9 Glipizide Side Effects and How to Manage Them

Glipizide is an oral diabetes pill that belongs to a class of medications called sulfonylureas. If metformin hasn’t been working well enough for you, glipizide can be a good add-on treatment. You may also be prescribed glipizide on its own. It comes as immediate-release (IR) and extended-release (ER) tablets.

Sulfonylureas like glipizide work well to lower blood glucose (sugar) levels. But they can also cause hypoglycemia (low blood glucose) and weight gain. Knowing what to expect from taking glipizide can help you prevent or manage certain side effects.

Glipizide side effects at a glance

During clinical trials, less than 12% of people taking glipizide reported side effects. Most glipizide side effects are mild and can be managed at home. Certain side effects may be more likely, depending on your dose and the form you’re taking. 

Common glipizide side effects include:

• Dizziness

• Diarrhea

• Nausea and vomiting

• Stomach upset

• Constipation

• Nervousness

• Tremors

• Gas

Less common but potentially serious glipizide side effects include:

• Severe hypoglycemia (low blood glucose)

• Hemolytic anemia

• Liver damage

• Skin reactions

• Severe allergic reactions

• Low sodium levels

Below, we take a closer look at nine glipizide side effects and provide tips for managing them.

1. Dizziness

Dizziness is a common glipizide side effect. It should improve as your body gets used to the medication. But you should see how glipizide affects you before driving a car or performing tasks that may be dangerous if you’re dizzy.

To lower the risk of falls when you’re dizzy, move slowly when changing positions, such as going from sitting to standing. And be sure to drink enough water throughout the day, since dehydration can cause or worsen dizziness.

Keep in mind that dizziness can also be a symptom of hypoglycemia. It may be a good idea to check your blood glucose levels to make sure they’re not too low.

If the dizziness isn’t going away or is getting worse, talk to your healthcare provider. They can help adjust your dosage or suggest a different medication.

2. Diarrhea

Diarrhea is another common glipizide side effect. Other gastrointestinal (GI) side effects, including nausea, vomiting, and constipation, were also reported during clinical trials. Higher glipizide doses may be more likely to cause these side effects.

Diarrhea from glipizide should resolve on its own. But if it’s persistent or gets worse, talk to your healthcare provider. If you’re taking glipizide IR, your provider may have you split your total daily dose into two smaller doses. Or they may consider lowering your dose.

3. Tremor

You may experience mild tremors while taking glipizide. Similar to dizziness, tremors (or shaking) can sometimes be a symptom of hypoglycemia. So if you notice tremors after taking glipizide, it’s a good idea to check your blood glucose levels to make sure they’re not too low.

Tremors can have a few different causes. If your tremors don’t seem to be from low blood glucose, aren’t going away, or are getting worse, contact your healthcare provider. They can help determine the cause and best next steps.

4. Gas

Glipizide can make you have more gas than usual. In some cases, this can make you feel bloated and uncomfortable. While gassiness from glipizide may improve over time, you can try these small changes:

• Slow down when you’re eating, since eating too fast makes you more likely to swallow air and increase bloating.

• Cut down on foods that increase bloating, such as dairy products and carbonated beverages.

• Move around or take a short walk after eating.

• If needed, you could try simethicone (Gas-X), to help relieve bloating from gas.

If you’re still experiencing uncomfortable gas, talk to your healthcare provider. If glipizide is the culprit, they may have you take a smaller glipizide dose more often or lower your total daily dosage.

5. Hypoglycemia

Hypoglycemia (low blood sugar) is a common side effect of sulfonylureas like glipizide. But compared to other sulfonylureas, glipizide lasts a shorter time in the body. So it may be a preferred option for people at higher risk of hypoglycemia, such as older adults

Watch for hypoglycemia symptoms such as a fast heartbeat, shakiness, and sweating. Blurry vision and dizziness are also possible. If these develop, check your blood glucose levels since they may be too low. If they’re less than 70 mg/dL, follow your healthcare team’s instructions for bringing your blood glucose levels back up.

There are a few things you can do to help prevent hypoglycemia. Examples include:

• Taking your diabetes medications and monitoring your blood glucose as directed

• Eating meals and snacks on a regular schedule

• Avoiding or cutting down on how much alcohol you drink

• Fueling up properly and checking your blood glucose before and after exercise

If you experience frequent hypoglycemia episodes while taking glipizide, talk to your healthcare provider. This may be a sign that your glipizide dose needs to be lower.

6. Weight gain

Glipizide and other sulfonylureas can cause weight gain — usually around 5 lbs, on average. Incorporating a diabetes-friendly diet and regular exercise can help manage potential fluctuations in your weight during treatment.

If you’re concerned about weight changes from glipizide, talk to your healthcare provider. They can discuss potential management strategies and options. If needed, they may recommend a different diabetes medication that’s less likely to cause weight gain (or one that causes weight loss).

7. Sun sensitivity

Glipizide can make you more sensitive to the sun. During treatment, you may notice small blister-like patches appearing on your skin after sun exposure. While this may not happen to everyone taking glipizide, it’s important to use proper sun protection to be safe.

Be sure to apply sunscreen every day. And when you go outside, wear protective clothing that covers your skin and seek shade, if possible. If you notice blister-like patches form on your skin, or that you’re burning more easily in the sun, let your healthcare provider know.

8. Hemolytic anemia

Hemolytic anemia is when your red blood cells aren’t being replaced as fast as they’re being destroyed. It’s a rare but serious glipizide side effect that has a higher likelihood of happening in people with a genetic health condition called glucose-6-phosphate dehydrogenase (G6PD) deficiency.

People with G6PD deficiency shouldn’t take glipizide. But you may not always know if you have it before starting the medication. 

Symptoms of hemolytic anemia can include tiredness, dizziness, and weakness. You may also have pain in your left upper abdominal area. Let your healthcare provider know right away if these symptoms develop. They can determine the best next steps.

9. Liver damage

While uncommon, another potentially serious glipizide side effect is liver damage. In most cases, your healthcare provider may notice that your liver enzymes are mildly elevated during a routine follow-up appointment. But you may not have any noticeable symptoms.

In rare cases, some people develop symptoms of more serious liver damage, such as fatigue, abdominal pain, and yellowing of the skin and eyes (jaundice). If this happens, it’s usually within 3 to 12 weeks of starting glipizide.

If you experience these symptoms, contact your healthcare provider right away. They will do some blood tests to check your liver. In most cases, they will recommend stopping glipizide and changing to a different medication.

When should you contact your healthcare provider about glipizide side effects?

Most glipizide side effects are mild and can be managed with small lifestyle changes at home. But for some side effects, lifestyle changes may not be enough. If you experience any side effects that are getting worse, won’t go away, or start affecting your quality of life, contact your healthcare provider. Don’t attempt to stop taking glipizide on your own.

If you have frequent hypoglycemia episodes, let your healthcare provider know. This may be a sign that your glipizide dose is too high. Your healthcare provider can help you figure out the best dose for you or if you need a different medication.

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Written by:

Sandy P. Bonfin, PharmD, BCPS

Sandy Bonfin has 9 years of experience as a pharmacist and has been working as a clinical pharmacist in a hospital in Florida for the past 7 years after a short stint as a mail-order retail pharmacist. Sandy has worked in pediatric medicine, emergency medicine, internal medicine, and intensive care.

Edited by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

Reviewed by:

Austin Ulrich, PharmD, BCACP

Austin Ulrich, PharmD, BCACP, is a board-certified ambulatory care clinical pharmacist. In his early career, he provided direct patient care in a variety of settings, including hospital and community pharmacies, and in a primary care clinic as a clinical pharmacist.

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