Glipizide/Metformin
(Glipizide/Metformin)Glipizide/Metformin Overview
This diabetes medication is a combination of 2 drugs (glipizide and metformin). Glipizide/Metformin is used along with a diet and exercise program to control high blood sugar in patients with type 2 diabetes. Glipizide is a sulfonylurea and works by stimulating the release of your body's natural insulin and by decreasing the amount of sugar that your liver makes. Metformin is a biguanide and works by decreasing the amount of sugar that your liver makes and that your stomach/intestines absorb. Both of these medications work by helping to restore your body's proper response to the insulin you naturally produce. Controlling high blood sugar helps prevent kidney damage, blindness, nerve problems, loss of limbs, and sexual function problems. Proper control of diabetes may also lessen your risk of a heart attack or stroke.
Glipizide/Metformin Warnings
Rarely, too much metformin can build up in the body and cause a serious (sometimes fatal) condition called lactic acidosis. Lactic acidosis is more likely if you are an older adult, if you have kidney or liver disease, dehydration, heart failure, heavy alcohol use, if you have surgery, if you have X-ray or scanning procedures that use iodinated contrast, or if you are using certain drugs. For some conditions, your doctor may tell you to stop taking Glipizide/Metformin for a short time. Ask your doctor or pharmacist for more details. Stop taking Glipizide/Metformin and get medical help right away if you have any symptoms of lactic acidosis, such as unusual tiredness, dizziness, severe drowsiness, chills, blue/cold skin, muscle pain, fast/difficult breathing, slow/irregular heartbeat, or stomach pain with nausea/vomiting/diarrhea.
How to Use Glipizide/Metformin
Read the Patient Information Leaflet available from your pharmacist before you start using Glipizide/Metformin and each time you get a refill. If you have any questions, consult your doctor or pharmacist. Take Glipizide/Metformin by mouth, usually once or twice a day with meals or as directed by your doctor. Drink plenty of fluids while taking Glipizide/Metformin unless otherwise directed by your doctor. The Dosage of Glipizide/Metformin is based on your medical condition, response to treatment, and other medications you may be taking. Be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products). To reduce your risk of side effects (such as upset stomach), your doctor may direct you to start Glipizide/Metformin at a low dose and gradually increase your dose. Follow your doctor's instructions carefully. If you are already taking another diabetes drug (such as chlorpropamide), follow your doctor's directions carefully for stopping the old drug and starting this combination medication. Colesevelam can decrease the absorption of glipizide. If you are taking colesevelam, take Glipizide/Metformin at least 4 hours before taking colesevelam. Use Glipizide/Metformin regularly in order to get the most benefit from it. Remember to use Glipizide/Metformin at the same time(s) each day. Tell your doctor if your condition lasts or gets worse (for example, if you have high/low blood sugar). It may take up to 2 weeks before the full benefit of Glipizide/Metformin takes effect.
Glipizide/Metformin Precautions
Before taking Glipizide/Metformin, tell your doctor or pharmacist if you are allergic to glipizide or metformin; or if you have any other allergies. Glipizide/Metformin may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details. Before using Glipizide/Metformin, tell your doctor or pharmacist your medical history,alcohol use, severe breathing problems (such as obstructive lung disease, severe asthma), blood problems (such as anemia, vitamin B12 deficiency), electrolyte imbalance (hyponatremia), fertility problems (such as ovulation problems), kidney disease, certain hormonal conditions (adrenal/pituitary insufficiency, thyroid disease, syndrome of inappropriate antidiuretic hormone-SIADH). Before having surgery or any X-ray/scanning procedure using iodinated contrast, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products). You may need to stop Glipizide/Metformin for a short time for the surgery/procedure. Ask your doctor or dentist for instructions before your surgery/procedure. You may experience blurred vision, dizziness, or drowsiness due to extremely low or high blood sugar. Do not drive, use machinery, or do any activity that requires alertness or clear vision until you are sure you can perform such activities safely. Limit alcohol while taking Glipizide/Metformin because it can increase the risk of developing hypoglycemia and lactic acidosis. Rarely, alcohol can interact with glipizide and cause a serious reaction (disulfiram-like reaction) with symptoms such as facial flushing, nausea, vomiting, dizziness, or stomach pain. Consult your doctor or pharmacist about using alcohol safely. It may be harder to control your blood sugar when your body is stressed (such as due to fever, infection, injury, or