From the Guidelines
Glipizide should be initiated at a conservative dose, such as 2.5 mg once daily, and titrated slowly to avoid hypoglycemia, as recommended by the most recent guidelines 1.
Key Considerations
- The dose can be adjusted based on blood glucose response, usually increasing by 2.5-5 mg every few days until blood glucose targets are achieved, with a maximum daily dose of 40 mg.
- For patients with chronic kidney disease, the dose should be adjusted according to the estimated glomerular filtration rate (eGFR), with a maximum dose of 10 mg daily for eGFR <45 mL/min/1.73 m2 1.
- Glipizide is available in immediate-release tablets (taken 30 minutes before meals) and extended-release formulations (taken once daily with breakfast).
- Patients should monitor for hypoglycemia, especially when starting therapy or increasing doses.
Important Details
- Glipizide works by stimulating insulin release from pancreatic beta cells, so it's only effective in patients who still have some pancreatic function.
- It should be taken consistently with meals to minimize gastrointestinal side effects and optimize blood glucose control.
- The immediate-release form can be divided into twice-daily dosing if needed, while the extended-release should not be crushed or split.
Evidence-Based Recommendation
The recommendation to initiate glipizide at a conservative dose and titrate slowly is based on the most recent guidelines from the American Diabetes Association and Kidney Disease: Improving Global Outcomes (KDIGO) 1. This approach prioritizes minimizing the risk of hypoglycemia and optimizing blood glucose control, while also considering the patient's kidney function and other individual factors.
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 initial dose of glipizide is 5 mg, given before breakfast, with dosage adjustments in increments of 2.5-5 mg. The maximum recommended once daily dose is 15 mg, and the maximum recommended total daily dose is 40 mg 2.
- Key points:
- Initial dose: 5 mg
- Titration increments: 2.5-5 mg
- Maximum once daily dose: 15 mg
- Maximum total daily dose: 40 mg
From the Research
Glipizide Dosing
There is no direct information available on glipizide dosing in the provided studies.
- The studies focus on GLP-1 receptor agonists, metformin, and SGLT2 inhibitors, but do not mention glipizide specifically 3, 4, 5, 6, 7.
- Glipizide is a sulfonylurea used to treat type 2 diabetes, but its dosing is not discussed in the context of the provided research.
- To determine the appropriate dosing for glipizide, it would be necessary to consult other sources, such as the medication's label or clinical guidelines.