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Glipizide / metformin Side Effects

Medically reviewed by Last updated on Nov 22, 2022.


More frequently reported side effects include: decreased vitamin b12 serum concentrate. Continue reading for a comprehensive list of adverse effects.

Applies to glipizide / metformin: oral tablet.


Oral route (Tablet)

Lactic acidosis is a rare, but serious, metabolic complication that can occur due to metformin accumulation during treatment with glipiZIDE/metformin hydrochloride; when it occurs, it is fatal in approximately 50% of cases. The risk of lactic acidosis increases with renal impairment, increased age, diabetes mellitus, congestive heart failure, hepatic insufficiency, and other conditions whenever there is significant tissue hypoperfusion and hypoxemia. Treatment with glipiZIDE/metformin hydrochloride should not be initiated in patients 80 years of age or older unless measurement of creatinine clearance demonstrates that renal function is normal. Therapy should temporarily be discontinued prior to any intravascular radiocontrast study or surgical procedure. Avoid excessive alcohol use since alcohol potentiates the effects of metformin on lactate metabolism. Discontinue therapy immediately and institute supportive measures promptly for suspected lactic acidosis.

Serious side effects

Along with its needed effects, glipizide / metformin may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking glipizide / metformin:

More common

Less common

  • Bladder pain
  • bloody or cloudy urine
  • difficult, burning, or painful urination
  • frequent urge to urinate
  • lower back or side pain
  • pounding in the ears
  • slow heartbeat


Symptoms of Overdose

Get emergency help immediately if any of the following symptoms of overdose occur while taking glipizide / metformin:

  • Abdominal discomfort
  • anxiety
  • behavior change, similar to drunkenness
  • blurred vision
  • cold sweats
  • coma
  • confusion
  • cool, pale skin
  • decreased appetite
  • diarrhea
  • difficulty in concentrating
  • drowsiness
  • excessive hunger
  • fast heartbeat
  • fast, shallow breathing
  • general feeling of discomfort
  • headache
  • muscle pain or cramping
  • nausea
  • nervousness
  • nightmares
  • restless sleep
  • seizures
  • shakiness
  • slurred speech
  • unusual sleepiness
  • unusual tiredness or weakness

Other side effects

Some side effects of glipizide / metformin may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More Common

  • Muscle or bone pain
  • stomach pain
  • vomiting

For Healthcare Professionals

Applies to glipizide / metformin: oral tablet.


Metabolic side effects, including lactic acidosis, which is a potentially fatal metabolic complication of biguanide therapy, has been reported in patients receiving metformin. The incidence of lactic acidosis has been about 0.03 cases per 1,000 patient years with approximately 0.015 fatal cases per 1,000 patient-years. The risk of lactic acidosis is particularly high in patients with underlying renal insufficiency. Cases of lactic acidosis occurring in patients with normal renal function have been rarely reported. Concomitant cardiovascular or liver disease, sepsis, and hypoxia may also increase the risk of lactic acidosis.[Ref]


Very Common (10% or more): Hypoglycemia (up to 12.6%)


Common (1% to 10%): Hypoglycemia


Rare (less than 0.1%): Lactic acidosis[Ref]


Very common (10% or more): Diarrhea (up to 18.4%)

Common (1% to 10%): Nausea/vomiting, abdominal pain[Ref]



Frequency not reported: Hemolytic anemia

Postmarketing reports: Hemolytic anemia in patients not known to have G6PD deficiency


Common (1% to 10%): Subnormal vitamin B12 levels

Frequency not reported: Anemia[Ref]



Rare (less than 0.1%): Cholestatic and hepatocellular hepatic injury accompanied by jaundice[Ref]


Very common (10% or more): Upper respiratory infection (up to 10.3%)[Ref]


Common (1% to 10%): Urinary tract infection[Ref]


Common (1% to 10%): Hypertension[Ref]

Nervous system

Very common (10% or more): Headache (up to 12.6%)

Common (1% to 10%): Dizziness[Ref]


Common (1% to 10%):: Musculoskeletal pain.[Ref]


1. Product Information. Metaglip (glipizide-metformin). Bristol-Myers Squibb. 2002.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.