Glipizide
Glydiazinamide
Also known as: Glucotrol XL Β· Metaglip Β· Minodiab Β· CP-28720 Β· glipizidum Β· glydiazinamide Β· K-4024
Reviewed by the VetSheet Veterinary TeamUpdated Apr 5, 2026Evidence-based veterinary reference
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Dosing by species
π NA β North Americaπ EU β Europe
Cats
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Diabetes mellitus (non-ketotic, relatively healthy) | 2.5 mg per cat (initially), may increase to 5 mg per cat | PO | q12h | Ongoing if stable | π NA |
| Diabetes mellitus | 2.5-5 mg per cat | PO | q12h | 2-3 months trial | π NA |
| Diabetes mellitus (mild weight loss, non-ketoacidotic, no peripheral neuropathy) | 2.5 mg (total dose) | PO | q12h | β | π NA |
| Diabetes mellitus | 5 mg per cat, may increase to 7.5 mg (maximum) | PO | q12h | 4-8 weeks trial | π NA |
| Non-ketotic diabetes mellitus | 2.5-5 mg per cat | PO | q12h | β | π EU |
- Diabetes mellitus (non-ketotic, relatively healthy): Give in conjunction with a meal. Perform spot BG checks every 3-4h for initial 12-18h. Increase dose to 5 mg BID after 2 weeks if hyperglycemia persists and no adverse reactions occur.
- Diabetes mellitus: Combine with dietary fiber therapy. Evaluate every 1-2 weeks. If fasting BG remains >200 mg/dL after 2-3 months, discontinue and institute insulin.
- Diabetes mellitus: Decrease dose if hypoglycemia occurs. Response may be delayed; evaluate over 4-8 weeks before determining efficacy.
- Non-ketotic diabetes mellitus: Start at the lower end of the dose range, increasing the dose as required if no adverse effects are reported after 2 weeks.
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Overview
Glipizide is a second-generation oral sulfonylurea antidiabetic agent primarily used in human medicine for Type II diabetes, but it has specific applications in veterinary medicine, particularly for feline patients.
- Feline Application: It may be beneficial in treating cats with uncomplicated diabetes mellitus who still possess a population of functioning pancreatic beta cells. Approximately β20% to 30%β of newly diagnosed diabetic cats may respond to glipizide therapy.
- Clinical Utility: It is typically reserved for situations where owners absolutely refuse insulin injections (often due to needle phobia) or when a cat is well-controlled on minute doses of insulin and the owner wishes to transition to an oral medication.
- Canine Limitation: Glipizide is generally ineffective in dogs. By the time dogs present with clinical hyperglycemia, they are typically absolutely or relatively insulinopenic (similar to human Type I diabetes) and lack the functional beta cells required for glipizide to work.
- Clinical Pearl: A glipizide trial requires patience; it may take 4 to 8 weeks before full therapeutic effects are observed. Furthermore, prolonged use in cats may contribute to increased islet amyloid deposition, potentially accelerating the destruction of remaining beta cells.
Mechanism of action
Glipizide lowers blood glucose concentrations by stimulating the release of endogenous insulin from the pancreas and enhancing peripheral insulin sensitivity.
- Pancreatic Mechanism: Glipizide binds to the βsulfonylurea receptor 1 (SUR1)β on the membrane of pancreatic βΞ²-cellsβ β This binding closes ATP-sensitive potassium (K+) channels β Decreased potassium efflux leads to cellular depolarization β Depolarization opens voltage-dependent calcium (Ca2+) channels β Calcium influx triggers the exocytosis of insulin-containing secretory granules.
- Extrapancreatic Effects: Ongoing use enhances peripheral tissue sensitivity to circulating insulin and reduces the production of hepatic basal glucose, though the exact mechanisms for these secondary effects remain partially unexplained.
Safety & warnings
Contraindications
- Severe burns, trauma, or infection
- Diabetic coma or other hypoglycemic conditions
- Major surgery
- Ketosis, ketoacidosis, or other significant acidotic conditions
- Known hypersensitivity to sulfonylureas
- Diabetic ketosis / ketoacidosis
- Hepatic impairment
- Renal impairment
- Absolute insulin deficiency (Type I diabetes)
- Insulin resistance
Adverse effects
- Gastrointestinal upset (anorexia, vomiting in ~15% of cats)
- Hypoglycemia (severe cases are rare)
- Hepatotoxicity (cholestatic jaundice and elevated liver enzymes in ~8% of cats)
- Increased pancreatic amyloid deposit formation
- Allergic skin reactions (reported in humans)
- Bone marrow suppression (reported in humans)
- Jaundice (hepatotoxicity)
- Skin rashes
- Fever
Precautions
Important: Glipizide should be used with extreme caution in patients with untreated adrenal or pituitary insufficiency, thyroid impairment, renal or hepatic function impairment, prolonged vomiting, high fever, malnourishment, or debilitated conditions.
- Efficacy Loss: While initially effective, glipizide may become ineffective weeks to months after starting therapy, eventually requiring a transition to insulin.
- Concurrent Endocrine Disease: Conditions causing excessive cortisol or growth hormone production (e.g., hyperadrenocorticism, acromegaly) can antagonize insulin effects and must be ruled out before initiating therapy.
