Glipizide

Sulfonylurea·Endocrinology - Oral Antidiabetics

Type 2 Diabetes Mellitus

PBSORALMinidiab, Melizide5 mg tabletS4+1

Max Dose

40 mg/day

Half-life

2-4 h

Hypoglycemia

HIGH RISK

Renal Adj.

DOSE RED.

Rapid Summary

Overview

Short-acting, second-generation sulfonylurea. Forces insulin secretion from the pancreas. Shorter half-life than Gliclazide, making it slightly safer regarding prolonged hypoglycemia, but requires multiple daily doses.

Maximum Dose

Max 40 mg/day (Doses > 15 mg should be divided).

Clinical Focus

Must be taken 30 minutes before a meal. If the patient skips the meal, they will suffer a severe hypoglycemic crash.

Bottom Line

Glipizide is a short-acting sulfonylurea for type 2 diabetes, but causes hypoglycaemia and weight gain and has largely been replaced by newer agents with better safety profiles.

Formulation & Access

Brand Names

Minidiab, Melizide

Oral Routes

Tablets (5 mg).

Prescribing & PBS

Unrestricted General Benefit (S4).

Indications & Use

Primary

PBSTGA

Type 2 Diabetes Mellitus.

Clinical Place

Alternative to Gliclazide. Useful in patients who experience post-prandial spikes but drop low overnight on longer-acting agents.

Quick reference

Class & Role

Sulfonylurea — Short-acting, second-generation sulfonylurea.

Route / Formulation

Tablets (5 mg). (Minidiab, Melizide)

Usual Dose & Max

Start PO 5 mg OD (30 mins before breakfast). Titrate by 2.5-5 mg every few days. Doses > 15 mg/day must be given BD. Max 40 mg/day (Doses > 15 mg should be divided).

Key Indication Doses

Type 2 Diabetes: Start PO 5 mg OD (30 mins before breakfast). Titrate by 2.5-5 mg every few days. Doses > 15 mg/day must be given BD. Elderly / Renal Impairment: Start at 2.5 mg OD. Highly susceptible to hypoglycemia.

Best Uses

Glipizide is a short-acting sulfonylurea for type 2 diabetes, but causes hypoglycaemia and weight gain and has largely been replaced by newer agents with better safety profiles.

Avoid / Cautions

Type 1 Diabetes, Diabetic Ketoacidosis (DKA), severe hepatic or renal impairment. Pregnancy Category C. Avoid due to neonatal hypoglycemia.

Key Risks

Endocrine: Severe hypoglycemia. HIGH — Weight gain (anabolic insulin effect). Gastrointestinal: Nausea, diarrhea. Immunological: Sulfa-allergy cross-reactivity.

Key Interactions

Beta-blockers mask the adrenergic warning signs of hypoglycemia (tremor/tachycardia). Fluconazole/Miconazole inhibit CYP2C9, significantly increasing glipizide levels and hypo risk.

Monitoring

Regular BSL checks. Withhold if the patient is NBM (Nil By Mouth) for surgery or a scan. Routine HbA1c and U&E.

Clinical Pearl

Unlike Gliclazide which can be taken *with* meals, Glipizide works best when taken 30 minutes *before* a meal, ensuring the forced insulin spike perfectly matches the post-prandial glucose spike.

Access

Minidiab, Melizide5 mg tablet

Brand: Minidiab, Melizide
Formulation: Tablets (5 mg)

Glipizide

Sulfonylurea·Endocrinology - Oral Antidiabetics

Type 2 Diabetes Mellitus

PBSORALMinidiab, Melizide5 mg tabletS4+1

Max Dose

40 mg/day

Half-life

2-4 h

Hypoglycemia

HIGH RISK

Renal Adj.

DOSE RED.

Rapid Summary

Overview

Maximum Dose

Max 40 mg/day (Doses > 15 mg should be divided).

Clinical Focus

Must be taken 30 minutes before a meal. If the patient skips the meal, they will suffer a severe hypoglycemic crash.

Bottom Line

Glipizide is a short-acting sulfonylurea for type 2 diabetes, but causes hypoglycaemia and weight gain and has largely been replaced by newer agents with better safety profiles.

Formulation & Access

Brand Names

Minidiab, Melizide

Oral Routes

Tablets (5 mg).

Prescribing & PBS

Unrestricted General Benefit (S4).

Indications & Use

Primary

PBSTGA

Type 2 Diabetes Mellitus.

Clinical Place

Alternative to Gliclazide. Useful in patients who experience post-prandial spikes but drop low overnight on longer-acting agents.

Quick reference

Class & Role

Sulfonylurea — Short-acting, second-generation sulfonylurea.

Route / Formulation

Tablets (5 mg). (Minidiab, Melizide)

Usual Dose & Max

Start PO 5 mg OD (30 mins before breakfast). Titrate by 2.5-5 mg every few days. Doses > 15 mg/day must be given BD. Max 40 mg/day (Doses > 15 mg should be divided).

Key Indication Doses

Best Uses

Glipizide is a short-acting sulfonylurea for type 2 diabetes, but causes hypoglycaemia and weight gain and has largely been replaced by newer agents with better safety profiles.

Avoid / Cautions

Type 1 Diabetes, Diabetic Ketoacidosis (DKA), severe hepatic or renal impairment. Pregnancy Category C. Avoid due to neonatal hypoglycemia.

Key Risks

Endocrine: Severe hypoglycemia. HIGH — Weight gain (anabolic insulin effect). Gastrointestinal: Nausea, diarrhea. Immunological: Sulfa-allergy cross-reactivity.

Key Interactions

Beta-blockers mask the adrenergic warning signs of hypoglycemia (tremor/tachycardia). Fluconazole/Miconazole inhibit CYP2C9, significantly increasing glipizide levels and hypo risk.

Monitoring

Regular BSL checks. Withhold if the patient is NBM (Nil By Mouth) for surgery or a scan. Routine HbA1c and U&E.

Clinical Pearl

Unlike Gliclazide which can be taken *with* meals, Glipizide works best when taken 30 minutes *before* a meal, ensuring the forced insulin spike perfectly matches the post-prandial glucose spike.

Access

Minidiab, Melizide5 mg tablet

Brand: Minidiab, Melizide
Formulation: Tablets (5 mg)