Glipizide/​Metformin

DEA Class; Rx

Common Brand Names; Metaglip

Indicated for the treatment of type 2 diabetes mellitus not controlled by diet and exercise alone.

Severe renal disease: eGFR <30 ml/min/1.73 m²

Documented hypersensitivity to drug or components

Acute or chronic metabolic acidosis, including diabetic ketoacidosis, with or without coma

Renal disease or renal dysfunction (eg, as suggested by serum creatinine levels ≥1.5 mg/dL [males], ≥1.4 mg/dL [females], or abnormal creatinine clearance) whichmay also result from conditions such as cardiovascular collapse (shock), acute myocardial infarction, and septicemia

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Patients with glucose-6-phosphate dehydrogenase deficiency may be at risk of sulfonylurea-induced hemolytic anemia

Administration of oral hypoglycemic drugs reported to be associated with increased cardiovascular mortality as compared to treatment with diet alone or diet plus insulin; data in support of this association is limited and several studies, including a large prospective trial, have not supported this association; metformin does not appear to share this risk; in patients with established atherosclerotic cardiovascular disease, other agents are preferred

Long-term metformin use is associated with vitamin B12 deficiency; measurement of hematologic parameters on an annual basis is advised in patients on metformin and any apparent abnormalities should be appropriately investigated and managed; certain individuals (those with inadequate vitamin B12 or calcium intake or absorption) appear to be predisposed to develop subnormal vitamin B 12 levels; in these patients, routine serum vitamin B12 measurements at 2- to 3-year intervals may be useful

In patients with advanced age, the drug should be carefully titrated to establish the minimum dose for adequate glycemic effect, because aging is associated with reduced renal function; in elderly patients, particularly those ≥80 years of age, renal function should be monitored regularly and, generally, the drug should not be titrated to the maximum dose

Before initiation of therapy and at least annually thereafter, renal function should be assessed and verified as normal; in patients in whom development of renal dysfunction is anticipated, renal function should be assessed more frequently and therapy discontinued if evidence of renal impairment is present

Cardiovascular collapse (shock) from whatever cause, acute congestive heart failure, acute myocardial infarction, and other conditions characterized by hypoxemia have been associated with lactic acidosis and may also cause prerenal azotemia; when such events occur in patients on this therapy, the drug should be promptly discontinued

Therapy should be temporarily suspended for any surgical procedure (except minor procedures not associated with restricted intake of food and fluids) and should not be restarted until the patient’s oral intake has resumed and renal function has been evaluated as normal

Alcohol is known to potentiate effect of metformin on lactate metabolism. Patients, therefore, should be warned against excessive alcohol intake, acute or chronic, while receiving; due to its effect on the gluconeogenic capacity of the liver, alcohol may also increase risk of hypoglycemia

Since impaired hepatic function has been associated with some cases of lactic acidosis, this drug should generally be avoided in patients with clinical or laboratory evidence of hepatic disease

Pregnancy Category: C

Lactation: enters breast milk; not recommended

Glipizide/Metformin

tablet

• 2.5mg/250mg
• 2.5mg/500mg
• 5mg/500mg