Is Glipizide (Glipizide) safe to use in patients with Chronic Kidney Disease (CKD)?

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Last updated: March 15, 2025View editorial policy

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From the Guidelines

Glipizide can be used in patients with Chronic Kidney Disease (CKD), but it requires careful dose adjustment and monitoring to minimize the risk of hypoglycemia, particularly in those with severe CKD (eGFR <30 mL/min) 1.

Key Considerations

  • Glipizide is preferred over other sulfonylureas in CKD because it does not have active metabolites and does not increase the risk of hypoglycemia in patients with CKD 1.
  • For patients with mild to moderate CKD (eGFR >30 mL/min), glipizide can typically be used at standard doses starting at 2.5-5 mg daily.
  • However, for patients with severe CKD (eGFR <30 mL/min), the risk of hypoglycemia increases significantly, and alternative agents like insulin or certain DPP-4 inhibitors may be safer options 1.

Dosing and Monitoring

  • If glipizide must be used in patients with advanced CKD, start with the lowest possible dose (2.5 mg daily) and monitor blood glucose levels closely 1.
  • Educate patients about recognizing and managing hypoglycemia symptoms, as the risk of prolonged hypoglycemia is particularly dangerous in this vulnerable population.

Alternative Options

  • Insulin and certain DPP-4 inhibitors may be safer options for patients with severe CKD (eGFR <30 mL/min) due to the increased risk of hypoglycemia associated with glipizide in this population 1.
  • Metformin should not be given to patients with serum creatinine concentrations of 1.5 mg/dL or greater in men and 1.4 mg/dL or greater in women due to the risk of lactic acidosis 1.

From the FDA Drug Label

Renal and Hepatic Disease:The metabolism and excretion of glipizide may be slowed in patients with impaired renal and/or hepatic function If hypoglycemia should occur in such patients, it may be prolonged and appropriate management should be instituted. Renal or hepatic insufficiency may cause elevated blood levels of glipizide and the latter may also diminish gluconeogenic capacity, both of which increase the risk of serious hypoglycemic reactions.

Key Considerations:

  • Glipizide metabolism and excretion may be slowed in patients with impaired renal function.
  • Renal insufficiency may cause elevated blood levels of glipizide, increasing the risk of serious hypoglycemic reactions.
  • Caution is advised when using glipizide in patients with Chronic Kidney Disease (CKD).
  • Initial and maintenance dosing should be conservative to avoid hypoglycemic reactions in patients with impaired renal function 2.

From the Research

Safety of Glipizide in Patients with Chronic Kidney Disease (CKD)

  • Glipizide is a sulfonylurea that can be used in patients with CKD, but its use requires careful consideration of the patient's renal function and the risk of hypoglycemia 3, 4.
  • According to some studies, glipizide does not require dose adjustment in patients with CKD, but it should be avoided in cases of advanced kidney disease due to the risk of hypoglycemia 3.
  • Other studies suggest that sulfonylureas with limited renal clearance, such as glipizide, are an alternative to metformin and may be more effective than repaglinide on glycemic control 4.
  • However, the use of glipizide in patients with CKD should be evaluated carefully, and dosing adjustments may be necessary to minimize the risk of hypoglycemia 4.

Key Considerations

  • Patients with CKD are at high risk of hypoglycemia, and close monitoring of glucose levels is necessary to minimize this risk 5.
  • The management of diabetes in patients with CKD requires individualized care, taking into account the patient's renal function, life expectancy, and comorbidities 3, 6.
  • Other antidiabetic agents, such as DPP-4 inhibitors, incretin analogues, and SGLT-2 inhibitors, may have potential nephroprotective effects, but their use in patients with CKD should be carefully evaluated 4.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Diabetes mellitus and kidney disease in the elderly.

Nefrologia : publicacion oficial de la Sociedad Espanola Nefrologia, 2014

Research

[Anti-diabetics and chronic kidney disease].

Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia, 2015

Research

Managing diabetes in hospitalized patients with chronic kidney disease.

Cleveland Clinic journal of medicine, 2016

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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