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Pronounced: GLUE-kuh-troll
Generic name: Glipizide
Other brand name: Glucotrol XL

Why is this drug prescribed: Glucotrol is an oral antidiabetic medication used to treat type 2 (non-insulin-dependent) diabetes. In diabetics either the body does not make enough insulin or the insulin that is produced no longer works properly. There are actually two forms of diabetes: type 1 insulin-dependent and type 2 non-insulin-dependent. Type 1 usually requires insulin injections for life, while type 2 diabetes can usually be treated by dietary changes and/or oral antidiabetic medications such as Glucotrol. Apparently, Glucotrol controls diabetes by stimulating the pancreas to secrete more insulin. Occasionally, type 2 diabetics must take insulin injections on a temporary basis, especially during stressful periods or times of illness.

Most important fact about this drug: Always remember that Glucotrol is an aid to, not a substitute for, good diet and exercise. Failure to follow a sound diet and exercise plan can lead to serious complications, such as dangerously high or low blood sugar levels. Remember, too, that Glucotrol is not an oral form of insulin, and cannot be used in place of insulin.

How should you take this medication: In general, to achieve the best control over blood sugar levels, Glucotrol should be taken 30 minutes before a meal. However, the exact dosing schedule as well as the dosage amount must be determined by your physician. Glucotrol XL should be taken with breakfast. Swallow the tablets whole; do not chew, crush, or divide them. Do not be alarmed if you notice something that looks like a tablet in your stool--it will be the empty shell that has been eliminated. --If you miss a dose... Take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Never take 2 doses at the same time. --Storage instructions... Glucotrol should be stored at room temperature and protected from moisture and humidity.

What side effects may occur: Side effects from Glucotrol are rare and seldom require discontinuation of the medication. More common side effects may include: Constipation, diarrhea, dizziness, drowsiness, gas, headache, hives, itching, low blood sugar, nervousness, sensitivity to light, skin rash and eruptions, stomach pain, tremor Less common or rare side effects may include: Anemia and other blood disorders, yellow eyes and skin Glucotrol and Glucotrol XL, like all oral antidiabetic drugs, can cause low blood sugar. This risk is increased by missed meals, alcohol, other diabetes medications, and excessive exercise. Low blood sugar is also more likely in older people, those with kidney or liver problems, and those with poorly functioning adrenal or pituitary glands. To avoid low blood sugar, you should closely follow the dietary and exercise regimen suggested by your physician. Symptoms of mild low blood sugar may include: Blurred vision, cold sweats, dizziness, fast heartbeat, fatigue, headache, hunger, light-headedness, nausea, nervousness Symptoms of more severe low blood sugar may include: Coma, disorientation, pale skin, seizures, shallow breathing Ask your doctor what steps you should take if you experience mild hypoglycemia. If symptoms of severe low blood sugar occur, contact your doctor immediately. Severe hypoglycemia should be considered a medical emergency, and prompt medical attention is essential.

Why should this drug not be prescribed: You should not take Glucotrol if you have had an allergic reaction to it previously. Glucotrol will be stopped if you are suffering from diabetic ketoacidosis (a life-threatening medical emergency caused by insufficient insulin and marked by excessive thirst, nausea, fatigue, pain below the breastbone, and a fruity breath).

Special warnings about this medication: It's possible that drugs such as Glucotrol may lead to more heart problems than diet treatment alone, or diet plus insulin. If you have a heart condition, you may want to discuss this with your doctor. If you are taking Glucotrol, you should check your blood and urine periodically for the presence of abnormal sugar (glucose) levels. Even people with well-controlled diabetes may find that injury, infection, surgery, or fever results in a lack of control over their diabetes. In these cases, the physician may recommend that you stop taking Glucotrol temporarily and use insulin instead. Glucotrol may not work well in patients with poor kidney or liver function. In addition, the effectiveness of any oral antidiabetic, including Glucotrol, may decrease with time. This may occur because of either a diminished responsiveness to the medication or a worsening of the diabetes. Be careful taking the extended-release form of the drug, Glucotrol XL, if you have any narrowing in your stomach or intestines. Also, if you have any stomach or intestinal disease, Glucotrol XL may not work as well.

Possible food and drug interactions when taking this medication: It is essential that you closely follow your physician's dietary guidelines and that you inform your physician of any medication, either prescription or nonprescription, that you are taking. Specific medications that affect Glucotrol include: Airway-opening drugs such as Sudafed Antacids such as Mylanta Aspirin Chloramphenicol (Chloromycetin) Cimetidine (Tagamet) Clofibrate (Atromid-S) Corticosteroids such as prednisone (Deltasone) Diuretics such as HydroDIURIL Estrogens such as Premarin Fluconazole (Diflucan) Gemfibrozil (Lopid) Heart and blood pressure medications called beta blockers such as Tenormin and Lopressor Heart medications called calcium channel blockers such as Cardizem and Procardia XL Isoniazid (Rifamate, Rimactane) Itraconazole (Sporanox) MAO inhibitors (antidepressant drugs such as Nardil and Parnate) Major tranquilizers such as Thorazine and Mellaril Miconazole (Monistat) Nicotinic acid (Nicobid) Nonsteroidal anti-inflammatory drugs such as Motrin and Naprosyn Oral contraceptives Phenytoin (Dilantin) Probenecid (Benemid) Rifampin (Rifadin) Sulfa drugs such as Bactrim and Septra Thyroid medications such as Synthroid Warfarin (Coumadin) Alcohol must be used carefully, since excessive alcohol consumption can cause low blood sugar.

Special information if you are pregnant or breastfeeding: The effects of Glucotrol during pregnancy have not been adequately studied. Therefore, if you are pregnant, or planning to become pregnant, you should take Glucotrol only on the advice of your physician. Since studies suggest the importance of maintaining normal blood sugar (glucose) levels during pregnancy, your physician may prescribe insulin during pregnancy. To minimize the risk of low blood sugar in newborn babies, Glucotrol, if taken during pregnancy, should be discontinued at least one month before the expected delivery date. Although it is not known if Glucotrol appears in breast milk, other oral antidiabetics do. Because of the potential for hypoglycemia in nursing infants, your doctor may advise you either to discontinue Glucotrol or to stop nursing. If Glucotrol is discontinued and if diet alone does not control glucose levels, your doctor may prescribe insulin.

Recommended dosage: Dosage levels must be determined by each patient's needs. ADULTS: Glucotrol The usual recommended starting dose is 5 milligrams taken before breakfast. Depending upon blood glucose response, your doctor may increase the initial dose in increments of 2.5 to 5 milligrams. The maximum recommended daily dose is 40 milligrams; total daily dosages above 15 milligrams are usually divided into 2 equal doses that are taken before meals. Glucotrol XL The usual starting dose is 5 milligrams each day at breakfast. After 3 months, your doctor may increase the dose to 10 milligrams daily. The maximum recommended daily dose is 20 milligrams. CHILDREN: The safety and effectiveness of this drug in children have not been established. OLDER ADULTS: Older people or those with liver disease usually start Glucotrol therapy with 2.5 milligrams. They can start Glucotrol XL treatment with 5 milligrams.

Overdosage: An overdose of Glucotrol can cause low blood sugar. (See side effects section for symptoms.) Eating sugar or a sugar-based product will often correct the condition. Otherwise, seek medical attention immediately.

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