Glipizide (Glucotrol, Glucotrol XL, and others)

How Medicare covers it

Part D (tablets and extended-release tablets taken 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 is used, along with diet and exercise, to improve blood sugar control in adults with type 2 diabetes. It is a sulfonylurea tablet taken by mouth. It is not for type 1 diabetes or diabetic ketoacidosis (a dangerous buildup of acids in the blood), which must be treated with insulin. Blood sugar and A1C should be checked regularly to find the lowest dose that works and to catch loss of control early.

What it is for, in depth

Glipizide is a sulfonylurea used as an add-on to diet and exercise — the label's wording is 'as an adjunct to diet and exercise' — to improve blood sugar control in adults with type 2 diabetes. It fits patients whose pancreas still produces insulin and who need extra help, mainly with blood sugar rises after meals. The label notes that short-term use may be enough during temporary loss of control in someone usually controlled by diet alone, and that some patients who no longer respond to other sulfonylureas may still respond to glipizide; it also describes switching stable patients from insulin or other oral diabetes drugs under a prescriber's direction. It is not for type 1 diabetes or diabetic ketoacidosis. It comes as 5 mg and 10 mg tablets.

How it works

Glipizide lowers blood sugar mainly by making the pancreas release more insulin from its beta cells, especially after a meal. The insulin response starts within about 30 minutes of a dose. Because of this, it only works if the pancreas can still make insulin. Effects on blood sugar can last up to 24 hours after a single dose, even as drug levels in the blood fall.

How it is taken

Tablets (5 mg and 10 mg) by mouth, usually about 30 minutes before a meal so it works best on the rise in blood sugar after eating. The usual starting dose is 5 mg before breakfast; older adults or people with liver disease may start at 2.5 mg. Doses are raised slowly, by 2.5 mg to 5 mg at a time. The most that should be taken once a day is 15 mg; the total daily maximum is 40 mg, with higher doses split before meals.

Common side effects

The most common problems are stomach-related: nausea and diarrhea (about 1 in 70 people), and constipation and stomach ache (about 1 in 100). Dizziness, drowsiness, and headache each occurred in about 1 in 50 people and usually pass. Allergic skin reactions — redness, rash, hives, and itching — occurred in about 1 in 70. Low blood sugar (hypoglycemia) can also occur and is covered in the warnings. Serious reactions were uncommon, and only about 1.5% of patients stopped the drug because of side effects.

Serious warnings

All sulfonylureas, including glipizide, can cause severe low blood sugar, which can be prolonged in people with kidney or liver problems. The label also carries a special warning, based on an older study of a related drug (tolbutamide), that oral diabetes drugs were linked with a higher risk of death from heart and blood vessel problems than diet alone or diet plus insulin. Loss of blood sugar control can happen during fever, infection, injury, or surgery, when insulin may be needed for a time.

Who should be careful

Older, frail, or undernourished people, and those with kidney, liver, adrenal, or pituitary problems, are more likely to develop low blood sugar, which can be hard to spot in older adults and in people taking beta-blockers. People with type 1 diabetes or ketoacidosis must not use it, nor should anyone allergic to it. Safety in children has not been established. In pregnancy it should be used only if the benefit justifies the risk; experts often recommend insulin instead.

Major interactions

Many drugs can make glipizide lower blood sugar too much, including some NSAID pain relievers, azole antifungals such as fluconazole and miconazole, salicylates, sulfonamide antibiotics, chloramphenicol, probenecid, blood thinners such as coumarins, MAO inhibitors, quinolones, and beta-blockers. Other drugs can raise blood sugar and cause loss of control, including water pills (thiazides), steroids, thyroid products, estrogen, phenytoin, and isoniazid. The cholesterol drug colesevelam can reduce glipizide absorption, so glipizide should be taken at least 4 hours before it.

Why it is in its tier

Glipizide is most commonly placed on Tier 1 — the preferred generic tier, which usually carries the lowest copays, often $0 to $15 — in the 2027 Part D formulary data used here: Tier 1 is the modal (most common) tier in 86.08% of listing plans, and the drug is listed by 100% of plans. Glipizide is a generic medicine, not a brand. CMS Part D dashboard data for 2024 show average program spending of $36.96 per beneficiary — that is an average spending figure for the program, not a copay and not what any one patient pays. The tier shown is the most common placement across plans, and individual plans vary, so check your own plan's formulary for your exact cost.

Sources

• GLIPIZIDE TABLET [ANI PHARMACEUTICALS, INC.] — DailyMed
• MedlinePlus — National Library of Medicine
• MedlinePlus — Glipizide

What official patient guides say

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, while the extended-release tablet is usually taken once a day with breakfast — at around the same time(s) every day, and extended-release tablets should be swallowed whole and not chewed, divided, or crushed. MedlinePlus advises asking your doctor before you start what to do if you forget a dose and writing those directions down; as a general rule, take the missed dose as soon as you remember it, but if it is almost time for the next dose, skip the missed dose and continue your regular schedule — do not take a double dose to make up for a missed one. Keep it in the container it came in, tightly closed and out of reach of children, stored 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 0.04258 per unit (GLIPIZIDE 10 MG TABLET) — 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, 5,495 list Glipizide (Glucotrol, Glucotrol XL, and others) — 100% of plans. Most of those plans put it on Tier 1: 4,730 plans, 86.1% of the plans that list it. Other plans place it on Tier 6 (715 plans), Tier 2 (47 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

• 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.