logo
episode-header-image
About this episode

Glipizide, or Glucotrol, is a sulfonylurea used for the treatment of Type 2 Diabetes. Pharmacologically, glipizide acts by stimulating beta-cells in the pancreas to release insulin. Specifically, glipizide will block the opening of ATP-sensitive potassium channels on the plasma membrane of beta-cells on the pancreas. The result of that is depolarization, which then causes stimulation of voltage-sensitive calcium channels, eventually causing the exocytosis of insulin. The increased insulin will then promote the storage of glucose, decreasing the amount of glucose in the blood. 

Due to the pharmacology of glipizide, the concerning adverse drug reactions are hypoglycemia and weight gain. Other adverse drug reactions include diaphoresis, dizziness, syncope, nervousness, anxiety, tremors, and diarrhea. The contraindications include hypersensitivity, Type 1 Diabetes, and DKA. Glipizide is not used as often due to the risk of hypoglycemia and weight gain. Glipizide is usually dosed once daily, but it can be split up if the dose is escalated. There are differences in administration depending on the formulation. For immediate release formulations, glipizide should be taken 30 minutes before meals to ensure that absorption is stable. For extended formulations, it can be given with breakfast or any other meal. 

Of all the sulfonylureas, glipizide is preferred in CKD. Other sulfonylureas, like glyburide, are not preferred due to a decrease in elimination that can result in dose accumulation. In geriatric populations, dosing is less aggressive to lessen the risk of any adverse drug reactions and more specifically hypoglycemia. There’s a risk of cross-reactivity with sulfonamide allergies, but the risk will vary and is low risk. If SJS occurs due to a sulfonamide-containing drug, glipizide likely wouldn’t be recommended.

The drug-drug interactions of glipizide include medications that can increase the risk of hypoglycemia, for example, medications like quinolone antibiotics and B-blockers can mask the symptoms of hypoglycemia. Other interactions include the type where it can counteract the effect of glipizide, for example, medications that can increase blood glucose levels like corticosteroids, antipsychotics such as olanzapine and clozapine, stimulants, and transplant medications like cyclosporine and tacrolimus. There are also CYP interactions that can impact glipizide since it’s metabolized by CYP2C9. More monitoring is warranted when medications that can inhibit CYP2C9, like fluconazole, and medications that can induce CYP2C9, like rifampin, are also given. In cases of overdose, hypoglycemia is most likely to occur. Correction of decreased glucose levels is necessary.

Show notes provided by Chong Yol G Kim, PharmD Student.

Be sure to check out our free Top 200 study guide – a 31 page PDF that is yours for FREE!

Support The Podcast and Check Out These Amazing Resources!

Flippin’ Pharmacology Flash Cards

Pharmacology Crossword Puzzle Book (Over 2,000 Clues/Questions!)

NAPLEX Study Materials

BCPS Study Materials

BCACP Study Materials

BCGP Study Materials

BCMTMS Study Materials

Meded101 Guide to Nursing Pharmacology (Amazon Highly Rated)

Guide to Drug Food Interactions (Amazon Best Seller)

Drug Interactions In Primary Care (Amazing Resource for Practicing Clinicians)

Perils of Polypharmacy (Great Resource for Those Who Work in Geriatrics)

