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 &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :445.5
  • %Protein binding &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :98–99
  • %Excreted unchanged in urine &nbsp &nbsp :
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp :

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

  • half-life – normal/ESRD (hrs)&nbsp &nbsp &nbsp :2–4/–

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

  • 20 to 50 &nbsp &nbsp : Initially 2.5 mg daily. Titrate according to response
  • 10 to 20 &nbsp &nbsp : Initially 2.5 mg daily. Titrate according to response
  • <10 &nbsp &nbsp &nbsp &nbsp &nbsp : Initially 2.5 mg daily. Titrate according to response

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

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

  • HD &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp &nbsp :Unlikely to be dialysed. Dose as in GFR <10 mL/min
  • HDF/high flux &nbsp :Unlikely to be dialysed. Dose as in GFR <10 mL/min
  • CAV/VVHD &nbsp &nbsp &nbsp: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

    –

    Route

    Oral

    Rate of Administration

    –

    Comments

    –

    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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