Glucotrol, Glucotrol XL

Generic name: Glipizide

What is Glucotrol, Glucotrol XL?

Glucotrol is used to treat high blood sugar in type 2 (non-insulin-dependent) diabetes in combination with diet and exercise. Glucotrol helps the body release more of its own insulin and respond better to it; it also lowers the amount of sugar (glucose) made by the body. Glucotrol also comes in an extended-release form called Glucotrol XL, which allows the medicine to be released slowly over 24 hours.

What is the most important information I should know about Glucotrol, Glucotrol XL?

Treatment with Glucotrol may increase the risk of death from heart disease compared with treatment of diabetes with diet alone or diet plus insulin.

Glucotrol may cause severe hypoglycemia (very low levels of sugar in your blood). This can happen if you do not follow your diet, exercise too much, drink alcohol, are under stress, or get sick. It can also happen if your dose of Glucotrol is higher than you need or if you're taking other glucose-lowering drugs. Your doctor will decide how to adjust your medication. Never adjust the dose yourself. Elderly, debilitated, and malnourished patients and those with adrenal or pituitary insufficiency are more susceptible to hypoglycemia. It may be difficult to recognize the signs and symptoms of hypoglycemia in the elderly and patients taking "beta-blockers" (a type of drug used to treat high blood pressure).

Glucotrol is an aid to, not a substitute for, good diet and exercise. Failure to follow a sound diet and exercise plan can lead to serious complications, such as dangerously high or low blood sugar levels. Glucotrol cannot be used in place of insulin. It is not an oral form of insulin.

Who should not take Glucotrol, Glucotrol XL?

Do not take Glucotrol if you are sensitive to the drug or any of its components.

Do not use Glucotrol if you are suffering from diabetic ketoacidosis (a life-threatening medical emergency caused by low insulin levels and marked by excessive thirst, nausea, fatigue, pain below the breastbone, and fruity-smelling breath). Diabetic ketoacidosis should be treated with insulin.

What should I tell my doctor before I take the first dose of Glucotrol, Glucotrol XL?

Tell your doctor about all prescription, over-the-counter, and herbal medications you are taking before beginning treatment with Glucotrol. Also, talk to your doctor about your complete medical history, especially if you ever had diabetic ketoacidosis, have a history of kidney or liver disease, thyroid disease, chronic (continuing) diarrhea or type 1 diabetes, if you have a serious infection, illness, or injury, need surgery, have narrowing of the stomach or intestines, or are pregnant or might be pregnant, or are breastfeeding.

What is the usual dosage?

The information below is based on the dosage guidelines your doctor uses. Depending on your condition and medical history, your doctor may prescribe a different regimen. Do not change the dosage or stop taking your medication without your doctor's approval.

Glucotrol

Adults: The usual starting dose is 5 milligrams (mg) taken before breakfast. Depending upon your blood sugar response, your doctor may increase the initial dose in increments of 2.5 to 5 mg. The maximum recommended daily dose is 40 mg. Total daily dosages above 15 mg are usually divided into 2 equal doses that are taken before meals.

Elderly or liver impairment: The usually starting dose is 2.5 mg.

For patients whose daily insulin intake is 20 units or less, insulin may be discontinued and Glucotrol therapy may be began at usual dosages.

For patients whose daily insulin intake is more than 20 units, the insulin dose should be reduced by 50% and Glucotrol therapy may be started at the usual dosages.

Glucotrol XL

Adults: The usual starting dose is 5 mg each day at breakfast. After 3 months, your doctor may increase the dose to 10 mg daily. The maximum recommended dose is 20 mg.

Elderly or liver impairment: The usually starting dose is 5 mg.

For patients whose daily insulin intake is 20 units or less, insulin may be discontinued and Glucotrol XL therapy may be started at the usual dosages.

For patients whose daily insulin intake is more than 20 units, the insulin dose should be reduced by 50% and Glucotrol XL therapy may begin at usual dosages.

How should I take Glucotrol, Glucotrol XL?

Take Glucotrol exactly as prescribed. To achieve the best control over blood sugar levels, Glucotrol should be taken 30 minutes before a meal. However, the exact dosing schedule as well as the dosage amount must be determined by your doctor.

Glucotrol XL should be taken with breakfast. Swallow the tablets whole. Do not chew, crush, or divide them. This damages the tablet and will release too much medicine into your body. Do not be alarmed if you notice something that looks like a tablet in your stool; it is only the empty shell that has been eliminated.

What should I avoid while taking Glucotrol, Glucotrol XL?

Follow diet, medication, and exercise routines closely. Changing any of these things can affect blood sugar levels.

Avoid alcohol as it can interfere with your blood sugar levels and your diabetes treatment.

What are possible food and drug interactions associated with Glucotrol, Glucotrol XL?

If Glucotrol is taken with certain other drugs, the effects of either could be increased, decreased, or altered. it is especially important to check with your doctor before combining Glucotrol with the following: alcohol, aspirin, beta-blockers (eg, atenolol and metoprolol), calcium-blockers (eg diltiazem, nifedipine, verapamil), chloramphenicol, cimetidine, clofibrate, corticosteroids (eg, dexamethasone and prednisone), diuretics (eg, water pills such as hydrochlorothiazide or furosemide), epinephrine, estrogens, fluconazole, gemfibrozil, isoniazid, mao inhibitors (eg, phenelzine and tranylcypromine), miconazole, nicotinic acid, nonsteroidal anti-inflammatory drugs (eg, ibuprofen or naproxen), norepinephrine, oral contraceptives, phenothiazines, phenytoin, probenecid, pseudoephedrine, rifampin, sulfa drugs (eg, sulfamethoxazole), thyroid drugs, warfarin

What are the possible side effects of Glucotrol, Glucotrol XL?

Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking this drug.

Side effects may include: constipation, diarrhea, dizziness, drowsiness, gas, headache, hives, itching, low blood sugar, nervousness, sensitivity to light, skin rash and eruptions, stomach pain, tremors

Glucotrol and Glucotrol XL can cause low blood sugar. This risk is increased by missed meals, alcohol, other diabetes medications, and excessive exercise. Low blood sugar is also more likely in older people, those with kidney or liver problems, and those with adrenal or pituitary gland diseases. To avoid low blood sugar, follow the dietary and exercise regimen suggested by your doctor.

Symptoms of mild low blood sugar may include: blurred vision, cold sweats, dizziness, fast heartbeat, fatigue, headache, hunger, light-headedness, nausea, nervousness, weakness, trembling, tingling in the lips or hands

Symptoms of more severe low blood sugar may include: coma, disorientation, pale skin, seizures, shallow breathing

If you experience any of these signs and symptoms of hypoglycemia, eat or drink something with sugar in it right away, such as a regular (not diet) soft drink, orange juice, honey, sugar candy, or glucose tablets. If you do not feel better or if your blood sugar does not go up, call your doctor immediately. If your doctor is unavailable in an emergency, call 911 or have someone drive you the nearest emergency room.

Can I receive Glucotrol, Glucotrol XL if I am pregnant or breastfeeding?

The effects of Glucotrol during pregnancy and breastfeeding are unknown. Tell your doctor immediately if you are pregnant, plan to become pregnant, or are breastfeeding.

What should I do if I miss a dose of Glucotrol, Glucotrol XL?

Take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Never take 2 doses at the same time.

How should I store Glucotrol, Glucotrol XL?

Store Glucotrol at room temperature away from heat and moisture.