From the Guidelines
The maximum recommended dose of glipizide is 40 mg daily for the immediate-release formulation and 20 mg daily for the extended-release formulation. According to the most recent evidence from 1, the maximum approved daily dose of glipizide is 40 mg for the immediate-release formulation and 20 mg for the extended-release formulation.
- The immediate-release formulation can be taken in divided doses, with doses above 15 mg given twice daily before meals.
- The extended-release formulation should be taken once daily with breakfast.
- Dose adjustments should be made carefully, with increases made no more frequently than every several days to allow proper assessment of the glycemic response.
- Glipizide works by stimulating insulin release from pancreatic beta cells and improving insulin sensitivity in peripheral tissues.
- Higher doses carry an increased risk of hypoglycemia, so careful monitoring is essential, particularly in elderly patients, those with liver or kidney impairment, or patients with poor nutritional status.
- Additionally, dose adjustments may be necessary if the patient is taking medications that interact with glipizide or has changes in renal or hepatic function, as noted in 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, which was used in a clinical trial to investigate the efficacy, safety, and dose-response characteristics of an extended-release preparation of glipizide 3.
- In this study, doses of 5,20,40, and 60 mg of glipizide were compared with placebo in patients with non-insulin-dependent diabetes mellitus (NIDDM).
- The study found that all doses of glipizide produced significant reductions in fasting plasma glucose (FPG) and glycosylated hemoglobin (HbA1c) compared with placebo.
- Another study compared the efficacy and safety of dapagliflozin with glipizide in patients with type 2 diabetes who had inadequate glycemic control with metformin monotherapy, and found that glipizide was up-titrated over 18 weeks to ≤ 20 mg/day 4.
Dose-Response Characteristics
- The study by the Glipizide Gastrointestinal Therapeutic System Study Group found that the dose-response characteristics of glipizide showed a significant relationship between plasma glipizide concentration and reduction in FPG and HbA1c over a dose range of 5-60 mg 3.
- The study also found that maximal efficacy was achieved at a dose of 20 mg for FPG and at 5 mg for HbA1c.
- However, another study found that the addition of 2.5 mg glipizide to metformin significantly improved glucose control in patients with type 2 diabetes inadequately controlled by metformin monotherapy 5.