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Glipizide ER: Your side effect survival guide

Glipizide ER: Your side effect survival guide

Optum Perks Author

By Optum Perks Author

Finding out you have type 2 diabetes can feel scary and overwhelming. It’s a lifelong condition that’s going to require management every single day in order to keep potential complications, such as vision loss and heart disease, in check. But the good news? Type 2 diabetes can be treated with medications such as glipizide ER (Glucotrol XL).

This medication is part of a class of drugs called sulfonylureas, and it works to lower blood sugar a few different ways. “Glipizide can help the pancreas release insulin, especially when you eat a meal,” says Alyssa Wozniak, PharmD, clinical assistant professor at D’Youville School of Pharmacy in Buffalo, New York.

“This hormone allows the sugar from your meal to move from your blood and into your cells for energy.” Glipizide also helps your cells use that insulin more effectively, and it decreases the amount of sugar your liver produces.

The extended-release (ER) form (sometimes also called glipizide XL) just means that it reaches its peak level more slowly than regular glipizide. The benefit with that? You only need to take glipizide ER once a day, with your first meal, says Lani Smith, MPharm, senior clinical pharmacist with OptumRx.

“It is useful for patients who may forget to take their medication later in the day or who would rather take fewer medications,” Wozniak says. “And when glipizide ER is taken consistently every day, your body can maintain more constant levels of the medicine in the blood.”

But like every medication, glipizide ER can come with side effects. Two of the more important ones to be aware of are weight gain and low blood sugar. Let’s look at each one.

Glipizide ER and weight gain

Weight gain isn’t something that will happen immediately, but it can occur over time, says Wozniak. “Your diabetes team typically monitors your weight while you take glipizide ER and can review your treatment regimen if weight gain becomes a concern.”


Part of the reason weight gain can happen with drugs such as glipizide: They increase the level and effectiveness of insulin. And the better your insulin works, the more calories your body can absorb, according to the American Diabetes Association.

There’s no real magic to preventing scale creep. Just stick with a regular exercise routine and follow a healthy diet. Your diabetes care team can help you with both.

Did you know that different pharmacies charge different prices for the same drug? Find the best deal on your glipizide ER prescription and download a coupon now.

Glipizide ER and low blood sugar

Low blood sugar, also called hypoglycemia, can happen with many diabetes medications. And with glipizide ER, it can occur when you first start taking the drug or after you’ve been on it for a while. To reduce the chances, your doctor will likely start you on a low dose and slowly increase it over time if needed, says Wozniak.


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“Low blood sugar is more likely to happen if you skip or delay meals or make a drastic change in the amount of sugar you eat during a meal,” says Wozniak. “It is also more likely to occur if you are more active than usual, are sick or stressed, or drink alcohol.”

The hypoglycemia signs you need to watch for include feeling shaky, sweaty, dizzy, confused, hungry, tired, nervous, and/or headachey. As soon as you notice any of these, check your blood sugar. If it’s less than 70 mg/dL, it’s too low.

If you’re in that danger zone, eat or drink something with 15 grams of sugar, such as:

  • 4 ounces of fruit juice or regular soda
  • a tablespoon of honey
  • four glucose tablets

Check your level again after 15 minutes. If it’s still below 70, take in another 15 grams of sugar, and then test again 15 minutes later. (This is called the 15-15 Rule.)


Once your blood sugar is back to normal, have a meal or snack to keep it there. If your 2 rounds of treatment didn’t work, seek immediate medical attention.

Monitoring for hypoglycemia is part of the territory when you have type 2 diabetes, but you can reduce your risk by following these guidelines:

  • Eat on a regular schedule and keep the sugar content consistent in your meals • Avoid alcohol • Check your blood sugar levels regularly, especially when you’re sick or unusually stressed • Take your medication exactly as directed with your first meal of the day

You may experience other side effects, too, such as gas and diarrhea. You may also see the shell of a tablet in your stool (random fact), which isn’t anything to be alarmed about, says Wozniak. The key to success with this is working closely with the members of your care team. Follow their instructions, stay on top of checkups, and let them know anytime something doesn’t feel right.