This video explains some side effects of glipizide extended-release tablets.

Mechanism of Action: Glipizide appears to lower the blood glucose acutely by stimulating the
release of insulin from the pancreas, an effect dependent upon functioning beta cells in the
pancreatic islets. Extrapancreatic effects also may play a part in the mechanism of action of oral
sulfonylurea hypoglycemic drugs. Two extrapancreatic effects shown to be important in the
action of glipizide are an increase in insulin sensitivity and a decrease in hepatic glucose
production. However, the mechanism by which glipizide lowers blood glucose during long-term
the administration has not been clearly established. Stimulation of insulin secretion by glipizide in
response to a meal is of major importance. The insulinotropic response to a meal is enhanced
with glipizide extended-release administration in diabetic patients. The postprandial insulin and
C-peptide responses continue to be enhanced after at least 6 months of treatment. In
2 randomized, double-blind, dose-response studies comprising a total of 347 patients, there was
no significant increase in fasting insulin in all glipizide extended-release treated patients combined
compared to placebo, although minor elevations were observed at some doses. There was no
increase in fasting insulin over the long term.
Some patients fail to respond initially, or gradually lose their responsiveness to sulfonylurea
drugs, including glipizide. Alternatively, glipizide may be effective in some patients who have
not responded or have ceased to respond to other sulfonylureas.

CONTRAINDICATIONS
Glipizide is contraindicated in patients with:
1. Known hypersensitivity to glipizide or any excipients in the GITS tablets.
2. Type 1 diabetes mellitus, diabetic ketoacidosis, with or without coma. This condition
should be treated with insulin.

Information for Patients: Patients should be informed that glipizide Extended
Release Tablets should be swallowed whole. Patients should not chew, divide or crush tablets.
Patients should not be concerned if they occasionally notice in their stool something that looks
like a tablet. In the glipizide Extended-Release Tablets, the medication is contained
within a nonabsorbable shell that has been specially designed to slowly release the drug so the
body can absorb it. When this process is completed, the empty tablet is eliminated from the
body.
Patients should be informed of the potential risks and advantages of glipizide extended-release tablets and of alternative modes of therapy. They should also be informed about the importance of adhering to dietary instructions, of a regular exercise program, and of regular testing of urine and/or blood glucose.
The risks of hypoglycemia, its symptoms and treatment, and conditions that predispose to its
development should be explained to patients and responsible family members. Primary and
secondary failure also should be explained.

Physician Counseling Information for Patients:
In initiating treatment for type 2 diabetes, the diet should be emphasized as the primary form of
treatment. Caloric restriction and weight loss are essential in the obese diabetic patient. Proper
dietary management alone may be effective in controlling the blood glucose and symptoms of
hyperglycemia. The importance of regular physical activity should also be stressed, and
cardiovascular risk factors should be identified and corrective measures are taken where possible.
Use of glipizide extended-release or other antidiabetic medications must be viewed by both the
physician and patient as a treatment in addition to diet and not as a substitution or as a
convenient mechanism for avoiding dietary restraint. Furthermore, loss of blood glucose control
on diet alone may be transient, thus requiring only short-term administration of glipizide extended-release or other antidiabetic medications. Maintenance or discontinuation of glipizide extended-release or other antidiabetic medications should be based on clinical judgment using regular clinical and laboratory evaluations.

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