From the FDA Drug Label
DOSAGE AND ADMINISTRATION There is no fixed dosage regimen for the management of diabetes mellitus with glipizide or any other hypoglycemic agent. Initial Dose:The recommended starting dose is 5 mg, given before breakfast. Geriatric patients or those with liver disease may be started on 2.5 mg. Titration:Dosage adjustments should ordinarily be in increments of 2. 5–5 mg, as determined by blood glucose response. The maximum recommended once daily dose is 15 mg. Doses above 15 mg should ordinarily be divided and given before meals of adequate caloric content. The maximum recommended total daily dose is 40 mg
The recommended starting dose of glipizide is 5 mg, given before breakfast. The maximum recommended total daily dose is 40 mg.
- Initial dose: 5 mg for normal patients, 2.5 mg for geriatric patients or those with liver disease
- Titration: increments of 2.5-5 mg
- Maximum once daily dose: 15 mg
- Maximum total daily dose: 40 mg 1
From the Research
Glipizide dosing typically starts at 2.5 mg once daily, taken before breakfast, as indicated in the study comparing sitagliptin with glipizide in patients with type 2 diabetes and moderate-to-severe chronic renal insufficiency 2. The dose may be adjusted based on blood glucose response, usually increasing by 2.5-5 mg every few days if needed, with a maximum recommended daily dose of 10 mg twice a day, as seen in the study 2. For elderly patients or those with liver impairment, starting at a lower dose of 2.5 mg is recommended. Some key points to consider when prescribing glipizide include:
- Glipizide is usually taken 30 minutes before meals because it works by stimulating insulin release from the pancreas, which helps lower blood sugar levels.
- The medication is available in immediate-release tablets (taken once or twice daily) and extended-release formulations (taken once daily).
- Extended-release tablets should be swallowed whole, not crushed or chewed.
- Patients should monitor their blood glucose regularly while taking glipizide and be aware of hypoglycemia symptoms such as dizziness, confusion, and sweating.
- This medication works best when combined with proper diet and exercise as part of a comprehensive diabetes management plan. It's also important to note that glipizide has been compared to other medications, such as sitagliptin, in terms of efficacy and safety, with studies showing that sitagliptin may have a lower risk of hypoglycemia and weight gain compared to glipizide 2. However, the most recent and highest quality study on glipizide dosing is not directly available, but based on the available evidence, the recommended dosing is as mentioned above. Additionally, a study on the effects of once-daily and twice-daily dosing on adherence with prescribed glipizide oral therapy for type 2 diabetes found that once-daily dosing results in better adherence and persistence compared to twice-daily dosing 3. But the study that guides the answer the most is the one that is most recent and of the highest quality, which in this case is not directly related to glipizide dosing but rather to the efficacy and safety of glucagon-like peptide 1 receptor agonists, including oral semaglutide, in reducing the incidence of major adverse cardiovascular events and kidney outcomes in individuals with type 2 diabetes 4. However, this study does not provide information on glipizide dosing, and therefore, the answer is based on the study that provides the most relevant information on glipizide dosing 2.