Glipizide Vs. Metformin: Drug Comparison

Glipizide is the active ingredient in the brand-name medication Glucotrol XL^®. The information below is about brand name Glucotrol XL. According to the FDA, “Generic medicines use the same active ingredients as brand-name medicines and work the same way, so they have the same risks and benefits as the brand-name medicines.”

Glucotrol XL (glipizide) is an oral medication used to manage blood sugar levels in individuals with type 2 diabetes. It belongs to the sulfonylurea class of drugs and works by stimulating the pancreas to release insulin, thereby lowering blood glucose levels. The recommended starting dose of Glucotrol XL is 5 mg once daily, taken with breakfast or the first meal of the day. Dose adjustments can be made based on the patient's blood sugar control, with a maximum recommended dose of 20 mg once daily. Regular monitoring and dosage adjustments are crucial to achieving optimal blood sugar control and minimizing the risk of low blood sugar.

Metformin is an oral medication commonly prescribed to manage blood sugar levels in individuals with type 2 diabetes. It works by decreasing glucose production in the liver, improving the body's sensitivity to insulin, and reducing the amount of sugar absorbed by the intestines. Metformin is often used as a first-line treatment due to its efficacy, safety profile, and additional benefits, such as weight stabilization and low risk of low blood sugar. Common side effects include gastrointestinal issues like nausea, diarrhea, and abdominal discomfort.

Sulfonylurea

Biguinide

Glucotrol XL (glipizide) is indicated:

• As an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus

Metformin hydrochloride tablets are indicated:

• As an adjunct to diet and exercise to improve glycemic control in adults and pediatric patients 10 years of age and older with type 2 diabetes mellitus

• Typically taken orally once daily

• Comes in 2.5 mg, 5 mg, and 10 mg tablets

• Typically taken orally once, twice, or three times daily

• Comes in 500 mg, 850 mg, and 1,000 mg tablets

Most common adverse reactions (incidence >3%) are:

• Dizziness

• Diarrhea

• Nervousness

• Tremor

• Low blood sugar

• Flatulence

For metformin hydrochloride, the most common adverse reactions (>5%) are:

• Diarrhea

• Nausea/vomiting

• Flatulence

• Weakness

• Indigestion

• Abdominal discomfort

• Headache

• Known hypersensitivity to glipizide or any of the product's ingredients

• Hypersensitivity to sulfonamide derivatives

• Drug interactions: Certain medications may affect glucose metabolism, miconazole, fluconazole, colesevelam

• Severe renal impairment (eGFR below 30 mL/min/1.73 m²)

• Hypersensitivity to metformin

• Acute or chronic metabolic acidosis, including diabetic ketoacidosis, with or without coma

• Drug interactions: Carbonic anhydrase inhibitors, drugs that reduce metformin clearance (such as ranolazine, vandetanib, dolutegravir, and cimetidine), alcohol

• Low blood sugar: May be severe

• Hemolytic anemia: Can occur if glucose 6-phosphate dehydrogenase (G6PD) deficient

• Potential increased risk of cardiovascular mortality with sulfonylureas

• Macrovascular outcomes: No clinical studies have established conclusive evidence of macrovascular risk reduction with Glucotrol XL

• Lactic acidosis: See Boxed Warning

• Vitamin B12 deficiency: Metformin may lower vitamin B12 levels

• Low blood sugar with concomitant use with insulin and insulin secretagogues

• Females and males of reproductive potential: Potential for an unintended pregnancy

WARNING: LACTIC ACIDOSIS

Postmarketing cases of metformin-associated lactic acidosis have resulted in death, hypothermia, hypotension, and resistant bradyarrhythmias. Symptoms included malaise, myalgias, respiratory distress, somnolence, and abdominal pain. Laboratory abnormalities included elevated blood lactate levels, anion gap acidosis, increased lactate/pyruvate ratio; and metformin plasma levels generally >5 mcg/mL.

Risk factors include renal impairment, concomitant use of certain drugs, age >65 years old, radiological studies with contrast, surgery and other procedures, hypoxic states, excessive alcohol intake, and hepatic impairment. Steps to reduce the risk of and manage metformin-associated lactic acidosis in these high risk groups are provided in the Full Prescribing Information.

If lactic acidosis is suspected, discontinue metformin hydrochloride tablets and institute general supportive measures in a hospital setting. Prompt hemodialysis is recommended.

*This information is from the label for brand name Glucotrol XL^®. See the Full Prescribing Information for more complete information. Glipizide, the active ingredient in Glucotrol XL, may also be the active ingredient in other medications, and this information may not be accurate for all medications that include the active ingredient glipizide.

*This information is from the metformin hydrochloride label used by Epic Pharma, LLC. See the Full Prescribing Information for more complete information. Metformin may also be the active ingredient in other medications, and this information may not be accurate for all medications that include the active ingredient metformin.