From the Guidelines
Glipizide is contraindicated in patients with hypersensitivity to glipizide or any sulfonylureas, type 1 diabetes mellitus, diabetic ketoacidosis, and severe hepatic or renal impairment, as well as in patients with G6PD deficiency, pregnancy, and breastfeeding. According to the most recent evidence from 1, glipizide should be initiated conservatively, such as 2.5 mg once daily, and titrated slowly to avoid hypoglycemia in patients with chronic kidney disease. The medication should be used with caution in elderly patients and those with adrenal or pituitary insufficiency due to increased hypoglycemia risk. Some key points to consider when prescribing glipizide include:
- Hypersensitivity to glipizide or any sulfonylureas is an absolute contraindication
- Type 1 diabetes mellitus, diabetic ketoacidosis, and severe hepatic or renal impairment are also absolute contraindications
- G6PD deficiency is a relative contraindication due to the risk of hemolytic anemia
- Pregnancy and breastfeeding are contraindications due to the potential for prolonged neonatal hypoglycemia and passage into breast milk
- Elderly patients and those with adrenal or pituitary insufficiency require caution due to increased hypoglycemia risk
- Concurrent use with certain medications, such as miconazole, may increase hypoglycemia risk, while others, such as corticosteroids, may reduce glipizide's effectiveness, as noted in 1 and 1. It is essential to carefully evaluate the patient's medical history and current condition before prescribing glipizide, and to closely monitor their glucose levels and adjust the dose as needed to avoid hypoglycemia.
From the FDA Drug Label
CONTRAINDICATIONS Glipizide tablets are contraindicated in patients with: Known hypersensitivity to the drug. Type 1 diabetes mellitus, diabetic ketoacidosis, with or without coma. This condition should be treated with insulin. The contraindications for Glipizide are:
- Known hypersensitivity to the drug
- Type 1 diabetes mellitus
- Diabetic ketoacidosis, with or without coma 2
From the Research
Glipizide Contraindications
- The provided studies do not directly address the contraindications of Glipizide 3, 4, 5, 6, 7.
- However, it is mentioned that individuals with coronary artery disease who take glipizide or glyburide have an increased risk of death 3.
- Additionally, the study notes that glipizide may cause DNA damage over time and that the way glipizide interacts with genetic variants may increase the risk of hypoglycemia 3.
- There is no comprehensive list of contraindications provided in the given studies.
Special Considerations
- Glipizide should be used with caution in patients with certain medical conditions, such as coronary artery disease 3.
- The interaction between glipizide and other medications, such as propranolol, should be considered, as it may enhance the hypoglycemic effect of glipizide 3.
- The combination of glipizide with other medications, such as dulaglutide, may have a minimal risk of muscular responses and acute pancreatitis 3.