surgery). Consult your doctor because this may require a change in your treatment plan, medications, or blood sugar testing. Glipizide/Metformin may make you more sensitive to the sun. Limit your time in the sun. Avoid tanning booths and sunlamps. Use sunscreen and wear protective clothing when outdoors. Tell your doctor right away if you get sunburned or have skin blisters/redness. Older adults may be at greater risk for lactic acidosis or low blood sugar while using Glipizide/Metformin. Glipizide/Metformin can cause changes in the menstrual cycle (promote ovulation) and increase the risk of becoming pregnant. Consult your doctor or pharmacist about the use of reliable birth control while using Glipizide/Metformin. During pregnancy, Glipizide/Metformin should be used only when clearly needed. Pregnancy may cause or worsen diabetes. Discuss a plan with your doctor for managing your blood sugar while pregnant. Your doctor may substitute insulin for Glipizide/Metformin during pregnancy. If glipizide is used, it may be switched to insulin at least 2 weeks before the expected delivery date because of glipizide's risk of causing low blood sugar in your newborn. Discuss the risks and benefits with your doctor. Glipizide/Metformin passes into breast milk and could have undesirable effects on a nursing infant. Consult your doctor before breast-feeding.
Glipizide/Metformin Misdose
If you miss a dose of Glipizide/Metformin, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.
Glipizide/Metformin Interactions
See also How to Use section. Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval. Many drugs can affect your blood sugar, making it harder to control. Before you start, stop, or change any medication, talk with your doctor or pharmacist about how the medication may affect your blood sugar. Check your blood sugar regularly as directed and share the results with your doctor. Tell your doctor right away if you have symptoms of high or low blood sugar. (See also Side Effects section.) Your doctor may need to adjust your diabetes medication, exercise program, or diet. Beta-blocker medications (such as metoprolol, propranolol, glaucoma eye drops such as timolol) may prevent the fast/pounding heartbeat you would usually feel when your blood sugar falls too low (hypoglycemia). Other symptoms of low blood sugar such as dizziness, hunger, or sweating are unaffected by these drugs. Check the labels on nonprescription/herbal products carefully. Some products may contain sugar/alcohol and may affect blood sugars. Ask your doctor or pharmacist about using these products safely.
Glipizide/Metformin Side Effects
Nausea, diarrhea, stomach upset, muscle aches, or headache may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly. If stomach symptoms return later (after you are on the same dose for several days or weeks), tell your doctor right away. Stomach symptoms that occur after the first days of your treatment may be a sign of lactic acidosis. Remember that Glipizide/Metformin has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using Glipizide/Metformin do not have serious side effects. Tell your doctor right away if you have any serious side effects,nausea that doesn't stop, easy bleeding/bruising, signs of infection (such as sore throat that doesn't go away, fever), severe stomach/abdominal pain, yellowing eyes/skin, dark urine. Glipizide/Metformin may cause low blood sugar (hypoglycemia), especially if you take other medications for diabetes, drink large amounts of alcohol, do unusually heavy exercise, or do not consume enough calories from food. Symptoms include cold sweat, blurred vision, dizziness, drowsiness, shaking, fast heartbeat, headache, fainting, tingling of the hands/feet, and hunger. It is a good habit to carry glucose tablets or gel to treat low blood sugar. If you don't have these reliable forms of glucose, rapidly raise your blood sugar by eating a quick source of sugar such as table sugar, honey, or candy, or drink fruit juice or non-diet soda. Tell your doctor about the reaction right away. To help prevent low blood sugar, eat meals on a regular schedule, and do not skip meals. Check with your doctor or pharmacist to find out what you should do if you miss a meal. Symptoms of high blood sugar (hyperglycemia) include thirst, increased urination, confusion, drowsiness, flushing, rapid breathing, and fruity breath odor. If these symptoms occur, tell your doctor right away. Your dosage may need to be increased. A very serious allergic reaction to Glipizide/Metformin is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction,rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing. This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch. In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
Glipizide/Metformin Storage
Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets. Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard Glipizide/Metformin when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
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