格列吡嗪

用途

• Diabetes mellitus (non-ketotic, relatively healthy)
• Diabetes mellitus
• Diabetes mellitus (mild weight loss, non-ketoacidotic, no peripheral neuropathy)
• Diabetes mellitus
• Non-ketotic diabetes mellitus

給藥方式

可能的副作用

• 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)
• Vomiting
• Hypoglycemia
• Jaundice (hepatotoxicity)
• Skin rashes
• Fever

注意事項與禁忌

• 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
• > **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.

藥物相互作用

• Alcohol: May cause a disulfiram-like reaction (anorexia, nausea, vomiting)
• Azole Antifungals (ketoconazole, itraconazole, fluconazole): May increase plasma levels of glipizide
• Beta-blockers: May potentiate hypoglycemic effect and mask signs of hypoglycemia
• Chloramphenicol: May displace glipizide from plasma proteins, increasing effect
• Cimetidine: May potentiate hypoglycemic effect
• Corticosteroids: May antagonize insulin effects and reduce glipizide efficacy
• Thiazide Diuretics: May reduce hypoglycemic efficacy
• Isoniazid: May reduce hypoglycemic efficacy
• MAO Inhibitors: May potentiate hypoglycemic effect
• Niacin: May reduce hypoglycemic efficacy
• Phenothiazines: May reduce hypoglycemic efficacy
• Phenytoin: May reduce hypoglycemic efficacy

常見問題