Prevalence of diabetes is relatively high in the US, with one tenth of the total population reportedly diagnosed with diabetes. Type 2 diabetes accounts for almost 95% of all diabetes cases, making it necessary to manage the chronic metabolic disorder with a greater sense of urgency. Various medications are presently in use globally to treat the condition and Glipizide has been in use for close to four decades, as a preferred second line glucose lowering treatment regimen. Similar to all prescription medications, certain undesirable side effects are sometimes reported by patients on Glipizide, especially as it involves long term use. Here is a detailed look at the side effects of glipizide and the best methods to mitigate the same.
Overview of the medication and side effects of glipizide
To fully understand the side effects of glipizide, it is necessary to learn more about the drug and its mechanism of action. Belonging to the category of sulfonylurea drugs, the oral hypoglycemic is typically prescribed for managing early-stage type 2 diabetes, when the patient has not been diagnosed with issues in the pancreas. This is because the medication requires functional pancreatic beta cells for effective outcomes. The medication is regarded as more effective than the first generation of sulfonylureas, due to the enhanced hypoglycemic property. The medication has a mechanism of action that brings about rapid absorption, followed by faster action. Another advantage from the medication is the shorter half life and duration of action, which contracts sharply with other blood glucose lowering medications that are typically associated with long lasting hypoglycemia.
Before we take a look at the side effects of glipizide, lets dive into information about type 2 diabetes. The chronic metabolic disorder, that results in high blood glucose levels is a complex disorder attributed to various factors. Typically blood glucose levels are regulated by insulin, and this is achieved by managing/controlling the uptake of glucose, which is stored in fat cells, in the muscle cells and in the liver. While many factors contribute to the condition, the best method is to commence early management of the condition. This typically involves changes in lifestyle – regular exercise and a regulated diet. This helps in preventing the onset of other conditions, thereby reducing mortality rates and managing overall health.
Mechanism of action of Glipizide
It is time to look at the mechanism of action of the medication and proceed to study the side effects of glipizide. The medication is known to work by stimulating the release of insulin from the pancreas. This results in increased insulin plasma concentrations, which is precisely why it is called as an insulin secretagogue. The mechanism of action of the medication hinges on the pancreatic beta cells, and the binding action of the sulfonylureas results in stimulating the increase of insulin granules from the cells. Additionally, the medication also brings about an increase in the utilization of glucose, which helps lower the blood glucose levels.
Dosage related information to avoid side effects of glipizide
Incorrect dosage and improper routines in taking the medication are sometimes the reasons for the side effects of glipizide. It is therefore necessary to ensure that the right dosage is taken, as per the recommendations. The medication is available both as immediate release formulation and extended-release formulation. Certain precautions need to be taken to prevent undesirable adverse effects of the medication. For instance, individuals with a known allergy or with a medical history of diabetic ketoacidosis are to intimate the same to the treating specialist for suitable medication recommendations. Individuals who have had a history of kidney related ailments or liver ailments are to inform the diabetologist accordingly.
Similarly, patients with chronic diarrhea are also advised to inform the diabetologist about the condition. Other issues that need particular mention include any possible blockage in the intestines and patients with G6PD – an enzyme deficiency. Finally, women who are either pregnant or planning a pregnancy are to avail special recommendations. For instance, expectant mothers are not to take the medication in the final two weeks. The recommended dosages are to be diligently followed without any changes in an effort to set right any missed doses. The immediate release formulations are typically recommended to be taken half an hour prior to consuming food, while the extended-release formulations are typically taken alongside food. The tablets are not be crushed or powdered, but to be consumed whole.
Recommended dosage
As mentioned above, to prevent side effects of glipizide, the recommended dosages are to be strictly followed. Here are the average recommended dosages for different age groups. It is important to understand that the following recommendations are only for the purpose of reference of the dosage, while the actual dosage may differ from person to person. The actual dosage recommendation typically depends on inputs such as the age of the patient, the severity of the condition, the reaction to the first dosage and the existence of other medical conditions. Additionally, the dosage also depends on other medications presently being used by the patient, to avoid drug interactions.
