Glipizide dosage

A 52-year-old woman took glipizide and enalapril and then, because of persistent hyperglycemia, metformin 1000 mg/day (103). Her liver enzymes were normal, and after 2 weeks the dosage of metformin was increased to 2000 mg/day. Two weeks later she became icteric and her bilirubin and liver enzymes were increased. Serological studies were negative. All drugs were withdrawn. A liver biopsy was consistent with... 

The risk of hepatotoxicity with the sulfonylureas varies with both the drug and the dosage. It has been described with chlorpropamide (95), tolazamide (96), tolbutamide (97), glipizide (98), and glibenclamide (99). Anicteric, cytolytic hepatitis has been described after glibenclamide (100). 

A diabetic patient taking glipizide and aspirin started taking nortriptyline, and, at the same time, his treatment with nifedipine was replaced by diltiazem 180 mg daily initially, raised to 240 mg daily after a week. Several changes in the nortriptyline dosage were made over a 4-week period because its plasma levels became unexpectedly high (the ratio of plasma nortriptyline to its dosage were approximately doubled). ... 

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