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Precautions and Warnings With Glipizide and Metformin

Specific Precautions and Warnings With Glipizide and Metformin

Warnings and precautions to be aware of before taking glipizide and metformin include the following:
 
  • Oral diabetes drugs, including glipizide and metformin, may increase the risk of death due to heart or blood vessel problems when compared to diabetes treatment with diet or insulin. This warning is based on one research study that looked at a diabetes medication similar to glipizide and metformin. However, it is unclear at this time how important this risk may be in people taking this particular drug.
     
  • In rare cases, metformin (one of the active ingredients of glipizide and metformin) may cause a life-threatening condition called lactic acidosis. Your risk of lactic acidosis increases with other medical conditions, including congestive heart failure, kidney failure, and liver problems, including liver failure and cirrhosis (see Metformin and Lactic Acidosis).
     
  • Drinking alcohol can increase your risk of lactic acidosis. Drinking large amounts of alcohol on a regular basis or drinking a large amount of alcohol at once (binge drinking) should be avoided while taking metformin (see Metformin and Alcohol).
     
  • Since liver disease (including liver failure and cirrhosis) can increase your risk of lactic acidosis, you should not take glipizide and metformin if your liver is not functioning normally. Also, your kidney function needs to be monitored while you are taking the drug. This means that you should have blood tests that check your kidneys before you start glipizide and metformin, and then you should have your kidneys checked at least once every year. If your kidney function is poor, you should not take glipizide and metformin due to an increased risk of lactic acidosis.
     
  • Taking metformin (one of the active ingredients in glipizide and metformin) and contrast dye at the same time can increase your risk of kidney damage. Contrast dye is used for certain radiology procedures, including some x-rays, CT scans, and heart catheterizations (see Metformin and Contrast Medium). Also, glipizide and metformin should be temporarily stopped for most major surgeries and then restarted when you are eating normally again.
     
  • Glipizide and metformin can cause low blood sugar (hypoglycemia) in some people. This is more common in elderly people and in people with adrenal, pituitary, liver, or kidney problems, as well as during fasting before surgery and after prolonged exercise. Symptoms of low blood sugar may include irritability, trembling, cold sweats, or blurry vision, among other things.
     
  • If you are allergic to sulfonamides ("sulfa" medications), you may also be allergic to glipizide and metformin, although most people with sulfa allergies can take the drug without problems. To be safe, let your healthcare provider know if you have a sulfa allergy.
     
  • Fever, infections, injury, or surgery can temporarily increase your blood sugar, even in people with well-controlled diabetes. Glipizide and metformin may not be enough to treat your diabetes at these times, and the use of insulin may be required. Contact your healthcare provider if you have a fever, infection, injury, or will be having surgery. Also, make sure you know the symptoms of high blood sugar and how to check your blood sugar levels (see Metaglip and Blood Sugar).
     
  • Let your healthcare provider know if you drink a much lower amount of liquid than normal or if you have an illness that causes severe vomiting, diarrhea, or fever. These conditions can lead to severe dehydration (loss of water in your body). You may need to stop taking glipizide and metformin for a short time.
     
  • Glipizide and metformin can decrease your vitamin B12 levels. As a result, your healthcare provider should monitor your vitamin B12 levels, especially if you have a vitamin B12 deficiency (including pernicious anemia).
     
  • Glipizide and metformin can cause low blood sugar (hypoglycemia), which is a potentially dangerous condition. Your risk of hypoglycemia increases if you increase your physical activity, do not eat as much as you usually do, or drink alcohol. Adrenal or pituitary insufficiency or liver or kidney problems can also increase your risk of low blood sugar. Talk to your healthcare provider about what to do if you have low blood sugar. Contact your healthcare provider immediately if you have very low blood sugar.
     
  • Glipizide and metformin can interact with certain medications (see Drug Interactions With Glipizide and Metformin).
     
  • Glipizide and metformin is considered a pregnancy Category C medication. This means that it may not be safe for use during pregnancy, although the full risks of taking the medication during pregnancy are not known. Talk to your healthcare provider before taking glipizide and metformin during pregnancy (see Metaglip and Pregnancy).
     
  • It is not known if glipizide and metformin passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider.
     
  • Sulfonylurea medicines, such as the glipizide component of glipizide and metformin, have been reported to increase sensitivity to the sun. Therefore, when going outdoors, try wearing long sleeves, pants, and a hat. Any exposed skin should be covered with sunscreen that is at least SPF 15.
     
Diabetes Tips for Seniors

Glipizide and Metformin Information

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