Pharmacological action Glipizide 5 mg:
Oral hypoglycemic agents, sulfonylureas II generation. It has a pancreatic and vnepankreaticheskim effects. Stimulates insulin secretion by lowering the threshold for glucose stimulation of beta cells of the pancreas and increases insulin sensitivity and degree of its binding to target cells, increases insulin release, enhances the effect of insulin on glucose uptake by muscles and liver, inhibits lipolysis in adipose tissue. The severity of hypoglycemic action depends on the number of functioning beta cells. Also has a lipid-lowering, fibrinolytic action, inhibits platelet aggregation, has a mild diuretic effect. Hypoglycemic action begins after 10-30 minutes after ingestion of the maximum – 1.5-2 h, duration – 20-24 hours
Uses Glipizide 5 mg:
Diabetes mellitus type 2 (in ineffectiveness of diet).
Contraindications Glipizide 5 mg:
Hypersensitivity, pregnancy, lactation. Disease, requiring the appointment of insulin: diabetes mellitus type 1, diabetic ketoacidosis, diabetic coma and precoma, hyperosmolar coma, extensive burns, major surgery, severe trauma and infectious zabolevaniya.C caution. Febrile syndrome, alcoholism, liver and / or renal failure, leukopenia. Diseases of the digestive tract, leading to a change in residence time of the drug in the intestine (intestinal obstruction, gastric paresis, diarrhea).
Side effects Glipizide 5 mg:
Hypoglycemia (anxiety, confusion, decreased ability to concentrate, fatigue, thirst, “veil” in front of the eyes, increased sweating, pale skin, palpitations, headache, nausea, nervousness, “nightmarish” dream, insomnia, slurred speech) , hypoglycemic coma. For the skin: skin rash and irritation, itching, erythema multiforme (including Stevens-Johnson syndrome), toxic epidermal necrolysis (Lyell’s syndrome), photosensitivity. On the part of hematopoiesis: suppression of bone marrow hematopoiesis (anemia, aplastic and hemolytic anemia, pancytopenia, leukopenia, agranulocytosis, eosinophilia, thrombocytopenia). Part of the digestive system: nausea, vomiting, diarrhea or constipation, bloating, cholestatic jaundice, hepatic failure, hepatic porphyria, hepatitis, late cutaneous (symptomatic) porphyria. From the senses: blurred vision, disturbance of accommodation. Other: weight gain, myalgia, muscle cramps, hyponatremia, disulfiramopodobnye reaktsii.Peredozirovka. Symptoms: hypoglycemia (hunger, sweating, severe weakness, palpitations, tremor, anxiety, headache, insomnia, irritability, depression, cerebral edema, impaired speech and vision, impaired consciousness), hypoglycemic coma. Treatment: If patient is conscious, take sugar by mouth, with loss of consciousness – in / dextrose (w / bolus of 40-50% solution, then infusion of 10% solution), 1.2 mg of glucagon n / a, / m or I / O and control blood glucose levels every 15 min, and determination of pH, urea nitrogen, creatinine, blood electrolytes. After recovery of consciousness is necessary to give the patient foods rich in carbohydrate (to avoid a recurrence of hypoglycemia). Swelling of the brain – mannitol and dexamethasone.
Dosage and administration Glipizide 5 mg:
The dose depends on age, severity of diabetes, fasting blood glucose and 2 hours after meals. Assign inside for 30 minutes before eating. The initial daily dose of fast forms – Glipizide 5 mg before breakfast, if there is no effect, the dose is increased by 2.5-5 mg with a constant monitoring of blood glucose concentration, in liver disease, kidney disease and older – 2.5 mg. The maximum single dose – 15 mg, the maximum daily dose – 45 mg. Multiplicity of reception – a once-daily at a dose of 15 mg – 2-4 times a day. When translating with insulin or other hypoglycemic drugs, should be aware of the rapid entry of glipizide in blood glucose control and blood in the first 4-5 days, 2-4 times a day. The initial daily dose of slow-forms – 5 mg at breakfast. To monitor the effectiveness of therapy 1 time in 3 months to determine the level of glycated Hb, with little effect dose is increased to 10 mg, and sometimes up to 20 mg (maximum daily dose). Tablets swallowed whole, not divided into parts. In appointing the slow-shape instead of sulfonylureas with longer T1 / 2 (eg chlorpropamide) should be closely monitored (1-2 weeks) to avoid hypoglycemia due to the superposition of their effects.
Cautions Glipizide 5 mg:
Should regularly monitor blood glucose fasting and after meals, the daily curve of glucose concentration in blood and urine. Need dosage adjustment in adrenal insufficiency, thyroid disorders (hypothyroidism or hyperthyroidism), physically and emotionally straining, change in diet. In the case of surgery or decompensated diabetes need to take into account the possibility of using insulin. It should warn patients about the increased risk of hypoglycemia in the case of reception of ethanol (including possible development disulfiramopodobnyh reactions: abdominal pain, nausea, vomiting, headache) NSAID during starvation. Clinical manifestations of hypoglycemia may be masked by taking beta-blockers, clonidine, reserpine, guanetidina. Against the background of long-term use may develop tolerance to the hypoglycemic effect of glipizide and inefficiencies. Tolbutamide (representative of sulfonylurea derivatives) leads to a significant increase in mortality from cardiovascular disease compared with diet or insulin therapy (one can not exclude a similar effect and other sulfonylureas). During the period of treatment must be careful when driving and occupation of other potentially hazardous activities that require your full attention and psychomotor speed of reaction.
Interaction Glipizide 5 mg:
ACE inhibitors (captopril, enalapril), H2-blockers of histamine receptors (cimetidine), antifungal drugs (miconazole, fluconazole), NSAIDs (phenylbutazone, azapropazon, oxyphenbutazone), fibrates (clofibrate, bezafibrate), tuberculosis (ethionamide), salicylates, coumarin anticoagulants some, anabolic steroids, beta-blockers, MAO inhibitors, long-acting sulfonamides, cyclophosphamide, biguanides, chloramphenicol, fenfluramine, acarbose, fluoxetine, guanetidin, pentoxifylline, tetracycline, theophylline, tubular secretion blockers, reserpine, bromocriptine, disopyramide, pyridoxine, and insulin enhance the effects of allopurinol. Diminish the effects of barbiturates, corticosteroids, adrenostimulyatory (epinephrine, clonidine), antiepileptic drugs (phenytoin), BCCI, carbonic anhydrase inhibitors (acetazolamide), thiazide diuretics, chlorthalidone, furosemide, triamterene, asparaginase, baclofen, danazol, diazoxide, isoniazid, morphine, ritodrin, salbutamol, terbutaline, glucagon, rifampin, thyroid hormones, salt, Li +, in high doses – nicotinic acid, chlorpromazine, oral contraceptives and estrogens. Antithyroid drugs and Myelotoxic increases the risk of agranulocytosis; past, moreover, increase the risk of bone marrow blood disorders (including development of thrombocytopenia).
