Clinical pharmacology of glipizide

The clinical pharmacology of glipizide and other sulfonylureas is briefly reviewed. Reevaluation of the University Group Diabetes Program data suggests that sulfonylureas do not increase cardiovascular mortality. Instead, a long-term study of subjects with impaired glucose tolerance indicates that sulfonylureas reduce the frequency of cardiovascular morbidity and can postpone or even prevent the development of impaired glucose tolerance to manifest diabetes. It is likely that all sulfonylureas have the same principal mechanism(s) of action but that they differ in potency and pharmacokinetics, resulting in considerable clinical differences. Thus, glipizide and glibenclamide (glyburide) are much more potent than tolbutamide and chlorpropamide. Glipizide has the most rapid absorption and onset of action, as well as the shortest half-life and effect-duration; hence the risk of long-lasting hypoglycemia is minute. Glipizide has complete bioavailability, and its blood glucose-lowering effect is improved when it is given before breakfast. Glipizide may be administered once daily without loss of therapeutic efficacy.