Key Takeaways
Repaglinide helps reduce after-meal glucose spikes by prompting rapid insulin release. This guide explains how it works, standard dosing patterns, safety considerations, and how it fits alongside other treatments.
- Meal-timed dosing: Taken before meals to blunt spikes.
- Short action window: Targets post-meal glucose excursions.
- Flexible use: Skip a dose if you skip a meal.
- Hypoglycemia risk: Monitor closely with dose changes.
Repaglinide: Key Facts
Repaglinide is an oral antihyperglycemic medicine for adults with type 2 diabetes. It is a rapid-acting insulin secretagogue (insulin-releasing drug) used to reduce postprandial hyperglycemia (after-meal high blood sugar). The drug’s brand name is Prandin, and its generic name is repaglinide. You may see it pronounced reh-PAG-lin-ide, which can help during clinic visits.
Clinically, it belongs to the meglitinides, a distinct group from sulfonylureas. For classification clarity, the term repaglinide class typically refers to the meglitinide class of insulin secretagogues. Many patients appreciate its short duration, which suits variable meal timing. For background on how secretagogues compare across outcomes, see Insulin Secretagogues for mechanism, benefits, and risks.
How It Works on Blood Glucose
This medicine stimulates pancreatic beta cells to release insulin when glucose rises after you eat. It closes ATP-sensitive potassium channels, which depolarizes the beta-cell membrane and opens calcium channels; calcium entry triggers insulin granule exocytosis (insulin release). This mechanism acts quickly and fades within several hours, matching typical meal patterns.
Clinicians describe this as the repaglinide mechanism of action, which focuses on controlling postprandial glucose rather than fasting levels. Because the effect is glucose-dependent, most insulin release occurs when blood sugar rises after a meal. For safety details summarized for prescribers, see the FDA prescribing information, which outlines pharmacology and key warnings. For a broader context on oral therapies, see Common Diabetes Medications for class-by-class comparisons.
Dosing and Administration
Most adults take the medicine 15–30 minutes before each main meal, aligning action to the carbohydrate load. Typical strategies emphasize meal-based titration, with smaller doses at lighter meals and omission when meals are skipped. The available strengths include 0.5 mg, 1 mg, and 2 mg tablets. Discuss a tailored plan for your eating schedule, activity level, and co-therapies.
Prescribers individualize the repaglinide dosage for adults based on blood glucose patterns, A1C results, and tolerance. Your dose frequency depends on meals per day, and total dose per day varies accordingly. Many patients start cautiously and adjust over time to reduce hypoglycemia risk. For details about timing and titration frameworks, see Repaglinide Dosage for clinical titration principles and examples.
Chronic Kidney Disease Considerations
Patients with impaired renal function require careful introduction and monitoring. Although hepatic metabolism plays a major role, kidney disease can still influence overall exposure and hypoglycemia risk through changes in meal patterns, comorbidities, and concomitant drugs. Clinicians typically use lower starting doses and longer intervals between adjustments while monitoring fasting and postprandial readings.
Because of these variables, guidance on repaglinide dose in ckd emphasizes caution, conservative uptitration, and frequent glucose checks. Consider potential interactions with other renally dosed drugs as well. For post-meal pattern tracking and symptom awareness, see Postprandial Hyperglycemia for signs, monitoring ideas, and next steps.
Safety and Contraindications
Use this medicine only when type 2 diabetes is established and dietary carbohydrate intake is predictable. It is not indicated for type 1 diabetes or diabetic ketoacidosis. Gemfibrozil coadministration significantly increases drug levels and is generally avoided. Always review medication lists, including over-the-counter products and supplements, before starting or changing therapy.
Prescribing references summarize repaglinide contraindications and precautions, including situations with severe metabolic instability. For a vetted overview of risks and prescriber guidance, the FDA prescribing information details drug–drug interactions and hypoglycemia warnings. For high-level care pathways and monitoring standards, the ADA Standards of Care discuss pharmacologic approaches to glycemic treatment. For broader management frameworks, see Diabetes Treatment for lifestyle and medication strategy overviews.
