Glipizide

Adults: Like other oral hypoglycaemic agents, Glipizide has no fixed dose. It can be adjusted by checking blood glucose levels from time to time. A short course of Glipizide may be enough when blood glucose control is lost for a short while in people who are usually well controlled on diet alone. In general, take Glipizide about 30 minutes before a meal, so that it gives the greatest reduction in the rise of blood glucose after eating. Initial dose The recommended starting dose is 5 mg, given before breakfast. Elderly people and those with liver disease may be started on 2.5 mg. Dosage adjustments The dose can be changed every several days, in steps of 2.5 to 5 mg, depending on how the blood glucose responds. If one daily dose doesn't work well enough, splitting that dose might help. The maximum recommended once daily dose is 15 mg. Anything above 15 mg should usually be divided and given before meals that contain enough calories. The maximum recommended total daily dose is 40 mg. Maintenance Some people are controlled well on a once daily dose, while others respond better to divided doses. Total daily doses above 30 mg have been given safely on a twice daily basis to long term users. Most people can be stabilised on a dose between 2.5 and 30 mg daily. Elderly, debilitated or malnourished patients, and those with impaired kidney or liver function, should have conservative initial and maintenance doses, to avoid hypoglycaemic reactions. Many stable non-insulin-dependent diabetic patients who are on insulin can be safely moved to Glipizide, if the physician decides to do so. For those already taking another oral hypoglycaemic agent, no transition period is needed when switching to Glipizide, as with other sulphonylureas. Watch them carefully, though, for any hypoglycaemic effect caused by the two drugs overlapping. Pediatric use Safety and effectiveness in children have not been established.