Up next
Jul 10
Ketoconazole Pharmacology
Ketoconazole is an imidazole antifungal that works by inhibiting fungal cytochrome P450 14α-demethylase, an enzyme essential for ergosterol synthesis, which disrupts fungal cell membrane integrity. Common adverse effects of ketoconazole include nausea, vomiting, abdominal pain, a ... Show More
14m 18s
Jul 3
NSAID Drug Interactions
NSAIDs can reduce the effectiveness of antihypertensive medications such as ACE inhibitors, ARBs, beta-blockers, and diuretics by promoting sodium and water retention and decreasing renal blood flow. Combining NSAIDs with anticoagulants or antiplatelet agents like warfarin or asp ... Show More
16m 28s
Jun 26
Lotrisone (Clotrimazole/Betamethasone) Pharmacology
Lotrisone is a topical cream that contains a combination of clotrimazole, an antifungal, and betamethasone dipropionate, a corticosteroid. It is used to treat fungal skin infections such as athlete’s foot, jock itch, and ringworm that also involve inflammation or itching. Clotrim ... Show More
13m 43s
Recommended Episodes
Mar 2019
8: USMLE and COMLEX Prep: Side Effects of Diabetes Medications
Session 08 Step 1 and Level 1 love to test the mechanisms or side effects of medications that treat diabetes. Follow along to test your knowledge of diabetic medications and side effects. Once again, we're joined by Dr. Andrea Paul, Chief Medical Officer at Board Vitals. Reminder ... Show More
16m 33s
Jun 2023
167 - Beyond One-Size-Fits-All: Unraveling the Genetic Tapestry of CYP2D6 Drug Metabolism
In this episode, we review the science behind genetic differences in humans in the CYP2D6 hepatic enzyme responsible for drug metabolism and how these genetic variants can lead to certain drugs being metabolized far too much or far too little, which can cause drug toxicities or a ... Show More
35m 18s
Jul 2022
Diabetes
Diabetes is an important topic in nursing school, and a common diagnosis that you’ll help treat in your future patients.  In this podcast, I talk about the: Differences between type 1 and type 2 diabetes. Complications such as Neuropathy, Retinopathy, Peripheral Vascular Disease, ... Show More
12m 42s
Dec 2023
350. GLP-1 Agonists: Mechanisms to Applications with Dr. Dennis Bruemmer
Calling all those with a passion for cardiovascular prevention! In this episode of the CardioNerds Cardiovascular Prevention Series, we take a deep dive into the world of glucagon-like peptide-1 (GLP-1) receptor agonists. Along the way, you’ll hear about the biology of the GLP-1 ... Show More
43m 40s
Jun 2024
#525: Cholesterol-Lowering Medication – Dr. Paddy Barrett
Cholesterol-lowering medications, particularly statins, play a pivotal role in reducing low-density lipoprotein cholesterol (LDL-C) and apolipoprotein B (apoB) concentrations, which are causal markers in atherosclerosis development. The efficacy of these medications is well-docum ... Show More
48m 29s
Oct 2023
Take These 5 Vitamins to STOP Diabetic Complications Now
Today I’m going to share five vitamins that can help with the complications of diabetes. High blood glucose affects four main tissues, including: 1. The eyes 2. The arteries 3. The nervous system (including the brain) 4. The kidneys However, the damage to these tissues can lead t ... Show More
10m 4s
May 2024
367. GLP-1 Agonists: Clinical Implementation of GLP-1 Receptor Agonists with Dr. Neha Pagidapati
CardioNerds (Drs. Gurleen Kaur and Richard Ferraro) and episode FIT Lead Dr. Spencer Carter (Cardiology Fellow at UT Southwestern) discuss the clinical implementation of GLP-1 receptor agonists with Dr. Neha Pagidapati (Faculty at Duke University School of Medicine). In this epis ... Show More
43m 3s
Oct 2023
Episode 189: Hyperkalemia 2.0
We revisit the topic of Hyperkelamia to update our prior episode from 2015 (pre-Lokelma) Hosts: Brian Gilberti, MD Jonathan Kobles, MD https://media.blubrry.com/coreem/content.blubrry.com/coreem/Hyperkalemia.mp3 Download Leave a Comment Tags: Renal Colic Show Notes Introduction B ... Show More
14m 57s
Jun 2024
Episode 908: Sympathomimetic Drugs
Contributor: Taylor Lynch MD Educational Pearls: Overview: Sympathomimetic drugs mimic the fight or flight response, affecting monoamines such as dopamine, norepinephrine, and epinephrine Limited therapeutic use, often abused. Types: Amphetamines: Methamphetamine, Adderall, Rital ... Show More
7m 54s
May 2023
Podcast 853: Critical Care Medications - Vasopressors
Contributor: Travis Barlock MD Educational Pearls: Three categories of pressors: inopressors, pure vasoconstrictors, and inodilators Inopressors:  Epinephrine - nonselective beta- and alpha-adrenergic agonism, leading to increased cardiac contractility, chronotropy (increased hea ... Show More
5m 10s