Glipizide with Guar Gum Interaction Details
Brand Names Associated with Glipizide
- Glipizide
- Glucotrol®
- Glucotrol® XL
- Metaglip® (as a combination product containing Glipizide, Metformin)
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Nov 12, 2023
Interaction Effect
Increased risk of hypoglycemia
Interaction Summary
In a study of 10 healthy volunteers, guar gum nonsignificantly delayed absorption and decreased the area under the curve (AUC) of glipiZIDE when given with glipiZIDE and 30 minutes after glipiZIDE. It is unknown to what extent the small delay in glipiZIDE absorption may affect patients with diabetes. If administration of guar gum is delayed for at least one hour following glipiZIDE administration, any potential interaction can likely be avoided. Guar gum may also delay absorption of glucose from meals, leading to less postprandial hyperglycemia . This may potentially allow a reduced dosage of glipiZIDE.
Severity
Minor
Onset
Rapid
Evidence
Probable
How To Manage Interaction
It is unknown to what extent the small delay in glipiZIDE absorption may affect patients with diabetes. If administration of guar gum is delayed for at least one hour following glipiZIDE administration, any potential interaction can likely be avoided. Closely monitor blood glucose levels and signs and symptoms of hypoglycemia in patients taking guar gum and glipiZIDE.
Mechanism Of Interaction
Delayed gastric emptying by guar gum
Literature Reports
A) GlipiZIDE absorption was not significantly affected by guar gum in 10 healthy volunteers. GlipiZIDE 2.5 mg alone, glipiZIDE 2.5 mg coadministered with guar gum 4.75 grams, or guar gum 4.75 grams 30 minutes after glipiZIDE 2.5 mg were administered, followed by a standard breakfast 30 minutes after glipiZIDE administration. Absorption of glipiZIDE was rapid for all three treatment approaches, perhaps explaining why glipiZIDE was minimally affected by guar gum. GlipiZIDE concentration at 30 minutes was highest when guar gum was coadministered (p less than 0.01). The area under the curve (AUC) for the entire 8 hour period was not significantly different when glipiZIDE was administered alone, with guar gum, or guar gum given 30 minutes following glipiZIDE administration (2330 nanomoles per liter per hour (nmol/L/hour), 2240 nmol/L/hour, and 1950 nmol/L/hour, respectively). Similarly, AUC for insulin and glucose was not significantly altered between the three treatment approaches, though the highest concentrations of insulin and glucose at 30 minutes occurred with glipiZIDE/guar gum simultaneous administration .
B) Guar gum significantly reduced urinary glucose output in 9 patients with diabetes. Patients supplemented their home diet (n equal to 4) or metabolic ward diet (n equal to 5) with guar gum 25 grams daily for 5 or 7 days. Six patients were treated with insulin (doses ranged from 38 units/day to 84 units/day), while one was controlled with diet alone. In the home diet studies, guar gum was incorporated into bread, canned soup, and fruit juice, and taken at the beginning of meals. During control periods, equal amounts of bread, canned soup, and fruit juice were taken. In metabolic ward studies, guar gum was given in bread, soup, and mashed potatoes. Urinary glucose output decreased by 46% (p less than 0.05) with the home diet and 54% (p less than 0.01) with the metabolic ward diet. Mean urinary glucose output for the home diet was reduced from 26.3 +/- 11.5 grams/24 hours to 14.1 +/- 9.8 grams/24 hours (p less than 0.05). Mean urinary glucose output for the metabolic ward diet was reduced from 29.0 +/- 9.2 grams/24 hours to 13.3 +/- 7.3 grams/24 hours (p less than 0.01). One study was stopped due to recurrent hypoglycemic episodes during the guar gum treatment period. Three patients found it necessary to reduce their insulin dose temporarily after the study, though they were taking their original dose within 2 weeks .
Glipizide Overview
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Glipizide is used along with diet and exercise, and sometimes with other medications, to treat type 2 diabetes (condition in which the body does not use insulin normally and, therefore, cannot control the amount of sugar in the blood). Glipizide is in a class of medications called sulfonylureas. Glipizide lowers blood sugar by causing the pancreas to produce insulin (a natural substance that is needed to break down sugar in the body) and helping the body use insulin efficiently. This medication will only help lower blood sugar in people whose bodies produce insulin naturally. Glipizide is not used to treat type 1 diabetes (condition in which the body does not produce insulin and, therefore, cannot control the amount of sugar in the blood) or diabetic ketoacidosis (a serious condition that may occur if high blood sugar is not treated).
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Over time, people who have diabetes and high blood sugar can develop serious or life-threatening complications, including heart disease, stroke, kidney problems, nerve damage, and eye problems. Taking medication(s), making lifestyle changes (e.g., diet, exercise, quitting smoking), and regularly checking your blood sugar may help to manage your diabetes and improve your health. This therapy may also decrease your chances of having a heart attack, stroke, or other diabetes-related complications such as kidney failure, nerve damage (numb, cold legs or feet; decreased sexual ability in men and women), eye problems, including changes or loss of vision, or gum disease. Your doctor and other healthcare providers will talk to you about the best way to manage your diabetes.
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Definitions
Severity Categories
Contraindicated
These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.
Major
This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.
Moderate
This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.
Minor
While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.
Onset
Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.
Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.
Evidence
Level of documentation of the interaction.
Established: The interaction is documented and substantiated in peer-reviewed medical literature.
Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.
How To Manage The Interaction
Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.
It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.
Mechanism Of Interaction
The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.
Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.
Where Does Our Information Come From?
Information for our drug interactions is compiled from several drug compendia, including:
The prescribing information for each drug, as published on DailyMED, is also used.
Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.
The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.