Side Effects and Weight Considerations
The most reported issue is low blood sugar, particularly with delayed or missed meals after dosing. Other reactions may include headache, mild gastrointestinal discomfort, or upper respiratory symptoms. Individual responses vary, and the overall risk depends on dose timing, meal composition, and combination therapy choices. Keep a record of symptoms and blood glucose patterns during the first few weeks.
Clinicians often group these under repaglinide side effects, highlighting hypoglycemia as the key concern. Modest weight gain can occur when total insulin exposure increases. If weight change becomes a pattern, discuss meal planning and activity adjustments with your care team. For patient-centered tips on recognizing and managing adverse effects, see Navigating Repaglinide Side Effects for warning signs and mitigation steps.
Drug Interactions and Monitoring
This medicine is metabolized primarily by CYP2C8 and to a lesser extent by CYP3A4. Potent inhibitors like gemfibrozil can markedly increase exposure, while inducers may reduce effect. Caution is warranted when combining with agents that also lower glucose, such as insulin or other secretagogues. Clarify all prescription and nonprescription drugs, and reassess if new therapies are added.
Monitoring typically includes self-measured pre- and post-meal glucose and periodic A1C. Carry a quick source of carbohydrate for unexpected lows. If you also use metformin, understand each drug’s hypoglycemia profile and how they interact with meals; for an overview, see Metformin Hypoglycemia for risk context and recognition. For class-level context, see Oral Diabetes Medication for how different agents fit into care plans.
Formulations, Brands, and Access
Tablets are commonly available in 0.5 mg, 1 mg, and 2 mg strengths. The repaglinide brand name historically was Prandin, though generic versions are widely used. Practical access depends on local formularies and pharmacy stock. If you need a quick reference to available strengths, review the product listing for clarity and packaging details.
When discussing ceilings, clinicians may reference a repaglinide max dose to frame safe titration limits. In practice, individual response, meal patterns, and concomitant therapies guide the final plan. For product details and strengths, see Repaglinide for a concise listing and labeling summary. For non-secretagogue options and add-on choices, compare mechanisms in Oral Diabetes Medication to understand how combinations may complement each other.
Comparisons and Practical Use Cases
Compared with sulfonylureas, this drug acts faster and for a shorter duration. That makes it useful for targeting post-meal spikes and for people with variable meal schedules. It is not a sulfonylurea, though both are insulin secretagogues. Some clinicians pair it with metformin when postprandial elevations persist after lifestyle measures.
People who eat irregularly may value its dose-per-meal flexibility. Those prone to missed meals should plan for hypoglycemia prevention, such as carrying glucose tablets and spacing activities around doses. For an overview of how oral drugs differ by onset, duration, and targets, see Common Diabetes Medications for comparative profiles. To explore when mealtime control matters most, see Postprandial Hyperglycemia for symptom patterns and testing approaches.
Tip: If you skip a meal, skip that dose to reduce low blood sugar risk.
Note: Alcohol can increase hypoglycemia risk; discuss safer use with your clinician.
Further Reading and Related Topics
For dose-timing illustrations and adjustment logic, review Repaglinide Dosage for prescriber-style frameworks and examples. For patient-focused side effect guidance, see Repaglinide Side Effects for identification and response steps. For high-level therapy sequencing, browse Diabetes Treatment to see how nutrition, activity, and medications align.
Curate your understanding across medication classes in Common Diabetes Medications to compare mechanisms and uses. If you want a single-page overview of oral options, see Oral Diabetes Medication for selection factors and safety notes. For an index of related topics, explore Type 2 Diabetes for articles organized by condition and treatment focus.
Recap
This short-acting secretagogue targets after-meal glucose and offers dose-per-meal flexibility. Its benefits depend on consistent meal timing, careful titration, and awareness of hypoglycemia. Safety depends on screening interactions and monitoring patterns during dose changes. Work with your healthcare team to align therapy with your meals, activity, and glycemic goals.
This content is for informational purposes only and is not a substitute for professional medical advice.
