic reactions).

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