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What is Glucotrol?
Glucotrol (glipizide) is an oral blood-glucose-lowering drug, which is prescribed for type 2 diabetes if diet therapy has become ineffective or has not been effective at all. The drug is used with a proper diet and exercise program.
How does it work?
The active substance, glipizide, has pancreatic and extra-pancreatic effects. It stimulates insulin secretion by lowering the glucose stimulation threshold of beta cells of the pancreas, increases insulin sensitivity and its binding to target cells, increases insulin release, enhances the effect of insulin on glucose absorption by muscles and liver, inhibits lipolysis in adipose tissue. The severity of hypoglycemic action depends on the number of functioning beta cells. It also has a hypolipidemic, fibrinolytic effect, inhibits platelet aggregation, has a mild diuretic effect.
How should I use Glucotrol?
The dose depends on the age, the severity of diabetes mellitus, fasting blood glucose concentration and 2 hours after a meal.
The drug is taken orally, 30 minutes before meals.
The initial daily dose is 5 mg before breakfast; if the effect is absent, the dose is increased by 2.5-5 mg with constant monitoring of the concentration of glucose in the blood.
In patients with diseases of the liver, kidneys and elderly patients, the initial daily dose is 2.5 mg.
The maximum single dose is15 mg, the maximum daily dose is40 mg. The frequency of admission is 1 time per day, daily doses exceeding 15 mg should be divided into 2-4 doses.
What are the contraindications of this medicine?
Do not use Glucotrol in the presence of any of the following conditions:
- hypersensitivity to sulfonylurea derivatives, sulfonamides;
- hypersensitivity to glipizide or any other component of the drug;
- type 1 diabetes;
- diabetic ketoacidosis, diabetic pre-coma and coma;
- hyperosmolar coma;
- conditions requiring insulin therapy (extensive burns, major surgery, severe injuries, infectious diseases);
- severe disorders of liver and kidney function;
- lactase deficiency, lactose intolerance, glucose-galactose malabsorption;
- pregnancy, lactation.
The drug is used with caution: febrile syndrome, alcoholism, adrenal insufficiency, diseases of the thyroid gland with a violation of its function (hypothyroidism or hyperthyroidism), hepatic and/or renal failure of mild to moderate severity, leukopenia.
What are the side effects of Glucotrol?
Glucotrol can cause the following side effects:
- Endocrine system: hypoglycemia, hypoglycemic coma;
- Nervous system: dizziness, headache, drowsiness;
- Skin: a rash on the skin and mucous membranes, pruritus, urticaria, eczema, photosensitivity;
- Blood-forming organs: inhibition of bone marrow hematopoiesis (anemia, including aplastic and hemolytic, pancytopenia, leukopenia, agranulocytosis, thrombocytopenia);
- Digestive system: nausea, vomiting, diarrhea or constipation, flatulence, cholestatic jaundice, liver failure, hepatitis, acute porphyria, hepatic porphyria;
- Senses: blurred vision, visual impairment;
- Laboratory indicators: increased activity of aspartate aminotransferase, lactate dehydrogenase, alkaline phosphatase, increased residual urea nitrogen in the blood plasma, hypercreatininemia;
- Others: weight gain, myalgia, convulsions, hyponatremia, disulfiram-like reactions.
What may interact with this medicine?
Do not combine Glucotrol with the following drugs and substances:
- ACE inhibitors (captopril, enalapril);
- H2-histamine receptor blockers (cimetidine);
- antifungal drugs (miconazole, fluconazole);
- NSAIDs (phenylbutazone, azapropazone, oxyphenbutazone);
- fibrates (clofibrate, bezafibrate);
- anti-tuberculosis (ethionamide);
- coumarin anticoagulants;
- anabolic steroid;
- beta blockers;
- MAO inhibitors;
- long-acting sulfonamides;
- canalicular secretion blockers;
- adrenostimulators (epinephrine, clonidine);
- antiepileptic drugs (phenytoin);
- carbonic anhydrase inhibitors (acetazolamide);
- thiazide diuretics;
- thyroid hormones;
- nicotinic acid;
- oral contraceptives and estrogens;
- antithyroid and myelotoxic drugs;
What should I watch for while using this medicine?
An overdose of glipizide can lead to hypoglycemia. Symptoms of hypoglycemia: feeling of hunger, increased sweating, severe weakness, feeling of heartbeat, tremor, anxiety, headache, insomnia, irritability, depression, impaired speech and vision, difficulty concentrating, impaired consciousness, hypoglycemic coma.
A patient should regularly monitor the concentration of glucose in the blood on an empty stomach and after meals.
Correction of the dose is necessary during physical and emotional overstrain, changing the diet.
In the case of surgical interventions or decompensation of diabetes, the possibility of insulin therapy should be considered.
Patients should be warned about the increased risk of hypoglycemia in cases of taking ethanol (including the development of disulfiram-like syndrome: abdominal pain, nausea, vomiting, headache), NSAIDs, with fasting.
Clinical manifestations of hypoglycemia may be masked when taking beta-blockers, clonidine, reserpine, guanethidine.
Long-term use can cause addiction to hypoglycemic action and a decrease in the effectiveness of Glucotrol.
During the period of treatment, care must be taken when driving and engaging in other potentially hazardous activities that require a high concentration of attention and speed of psychomotor reactions.