- Hepatic Monitoring: Monitor liver enzymes closely. Discontinue if ALT exceeds 500 IU/L or if icterus develops.
Drug interactions
May cause a disulfiram-like reaction (anorexia, nausea, vomiting)
May increase plasma levels of glipizide
May potentiate hypoglycemic effect and mask signs of hypoglycemia
May displace glipizide from plasma proteins, increasing effect
May potentiate hypoglycemic effect
May antagonize insulin effects and reduce glipizide efficacy
May reduce hypoglycemic efficacy
May reduce hypoglycemic efficacy
May potentiate hypoglycemic effect
May reduce hypoglycemic efficacy
May reduce hypoglycemic efficacy
May reduce hypoglycemic efficacy
May potentiate hypoglycemic effect
May displace glipizide from plasma proteins, increasing effect
May reduce hypoglycemic efficacy
May reduce hypoglycemic effect
May displace glipizide from plasma proteins
May enhance the hypoglycemic effects of glipizide
May enhance the hypoglycemic effects of glipizide
May enhance the hypoglycemic effects of glipizide
May enhance the hypoglycemic effects of glipizide
Monitoring
- Physical examination and body weight (weekly during first month)
- Urine glucose and ketones
- Serial blood glucose measurements or spot checks
- Liver enzymes (ALT, AST, ALP) and bilirubin (every 1-2 weeks initially)
- Complete Blood Count (CBC)
- Clinical signs of hypoglycemia or gastrointestinal distress
- Blood glucose curves
- Fructosamine levels
- Liver enzymes (ALT, AST, ALP, Bilirubin)
- Renal function (BUN, Creatinine)
- Clinical signs of diabetes (water intake, urination, weight)
Pharmacokinetics
Half-life
Absorption
Rapidly and practically completely absorbed after oral administration. Absolute bioavailability in humans is 80-100%. Food alters the rate, but not the extent, of absorption. Transdermal administration in cats is not adequately absorbed.
Distribution
Very highly bound to plasma proteins.
Metabolism
Primarily biotransformed in the liver to inactive metabolites.
Elimination
Metabolites are excreted primarily by the kidneys.
Overdose
Toxicity Profile: Oral LD50 is greater than 4 g/kg in all tested animal species. The primary and most dangerous consequence of an overdose is profound hypoglycemia.
Management:
- Decontamination: Employ gut-emptying protocols (emesis, activated charcoal) if the ingestion is recent and the patient is asymptomatic.
- Treatment: Monitor blood glucose closely. Administer parenteral glucose (e.g., IV dextrose bolus followed by a CRI) as needed.
- Monitoring: Because of its relatively short half-life, prolonged hypoglycemia is less likely compared to older sulfonylureas (like chlorpropamide), but blood glucose monitoring and supportive care may still be required for several days. Massive overdoses may require monitoring of blood gases and serum electrolytes.
Available products
Formulations
- Oral extended-release tablets
- Oral film-coated tablets (in combination with metformin)
- 2.5 mg oral tablets
Veterinary
- None
Human-labeled
- Glipizide Oral Tablets: 5 mg & 10 mg (Glucotrol, generic)
- Glipizide Oral Extended Release Tablets: 2.5 mg, 5 mg, & 10 mg (Glucotrol XL, generic)
- Glipizide/Metformin Hydrochloride Tablets: 2.5 mg/250 mg, 2.5 mg/500 mg, 5 mg/500 mg (Metaglip, generic)
- Minodiab 2.5 mg tablets
- Minodiab 5 mg tablets
- Generic Glipizide tablets
Regulatory status
POM (Prescription Only Medicine)
POM-V (Prescription Only Medicine - Veterinarian)
No regulatory data for: πΊπΈ US Β· ππ° HK Β· πΉπΌ TW Β· π―π΅ JP Β· π°π· KR Β· π¦πΊ AU
Storage & stability
Tablets should be stored in tight, light-resistant containers at room temperature.
Client information
Your veterinarian has prescribed glipizide to help manage your cat's diabetes. This medication works by stimulating your cat's pancreas to release more insulin.
- Patience is Key: It can take 4 to 8 weeks to see the full benefits of this medication. Do not stop giving it unless directed by your veterinarian.
- βWatch for Low Blood Sugar (Hypoglycemia)β: Signs include weakness, wobbliness, lethargy, muscle twitching, or seizures. If you see these signs, rub a little corn syrup or honey on your cat's gums and contact your vet immediately.
- βWatch for High Blood Sugar (Hyperglycemia)β: If the medication isn't working well enough, you may notice increased thirst, increased urination, or weight loss.
- Side Effects: Some cats may experience vomiting or loss of appetite, especially when first starting the drug. If vomiting is severe or lasts more than a couple of days, or if you notice a yellowing of the eyes/gums (jaundice), call your veterinarian.
- Diet: Give this medication with a meal as directed, and stick to the specific diet (often high-protein/low-carbohydrate or high-fiber) recommended by your vet.
VetSheet drug reference is intended for licensed veterinary professionals as a clinical decision-support aid, not a substitute for professional judgement or the manufacturerβs current label.