Glipizide / metformin (Metaglip and others)

How Medicare covers it

Part D (forms used at home). Part A during a covered inpatient stay. No Part B clinician-administered form in the CMS Part B spending file.

What it treats

Glipizide and metformin hydrochloride tablets are used, along with diet and exercise, to improve blood sugar control in adults with type 2 diabetes mellitus.

What it is for, in depth

This combination tablet is for adults with type 2 diabetes whose blood sugar is not controlled well enough by diet and exercise alone, and it has been studied both as a first treatment and as a second-line treatment after one of its ingredients alone. Putting glipizide and metformin in one tablet pairs a drug that increases insulin release with a drug that cuts liver glucose production and improves insulin sensitivity, so the two reinforce each other. Blood sugar should be monitored during dose changes, and HbA1c should be checked about every 3 months to judge how well therapy is working. The tablets come in three film-coated strengths: 2.5 mg glipizide with 250 mg metformin, 2.5 mg with 500 mg, and 5 mg with 500 mg.

How it works

The tablet combines two diabetes drugs that work in different, complementary ways. Glipizide makes the pancreas release more insulin, especially after meals, while metformin lowers the amount of glucose the liver produces, reduces glucose absorbed from food, and helps the body respond better to insulin.

How it is taken

The tablets are taken by mouth with meals, starting at a low dose that is raised gradually; the dose is set for each person and must not go above 20 mg of glipizide and 2000 mg of metformin per day. Starting low and increasing slowly helps avoid low blood sugar (mainly from the glipizide) and stomach side effects (mainly from the metformin). If you also take colesevelam, take this medicine at least 4 hours before it.

Common side effects

In the label's clinical trials, the most common effects included diarrhea, headache, upper respiratory infection, nausea and vomiting, abdominal pain, dizziness, and muscle or joint pain. Stomach effects such as diarrhea and nausea come mainly from the metformin part of the tablet.

Serious warnings

The metformin in this tablet can cause a rare but serious build-up of lactic acid in the blood, called metformin-associated lactic acidosis, especially when the kidneys are not working well, so kidney function should be checked regularly to help prevent it. The glipizide part can cause low blood sugar, which is a particular risk for older, weakened, or malnourished people. This medicine must not be used by people with severe kidney damage or with metabolic acidosis, including diabetic ketoacidosis, which should be treated with insulin instead.

Who should be careful

Do not take it if your kidneys are severely impaired (eGFR below 30), if you are allergic to glipizide or metformin, or if you have acute or chronic metabolic acidosis, including diabetic ketoacidosis. It is not recommended during pregnancy or for children. Older adults should start and stay on conservative doses because kidney function often declines with age, and older, debilitated, or malnourished patients should generally not be raised to the maximum dose because of low blood sugar risk.

Major interactions

Certain drugs can raise blood sugar and cause loss of control, including thiazides and other diuretics, corticosteroids, phenothiazines, thyroid products, estrogens, oral contraceptives, phenytoin, nicotinic acid, sympathomimetics, calcium channel blocking drugs, and isoniazid. If one of these drugs is stopped while you take this medicine, watch closely for low blood sugar instead. Taking colesevelam at the same time lowers how much glipizide the body absorbs, so the two should be spaced at least 4 hours apart.

Cost and saving notes

Glipizide-metformin is covered under Medicare Part D. If your plan's tier makes it hard to afford, you can ask your plan for a tier exception to pay a lower tier price. If you qualify for Extra Help, the Part D low-income help, your drug costs will be much lower.

Why it is in its tier

Glipizide / metformin (Metaglip and others) sits on Tier 1 in 85.05% of the plans that list it (4665 of 5485 listing plans). Tier 1 is the preferred generic tier — the lowest copays, often $0-$15. The data-visible drivers: It is a generic product, and the CMS dashboard puts its average Part D spending at about $203 per beneficiary for 2024 — a relatively low-cost drug, which matches where plans place it. It is listed by 99.82% of Part D plans. The tier shown is the most common one; individual plans vary.

