Repaglinide

What is Repaglinide (Prandin)?

Repaglinide is an oral medication your doctor may prescribe to regulate blood sugar level control in the treatment of your type 2 diabetes mellitus. It belongs to a class of medications known as meglitinides, or simply Glinides for short. If needed, other diabetes medicines can be sometimes prescribed together with it. It should be used in addition to a healthy diet and regular exercise.

What is it used for?

Repaglinide is used to help lower blood sugar levels in patients with type 2 diabetes whose blood sugar levels cannot be regulated by diet and exercise alone. It can also be used in combination with metformin or rosiglitazone to help lower blood sugar levels in patients whose blood sugar levels cannot be regulated by diet and exercise only, or with metformin or rosiglitazone alone.

How does Repaglinide (Prandin) work?

Repaglinide is an oral antidiabetic drug that helps your body release more insulin when your blood sugar levels get too high. It is part of a class of drugs called meglitinides, as mentioned above. It works by lowering blood sugar levels by stimulating the release of insulin from the beta cells of the pancreas. Insulin itself regulates the breakdown of food (carbohydrates, fats and protein) by promoting the absorption of sugar from the blood into fat, liver and skeletal muscle cells.

How to take this medication

Your doctor will prescribe Repaglinide depending on your individual needs. You should always take it exactly as prescribed by your doctor. The dose can be taken with food, usually 15 minutes before a meal. However, it may be taken 30 minutes before a meal or even right before a meal.

Dosage

Always follow the directions on the prescription label. To get the best results, your doctor may occasionally change your dose. Never take it in bigger or smaller amounts or for longer or shorter period than recommended by your doctor.

Repaglinide is usually taken two to four times a day, within 30 minutes before a meal. If you should happen to skip a meal, do not take that missed dose and just wait until your next meal.

The recommended dose range is in between 0.5 to 4 mg orally with each meal, with the maximum recommended daily dose being 16 mg.

Individualized Therapy

For patients who have not been previously treated with any other diabetes medication, or whose average longer-term blood sugar level, as measured by glycosylated hemoglobin (HbA1c), is less than 8%, the initial dose is usually 0.5 mg orally with each meal. For patients who have been previously treated with antidiabetic agents or whose HbA1c is 8% or higher, the initial dose is usually 1 to 2 mg orally with each meal.

Dose adjustments are commonly made in response to your own blood sugar response. Your doctor may double your dose up to a maximum meal time dose of 4 mg until a satisfactory blood sugar level response is achieved. You should allow at least one week to assess your blood sugar level response after each dose adjustment.

Your blood sugar levels will need to be checked often, and your doctor may require you to take other blood tests. Your blood sugar level should be carefully monitored during times of stress, illness, travel, surgery or a medical emergency, strenuous exercise, or if you happen to drink alcohol or skip meals. All of these things may affect your blood sugar levels and your dose needs may also change because of them. Never change your schedule or dose without your doctor’s advice.

Repaglinide is only a part of your treatment program that may also include a healthy diet, regular exercise, supervised weight control, frequent blood sugar level testing, and special medical care. Always follow your doctor’s instructions as close as possible.

Overdose

If you happen to take more Repaglinide than you should your blood sugar level may become too low, leading to what is called a hypoglycemic event. The symptoms of such an event include headache, nausea, dizziness, tiredness, nervousness, rapid heartbeat, shakiness and sweating. Contact your doctor immediately if you experience any of these symptoms.

Warnings and Precautions

Do not take the drug:

• If you have any known hypersensitivity or allergy to Repaglinide, or any of the other ingredients
• If you have type 1 diabetes
• If you have severe liver disease
• If you suffer from diabetic ketoacidosis (an accumulation of ketones in the blood and urine)
• If you are taking the drug gemfibrozil (used to lower increased fat levels in the blood)
• If you are taking the drug clopidogrel (used to prevent blood clots)

It is not recommended for the treatment of children and adolescents less than 18 years of age.

It may cause hypoglycemia (low blood sugar), specifically if you happen to skip a meal, exercise for extended lengths of time, drink a lot of alcohol or use other diabetes medications.

Ask your doctor about the symptoms of low blood sugar levels and what to do if you experience them. You should always remember to test your blood sugar levels as instructed by your doctor.