The immediate release oral formulations available in 5mg and 10mg strengths, while the extended-release oral formulations are available in 2.5mg, 5 mg, and 10 mg strengths. To avoid side effects of glipizide, adults below the age of 65 years are typically recommended dosages of 5 mg per day with an upper limit of 20 mg, when extended-release forms are prescribed. When immediate release formulations are prescribed, the initial dosages are often 5 mg per day, with an upper limit of 40 mg per day. Adults above the age of 65 years are typically recommended lower starting dosages of 2.5 mg per day to factor in the sensitivity to glipizide. For children below the age of 17 years, the dosage is determined by various factors, and safe dosage levels are yet to be identified.
Side effects of glipizide
It is time to look at the side effects of glipizide. Typically, side effects are categorised as common side effects and serious side effects. The common side effects are typically frequently occurring in nature, while the serious side effects are rare in occurrence. The manner in which the side effects are managed or mitigated depend on the severity and duration of the adverse effects. The common side effects of glipizide are typically dipping of blood sugar levels below the desired levels. Known as hypoglycemia, this condition occurs when the medication results in lowering of blood sugar levels, either as a result of strong dosage or as a result of a combination of factors. Individuals on the medication are also likely to end up with complications such as diarrhea, or bouts of constipation or experience digestive issues.
The serious side effects of glipizide can sometimes be life-threatening in nature, and may require emergency treatment or triaging at a healthcare facility. For instance, patients may end up with any of the following symptoms that indicate extremely low blood sugar levels. Abnormal nervousness, or tremors may be experienced by the patient as a result of low blood sugar. The individual may feel hungry despite having food on time, while some are known to feel drowsy for unexplained reasons. The rate of heart beat may spike to abnormally high levels, while some patients experience clammy sweat and chills. The individual is likely to enter into some kind of depression, while others may experience a headache, and feel irritated without any reason. A lightheaded feeling is also a possibility, that may or may not be accompanied by blurred vision. Strangely, some patients are also known to cry with no particular reason attributed for crying. Finally, individuals may experience nightmares and feel irritated or confused at times.
In addition to the above side effects of glipizide, there is also the possibility of allergic reactions to the medication. A section of patients have reported the outbreak of rashes on the skin, while others have experienced dry skin when on the medication. Other possible allergic reactions include itching and reddish appearance of the skin. Other symptoms of side effects of glipizide include a reduction in platelet count, which could manifest as infections. Another indication of low blood cell count is bleeding that is difficult to control. Patients who experience nausea or experiencing some kind of fatigue that is not attributed to other reasons could actually be suffering from low blood sodium levels. This could also manifest as seizures, or a sudden weakness in the muscle. There is also the likelihood of the patient entering into a coma, while some are known to feel confused.
The side effects of glipizide include possible complications in the liver. The common manifestations or indications of liver problems include severe or sharp pain in the stomach that is sometimes accompanied by swelling. Individuals may experience some kind of itchy feeling on the skin as a result of the condition. The skin and the whites of the eyes may turn yellowish in appearance, that is similar to jaundice. Discoloration of the urine or stool is also a possibility, with the stool appearing tarry or pale. Patients are known to feel tired most of the time, while many individuals end up with edema – the condition where the lower limb extremities end up swollen.
Side effects of glipizide : drug interactions
Side effects of glipizide also include the possibility of drug interactions. The medication is known to interact with other medications, that include prescription medications, supplements and OTC medications. It is essential to seek medical advice when other medications are started after the commencement of diabetes treatment. For instance, patients on NSAIDS (non-steroidal anti-inflammatory drugs) are likely to experience adverse effects of the combination of the drugs. Blood sugar levels of patients are likely to reduce to levels that are unsafe, when the two medications are taken together. Similarly, patients on antifungal medications are also at risk of ending up with low blood sugar levels, when taken along with glipizide. Other drugs that interact with glipizide, include formulations with sulfonamide as an active ingredient. Finally, patients on blood thinners and medications to treat depression are also at risk of ending up with low blood sugar levels. To avoid the side effects of glipizide interacting with these medications, it is important to intimate the same to the diabetologist, when these medications are prescribed.