Sources

• GLIPIZIDE AND METFORMIN HYDROCHLORIDE TABLET, FILM COATED [REMEDYREPACK INC.] — DailyMed
• MedlinePlus — Glipizide

What official patient guides say

This combination tablet (glipizide and metformin) has no separate MedlinePlus page — the MedlinePlus Drug Information A-Z index for the letter G, checked 2026-10-31, lists a Glipizide page and a Glyburide and Metformin combination page, but no page for the glipizide and metformin combination. The daily-life facts below therefore come from the MedlinePlus Glipizide page, for the first-named ingredient (glipizide) of this combination tablet. Glipizide comes as tablets and extended-release (long-acting) tablets to take by mouth. The regular tablet is usually taken one or more times a day, 30 minutes before breakfast or meals. The extended-release tablet is usually taken once a day with breakfast, and the extended-release tablets are swallowed whole — do not chew, divide, or crush them. To help you remember to take glipizide, take it around the same time(s) every day. Take glipizide exactly as directed — do not take more or less of it or take it more often than prescribed by your doctor. Your doctor will probably start you on a low dose of glipizide and gradually increase your dose if needed. Glipizide helps control blood sugar but does not cure diabetes. Continue to take glipizide even if you feel well, and do not stop taking glipizide without talking to your doctor. If you forget a dose: before you start to take glipizide, ask your doctor what you should do if you forget to take a dose, and write these directions down so that you can refer to them later. As a general rule, take the missed dose as soon as you remember it. If it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one. Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

Source: MedlinePlus — Glipizide

Part D formulary coverage

Source: CMS Prescription Drug Plan Formulary, Pharmacy Network, and Pricing Information Files — Monthly file 2026-10-15 (plan year 2027), file 2027_20261008.zip (data.cms.gov dataset ed1496ea-23e7-41f1-9292-172fa842ccfb): basic drugs formulary file + plan information file, both dated 20261031 inside the zip; downloaded and aggregated 2026-10-30. Medication RxCUI sets resolved through the NLM RxNav (RxNorm) API.

What you pay

Without insurance, the cash benchmark is 0.22333 per unit (GLIPIZIDE-METFORMIN 2.5-250 MG) — about nan for 30 units. NADAC benchmark — the average price pharmacies pay (CMS, as of 2026-11-04). Pharmacy shelf prices vary.

A tier is not a price; what you pay depends on your plan, pharmacy, and benefit stage; Extra Help or Medicaid can lower it further.

Sources: CMS Plan Benefit Package + formulary data; CMS NADAC · Checked 2026-11-08

Coverage by plan and tier

Of the 5,495 Medicare drug plans we track for 2027, 5,485 list Glipizide / metformin (Metaglip and others) — 99.8% of plans. Most of those plans put it on Tier 1: 4,665 plans, 85.0% of the plans that list it. Other plans place it on Tier 6 (705 plans), Tier 2 (110 plans) or Tier 5 (3 plans). For example: Aetna Medicare Dual Extra (HMO D-SNP) puts it on Tier 1; Aetna Medicare Dual Extra Care (PPO D-SNP) puts it on Tier 1; Aetna Medicare Value Plus (PPO) puts it on Tier 1. You can compare these plans side by side on our Medicare Advantage hub. A tier is not a price. What you pay also depends on whether you have met your plan';s deductible, whether the drug costs a flat copay or a share of the price, and whether you get Extra Help or Medicaid.

Read next

• Part D in 2027: The $700 Deductible, the $2,400 Cap, and the $35 Insulin Rule
• Extra Help in 2027: Lower Drug Copays and Who Qualifies
• Checking Medicare Savings Programs and Extra Help

Part D spending averages (2024)

Source: CMS Medicare Part D Spending by Drug (Drug Spending Dashboard), release RY26 P04 V10, data through 2024 (DSD_PTD_RY26_P04_V10_DY24_BGM.csv), downloaded 2026-10-30

Companies covering this drug

Part D and Medicare Advantage plan sponsors that list this drug on a formulary, 50 at a time.