From the Guidelines
The maximum recommended dose of glipizide is 40 mg per day for the immediate-release formulation and 20 mg per day for the extended-release formulation.
Key Considerations
- The dose of glipizide should be adjusted based on the patient's blood glucose response, with careful monitoring to avoid hypoglycemia.
- For patients with renal impairment, the dose of glipizide should be initiated conservatively and titrated slowly to avoid hypoglycemia, as recommended by the consensus report by the American Diabetes Association (ADA) and Kidney Disease: Improving Global Outcomes (KDIGO) 1.
- The medication works by stimulating insulin release from pancreatic beta cells and improving insulin sensitivity in peripheral tissues, thereby lowering blood glucose levels.
Dosing Guidelines
- Immediate-release glipizide: doses above 15 mg are usually divided into two daily doses.
- Extended-release formulations (Glucotrol XL): the maximum daily dose is 20 mg, taken once daily with breakfast.
- Elderly patients and those with liver impairment may require dose adjustments due to increased sensitivity to the medication's effects.
Monitoring and Education
- Patients should be educated about recognizing and managing hypoglycemic symptoms, especially when taking higher doses of this medication.
- Careful monitoring of blood glucose levels is essential to avoid hypoglycemia and adjust the dose as needed. According to the most recent evidence from the standards of care in diabetes-2025, the maximum approved daily dose of glipizide is 40 mg for the immediate-release formulation and 20 mg for the extended-release formulation 1.
From the FDA Drug Label
DOSAGE AND ADMINISTRATION ... The maximum recommended total daily dose is 40 mg
- The highest dose of glipizide is 40 mg per day.
- This dose can be divided and given before meals of adequate caloric content 2.
From the Research
Highest Dose of Glipizide
- The highest dose of glipizide mentioned in the studies is 60 mg per day, as seen in the study by 3.
- Another study by 4 mentions a dose of 40 mg per day, which was given to patients in three different dose schedules for 3 months each.
- The study by 3 also found that all doses of glipizide GITS in both trials produced significant reductions from placebo in FPG and HbA1c, with maximal efficacy achieved at a dose of 20 mg for FPG and at 5 mg for HbA1c.
- However, the study by 4 found that increasing the glipizide dose to more than 10 mg once daily produces little or no benefit and may reduce beta-cell function.
- Other studies, such as those by 5, 6, and 7, mention various doses of glipizide, including 2.5 mg, 5 mg, 10 mg, and 20 mg per day, but do not specifically address the highest dose of glipizide.