How does it work?

• Minodiab tablets contain the active ingredient glipizide, which is a type of medicine called a sulphonylurea. (NB: glipizide is also available without a brand name, ie as the generic medicine.) Glipizide is used to help control blood sugar levels in people with type 2 diabetes.
• People with type 2 diabetes (non-insulin dependent diabetes) have a deficiency of a hormone called insulin. Insulin is produced by the pancreas and is the main hormone responsible for controlling sugar levels in the blood. It normally makes the cells of the body remove excess sugar from the blood. In type 2 diabetes insulin is produced inefficiently in response to surges of blood sugar, eg following a meal. The cells of the body also become resistant to the action of insulin that is produced, which means that blood sugar levels can become too high.
• Glipizide works mainly by stimulating the cells in the pancreas that produce insulin. These cells are called beta cells. Glipizide causes the beta cells to produce more insulin. This helps to decrease the amount of sugar in the blood of people with type 2 diabetes.
• Glipizide also increases the uptake of sugar from the blood into muscle and fat cells and decreases the production of sugar by the liver.
• Glipizide is a first line option for treating type 2 diabetes in people who are not overweight, or who cannot take metformin. It is used when diet and exercise have failed to control blood sugar levels. It can also be used in combination with other antidiabetic medicines to provide better control of blood sugar.
• All these actions help to decrease the amount of sugar in the blood of people with type 2 diabetes.
• Minodiab tablets should normally be taken before breakfast or the first main meal of the day.

Warning!

• Your doctor may want you to check your blood sugar level from time to time while you are taking this medicine. Make sure you discuss how to do this and how often with your GP, pharmacist or diabetes specialist.
• Low blood sugar (hypoglycaemia) can occasionally occur as a side effect of this medicine. For this reason, it is important that you are aware of the symptoms of hypoglycaemia (these may include cold sweats, cool pale skin, tremor, anxious feeling, unusual tiredness or weakness, confusion, difficulty in concentration, excessive hunger, temporary vision changes, headache or nausea) and what to do if you experience these symptoms. Discuss this with your GP, pharmacist or diabetes specialist.
• People who are taking antidiabetic tablets should only drink alcohol in moderation and accompanied by food. This is because alcohol can make your warning signs of low blood sugar less clear, and can cause delayed low blood sugar, even several hours after drinking.
• If you get an infection or are under particular stress you should let your doctor know, because when the body is put under stress this medicine may become less effective at controlling your blood sugar. In these cases your doctor may need to temporarily replace your treatment with insulin. You should also consult your doctor about your diabetes treatment if you are due to have surgery under a general anaesthetic, or if you get pregnant. In these situations blood sugar is normally controlled by insulin.
• This type of medicine can occasionally cause liver problems. For this reason, you should consult your doctor if you develop any of the following symptoms while taking this medicine, so that your liver can be checked: unexplained nausea, vomiting, abdominal pain, fatigue, loss of appetite, darkened urine or yellowing of the eyes or skin (jaundice).

Use with caution in

• Elderly people.
• Decreased kidney function.
• Decreased liver function.
• Not to be used in
• Type 1 (insulin dependent) diabetes.
• Diabetic ketoacidosis.
• Diabetic coma or precoma.
• Severely decreased liver function.
• Severely decreased kidney function.
• People who are using an anti-fungal medicine called miconazole.
• Pregnancy.
• Breastfeeding.
• Hereditary blood disorders called porphyrias.

This medicine should not be used if you are allergic to any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.

If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and breastfeeding

• This medicine should not be used during pregnancy. Diabetes is usually controlled using insulin during pregnancy, because this provides a more stable control of blood sugar. If you get pregnant while taking this medicine, or are planning a pregnancy, you should seek medical advice from your doctor.
• This medicine may pass into breast milk. As this could cause low blood sugar in the nursing infant, this medicine should not be used by breastfeeding mothers. Discuss this with your doctor.

Side effects

• Disturbances of the gut such as diarrhoea, constipation, nausea, vomiting or abdominal pain.
• Low blood glucose level (hypoglycaemia).
• Weight gain.
• Dizziness.
• Drowsiness.
• Disturbance in the normal numbers of blood cells in the blood.
• Disturbance in liver function.
• Inflammation of the liver (hepatitis).
• Cholestatic jaundice.
• Skin reactions, such as rash, itching and redness.

The side effects listed above may not include all of the side effects reported by the medicine's manufacturer.

For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

How can this medicine affect other medicines?

This medicine should not be used in combination with the anti-fungal miconazole. Miconazole can increase significantly the blood sugar lowering effect of glipizide.

The following medicines may enhance the blood sugar lowering effect of this medicine and therefore increase the chance of your blood sugar falling too low (hypoglycaemia):

• ACE inhibitors, eg captopril (these can cause unpredictable drops in blood sugar)
• anabolic steroids, eg testosterone, nandrolone, stanozolol
• chloramphenicol
• cimetidine
• ciprofloxacin
• co-trimoxazole
• disopyramide
• fibrates, eg clofibrate
• fluconazole
• fluoxetine
• insulin
• MAOI antidepressants, eg phenelzine
• non-steroidal anti-inflammatory drugs (NSAIDS), such as phenylbutazone
• octreotide
• quinolone antibiotics such as ciprofloxacin
• large doses of salicylates, eg aspirin (small pain relieving doses do not normally have this effect)
• sulfinpyrazone
• voriconazole.

Beta-blockers, eg propranolol (including eye drops containing beta-blockers) can mask some of the signs of low blood sugar, such as increased heart rate and tremor. They also prolong episodes of low blood sugar and impair recovery back to normal glucose levels.

The warning symptoms of hypoglycaemia may also be masked by clonidine.

The following medicines may increase blood glucose levels. If you start treatment with any of these your doctor may need to increase your dose of glipizide:

• some antipsychotic medicines, eg chlorpromazine, olanzapine
• corticosteroids, eg hydrocortisone, prednisolone
• danazol
• diuretics, especially thiazide diuretics, eg bendroflumethiazide
• lithium
• isoniazid
• oestrogens and progesterones, such as those contained in oral contraceptives
• protease inhibitors, eg ritonavir
• somatropin (human growth hormone).

Rifampicin may reduce the blood level of this medicine. If you are prescribed rifampicin, your dose of this medicine may need to be increased to control your blood sugar.

This medicine may enhance the anti-blood-clotting effect of warfarin.

References:

https://en.wikipedia.org/wiki/Glipizide

https://www.netdoctor.co.uk/medicines/diabetic/a7125/minodiab-glipizide/

https://www.medicines.org.uk/emc/product/8543/smpc

https://www.webmd.com/drugs/2/drug-10094-9061/glipizide-oral/glipizide-tablet-oral/details

https://www.healthline.com/health/glipizide-oral-tablet

https://www.drugs.com/glipizide.html

https://medlineplus.gov/druginfo/meds/a684060.html