Glucotrol XL (glipizide) is an extended-release oral medication designed for the management of type 2 diabetes mellitus. As a second-generation sulfonylurea, it facilitates controlled insulin secretion from pancreatic beta cells, aiding in the reduction of blood glucose levels. Its unique gastrointestinal therapeutic system (GITS) allows for consistent 24-hour drug delivery, supporting stable glycemic control with once-daily dosing. This formulation is indicated as an adjunct to diet and exercise when lifestyle modifications alone prove insufficient.

Features

• Active ingredient: Glipizide
• Formulation: Extended-release tablet (GITS)
• Available strengths: 2.5 mg, 5 mg, 10 mg
• Administration: Oral, once daily
• Mechanism: Insulin secretagogue via pancreatic beta-cell stimulation
• Duration: 24-hour controlled release

Benefits

• Promotes sustained reduction in fasting and postprandial blood glucose levels
• Supports long-term glycemic control as measured by HbA1c
• Convenient once-daily dosing enhances patient adherence
• Minimizes peak-trough fluctuations in plasma drug concentrations
• May reduce diabetes-related microvascular complications over time
• Compatible with comprehensive diabetes management plans

Common use

Glucotrol XL is primarily prescribed for adults with type 2 diabetes mellitus who have not achieved adequate glycemic control through diet and exercise alone. It is often used as monotherapy or in combination with other antihyperglycemic agents when additional glycemic control is required. The medication is particularly suitable for patients who benefit from the convenience of once-daily dosing and require stable plasma glucose levels throughout the day and night.

Dosage and direction

The initial recommended dose is 5 mg once daily, taken with breakfast or the first main meal of the day. Dosage adjustments should be made in increments of 2.5–5 mg at weekly intervals based on blood glucose response. The maximum recommended daily dose is 20 mg. Tablets must be swallowed whole and not crushed, chewed, or divided. Dose titration should be conservative in elderly patients, those with hepatic impairment, or patients with renal insufficiency.

Precautions

Regular monitoring of blood glucose and HbA1c is essential. Patients should be educated about recognizing and managing hypoglycemia. Use with caution in patients with G6PD deficiency due to risk of hemolytic anemia. Hepatic and renal function should be assessed periodically. Stress situations such as fever, trauma, or surgery may require temporary insulin therapy. Elderly patients are more susceptible to hypoglycemia and require careful dose titration.

Contraindications

Hypersensitivity to glipizide or other sulfonylureas, type 1 diabetes mellitus, diabetic ketoacidosis, severe renal impairment, or severe hepatic impairment. Not recommended during pregnancy or breastfeeding. Should not be used concomitantly with bosentan.

Possible side effect

• Hypoglycemia (most common)
• Gastrointestinal disturbances (nausea, diarrhea, constipation)
• Dizziness or headache
• Skin reactions (rash, pruritus)
• Transient visual disturbances
• Weight gain
• Hematologic changes (rare)

Drug interaction

Enhanced hypoglycemic effects with: insulin, other oral antidiabetics, ACE inhibitors, beta-blockers, fibrates, fluconazole, MAO inhibitors. Reduced efficacy with: corticosteroids, diuretics, phenothiazines, thyroid products, estrogens, phenytoin, nicotinic acid, sympathomimetics, calcium channel blockers, isoniazid. Concomitant use with alcohol may cause disulfiram-like reaction.

Missed dose

If a dose is missed, it should be taken as soon as remembered unless it is nearly time for the next dose. Do not double the dose to make up for the missed one. Patients should monitor blood glucose levels closely and contact their healthcare provider if uncertain about management.

Overdose

Symptoms primarily include severe hypoglycemia (sweating, tremor, tachycardia, hunger, confusion). Management involves immediate glucose administration (oral or intravenous depending on consciousness level). Hospitalization may be required for severe cases. Continuous glucose monitoring and supportive care are essential until glycemic stability is restored.

Storage

Store at controlled room temperature (20–25°C or 68–77°F). Protect from moisture and light. Keep in original container with lid tightly closed. Keep out of reach of children. Do not use after expiration date printed on packaging.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional before starting or changing any treatment regimen. Individual patient responses may vary. Proper diabetes management requires comprehensive care including diet, exercise, and regular medical supervision.

Reviews

Clinical studies demonstrate Glucotrol XL effectively reduces HbA1c by 1.5–2.0% when used as monotherapy. Patients report satisfaction with once-daily dosing convenience and stable glucose control throughout the day. Healthcare providers note improved patient adherence compared to immediate-release formulations. Long-term studies show maintained efficacy with proper dose titration and monitoring.