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What is Glucotrol XL?
Glucotrol XL (glipizide extended release) is is an oral drug that helps control blood sugar levels used together with diet and exercise to treat type 2 diabetes. Glipizide 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. Hypoglycemic action begins 10-30 minutes after administration.
How should I use Glucotrol XL?
Tablets are taken orally, swallowed whole (without chewing or breaking into parts). The initial dose is 5 mg per day during breakfast, the dose is increased with an interval of several days up to a maximum of 20 mg per day.
What are the contraindications of this medicine?
Do not take Glucotrol XL if you have any of the following conditions:
- hypersensitivity, pregnancy, lactation;
- diseases requiring the use of insulin: type 1 diabetes mellitus, diabetic ketoacidosis, diabetic precoma and coma, hyperosmolar coma, extensive burns, major surgical procedures, severe injuries and infectious diseases.
With caution: feverish syndrome, alcoholism, liver and/or renal failure, leukopenia, diseases of the gastrointestinal tract, leading to a change in the time of the drug in the intestine (intestinal obstruction, paresis of the stomach, diarrhea).
What are the side effects of Glucotrol XL?
- Hypoglycemia (anxiety, confusion, decreased ability to concentrate, fatigue, thirst, “veil” before the eyes, increased sweating, pallor of the skin, palpitations, headache, nausea, nervousness, nightmares, insomnia, slurred speech) hypoglycemic coma;
- Skin: rash, itching, erythema multiforme exudative (including Stevens-Johnson syndrome), toxic epidermal necrolysis (Lyell’s syndrome), photosensitization;
- Blood-forming organs: inhibition of bone marrow hematopoiesis (anemia, aplastic and hemolytic anemia, pancytopenia, leukopenia, agranulocytosis, eosinophilia, thrombocytopenia);
- Digestive system: nausea, vomiting, diarrhea or constipation, flatulence, cholestatic jaundice, liver failure, hepatic porphyria, hepatitis, late skin (symptomatic) porphyria;
- Senses: blurred vision, disturbed accommodation;
- Others: weight gain, myalgia, convulsions, hyponatremia, disulfiram-like reactions.
What may interact with this medicine?
Do not use this medicine if you are taking any of 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;
- cyclophosphamides, biguanides;
- canalicular secretion blockers;
- adrenergic stimulants (epinephrine, clonidine);
- antiepileptic drugs (phenytoin);
- carbonic anhydrase inhibitors (acetazolamide);
- thiazide diuretics;
- thyroid hormones;
- salt Li +;
- nicotinic acid – in high doses;
- oral contraceptives and estrogens;
- antithyroid and myelotoxic drugs.
What should I watch for while using this medicine?
Patients should regularly monitor the concentration of glucose in the blood on an empty stomach and after a meal, the daily curve of the concentration of glucose in the blood and urine.
Dose adjustment is necessary for adrenal insufficiency, thyroid disease (hypothyroidism or thyrotoxicosis), physical and emotional overstrain, change in diet.
In the case of surgical interventions or decompensation of diabetes, it is necessary to consider the possibility of using insulin.
Patients should be warned about the increased risk of hypoglycemia in cases of ethanol administration (including possible development of disulfiram-like reactions: abdominal pain, nausea, vomiting, headache), NSAIDs, during fasting.
Clinical manifestations of hypoglycemia may be masked when taking beta-blockers, clonidine, reserpine, guanethidine.
Long-term use of the drug can cause addiction to hypoglycemic action and a decrease in the effectiveness of Glucotrol XL.
During the period of treatment, care must be taken when driving vehicles and engaging in other potentially hazardous activities that require increased concentration and psychomotor speed.