Gluco-Rite

/ Perrigo

Route of administration Oral
As for any hypoglycaemic agent, dosage must be adapted for each individual case.
Short term administration of glipizide may be sufficient during periods of transient loss of control in patients usually controlled well on diet.
In general, glipizide should be given shortly before a meal to achieve the greatest reduction in post-prandial hyperglycaemia.
Initial Dose: The recommended starting dose is 5 mg, given before breakfast or the midday meal. Mild diabetics, geriatric patients or those with liver disease may be started on 2.5 mg.
Titration: Dosage adjustments should ordinarily be in increments of 2.5 to 5 mg, as determined by blood glucose response. At least several days should elapse between titration steps. The maximum recommended single dose is 15 mg. If this is not sufficient, splitting the daily dosage may prove effective. Doses above 15 mg should ordinarily be divided.
Maintenance: Some patients may be effectively controlled on a once-a-day regimen. Total daily dosage above 15 mg should ordinarily be divided.
The maximum recommended daily dosage is 20 mg.
Use in Children: Safety and effectiveness in children have not been established.
Use in Elderly and in High Risk Patients: In elderly patients, debilitated or malnourished patients and patients with an impaired renal or hepatic function, the initial and maintenance dosing should be conservative to avoid hypoglycaemic reactions.
Patients Receiving Other Oral Hypoglycaemic Agents: As with other sulphonylurea class hypoglycaemics, no transition period is necessary when transferring patients to glipizide. Patients should be observed carefully (1-2 weeks) for hypoglycaemia when being transferred from longer halflife sulphonylureas (e.g. chlorpropamide) to glipizide due to potential overlapping
of drug effect.

Gluco-Rite is indicated as an adjunct to diet for the control of hyperglycemia and its associated symptomatology in patients with diabetes mellitus type II.

1. Hypersensitivity to glipizide, other sulphonylureas or sulphonamides, or any
excipients in the tablets;
2. Insulin-dependent diabetes, diabetic ketoacidosis, diabetic coma;
3. Severe renal or hepatic insufficiency;
4. Patients treated with miconazole;
5. Pregnancy and lactation

G6PD-deficiency: Since glipizide belongs to the class of sulfonylurea agents,
caution should be used in patients with G6PD-deficiency. Treatment of patients
with G6PD-deficiency with sulfonylurea agents can lead to haemolytic anaemia
and a non-sulfonylurea alternative should be considered.
Hypoglycaemia: All sulphonylurea drugs are capable of producing severe hypoglycaemia. 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 hypoglycaemic reactions. Elderly, debilitated or malnourished patients and those with adrenal or pituitary insufficiency are particularly susceptible to the hypoglycaemic action of glucose-lowering drugs.
Hypoglycaemia may be difficult to recognise in the elderly, and in people who are taking beta-adrenergic blocking drugs (see interactions). Hypoglycaemia is more likely to occur when caloric- intake is deficient, after severe or prolonged exercise, when alcohol is ingested, or when more than one glucose-lowering drug is used.
Loss of control of blood glucose: When a patient stabilised on a diabetic regimen is exposed to stress such as fever, trauma, infection, or surgery, a loss of control may occur. At such times, it may be necessary to discontinue glipizide and administer insulin.
The effectiveness of any oral hypoglycaemic drug, including glipizide, in lowering blood glucose to a desired level decreases in many patients over a period of time, which may be due to progression of the severity of diabetes or to diminished responsiveness to the drug. This phenomenon is known as secondary failure, to distinguish it from primary failure in which the drug is ineffective in an individual patient when first given. Adequate adjustment of dose and adherence to diet should be assessed before classifying a patient as a secondary failure.
Renal and Hepatic Disease: The pharmacokinetics and/or pharmacodynamics of glipizide may be affected in patients with impaired renal or hepatic function. If hypoglycaemia should occur in such patients, it may be prolonged and appropriate management should be instituted.
See prescribing information for full details.

Common: Nausea, diarrhoea, abdominal pain and upper abdominal pain, hypoglycemia.
See prescribing information for full details.

The hypoglycemic action of sulfonylureas may be potentiated by certain drugs, including NSAIDs and other drugs that are highly protein bound, salicylates, sulfonamides, chloramphenicol, probenecid, coumarins, MAOIs, and beta adrenergic blocking agents. Certain drugs tend to produce hyperglycemia, including thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blocking drugs and isoniazid.
See prescribing information for full details.

Pregnancy: Glipizide is contraindicated in pregnancy.
Because recent information suggests that abnormal blood glucose levels during
pregnancy are associated with a higher incidence of congenital abnormalities,
many experts recommend that insulin be used during pregnancy to maintain blood glucose levels as close to normal as possible.
Lactation: No data are available on secretion into breast milk. Therefore glipizide is contraindicated in lactation.
See prescribing information for full details.

There is no well documented experience with glipizide overdosage.
See prescribing information for full details.