Repaglinide

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Generic Name: Repaglinide Brand Name(s): Generics only. No brands available.

Uses

What is Repaglinide used for?

Repaglinide is used alone or with other medications to control high blood sugar along with a proper diet and exercise program. It is used in people with type 2 diabetes. Controlling high blood sugar helps prevent kidney damage, blindness, nerve problems, loss of limbs, and sexual function problems. Proper control of diabetes may also lessen your risk of a heart attack or stroke. It works by stimulating the body to produce more insulin. Insulin is a natural substance that allows the body to properly use sugar from the diet.

How should I take Repaglinide?

Take this medication by mouth 15 minutes before each meal, usually 2-4 times daily depending on the number of meals or as directed by your doctor. Take this drug no earlier than 30 minutes before the meal. You may also take it just before the meal if necessary. Do not take a dose of medication if you are skipping that meal or if your blood sugar is low.

The dosage is based on your medical condition, response to treatment, and other medications you may be taking. Be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

If you are changing from a different diabetes drug (such as chlorpropamide) to repaglinide, follow your doctor’s directions carefully for stopping the old drug and starting this medication.

Use this medication regularly as directed by your doctor in order to get the most benefit from it. Carefully follow the medication treatment plan, meal plan, and exercise program your doctor has recommended.

Check your blood sugar regularly as directed by your doctor. Keep track of the results, and share them with your doctor. This is very important in order to determine the correct dose. Tell your doctor if your blood sugar measurements are too high or too low. Your treatment plan may need to be changed.

How do I store Repaglinide?

Repaglinide is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store Repaglinide in the bathroom or the freezer. There may be different brands of Repaglinide that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush Repaglinide down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using Repaglinide?

Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney disease, liver disease.

You may experience blurred vision, dizziness, or drowsiness due to extremely low or high blood sugar. Do not drive, use machinery, or do any activity that requires alertness or clear vision until you are sure you can perform such activities safely.

Limit alcohol while taking this medication because it can increase the risk of developing low blood sugar.

During times of stress, such as fever, infection, injury, or surgery, it may be more difficult to control your blood sugar. Consult your doctor because increased stress may require a change in your treatment plan, medications, or blood sugar testing.

During pregnancy this medication should be used only when clearly needed. Pregnancy may cause or worsen diabetes. Discuss a plan with your doctor for managing your blood sugar while pregnant. Your doctor may change your diabetes treatment during your pregnancy. Discuss the risks and benefits of different treatments (such as diet, exercise, and medications including insulin).

It is unknown if this drug passes into breast milk. Because of possible risk to the infant, breast-feeding while using this drug is not recommended. Consult your doctor before breast-feeding.

Is it safe during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using this Repaglinide during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking Repaglinide. Repaglinide is pregnancy risk category C according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk,
  • B=No risk in some studies,
  • C=There may be some risk,
  • D=Positive evidence of risk,
  • X=Contraindicated,
  • N=Unknown

Side effects

What side effects can occur from Repaglinide?

Weight gain, diarrhea, and joint pain may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Repaglinide can cause low blood sugar (hypoglycemia) especially if you are taking other medicines for diabetes. Consuming large quantities of alcohol, not getting enough calories from food, or doing unusually heavy exercise may also lead to low blood sugar. Symptoms may include chills, cold sweat, dizziness, drowsiness, shaking, fast heartbeat, weakness, headache, fainting, tingling of the hands or feet, or hunger. It is a good habit to carry glucose tablets or gel to treat low blood sugar. If you don’t have these reliable forms of glucose, raise your blood sugar quickly by eating a quick source of sugar such as table sugar, honey, candy, or drinking a glass of fruit juice or non-diet soda. Check with your doctor or pharmacist to find out what you should do if you miss a meal.

Symptoms of high blood sugar (hyperglycemia) include thirst, increased urination, confusion, drowsiness, flushing, rapid breathing, and fruity breath odor. If these symptoms occur, tell your doctor right away. Your doctor may need to adjust your diabetes medication(s).

A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any of the following symptoms of a serious allergic reaction: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Repaglinide?

A product that may interact with this drug is: NPH insulin.

Other medications can affect the removal of repaglinide from your body, which may affect how repaglinide works. Examples include clopidogrel, gemfibrozil, trimethoprim, azole antifungals (such as itraconazole), macrolide antibiotics (such as erythromycin), rifamycins (such as rifabutin), St. John’s wort, among others.

Many drugs can affect your blood sugar, making it harder to control. Examples include corticosteroids (such as prednisone), psychiatric medicines (such as olanzapine), fluoroquinolone antibiotics (such as ciprofloxacin), among others. Check your blood sugar regularly as directed and share the results with your doctor. Tell your doctor right away if you have symptoms of high or low blood sugar. (See also Side Effects section.) Your doctor may need to adjust your diabetes medication, exercise program, or diet.

Beta-blocker medications (such as metoprolol, propranolol, glaucoma eye drops such as timolol) may prevent the fast/pounding heartbeat you would usually feel when your blood sugar falls too low (hypoglycemia). Other symptoms of low blood sugar such as dizziness, hunger, or sweating are unaffected by these drugs.

Check the labels on all your medicines (such as cough-and-cold products) carefully. Some products may contain sugar or alcohol and may affect your blood sugar. Ask your doctor or pharmacist about using these products safely.

Other medications can affect the results of urine tests for sugar or ketones. Consult your doctor or pharmacist for more information.

Repaglinide may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Does food or alcohol interact with Repaglinide?

Repaglinide may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Repaglinide?

Repaglinide may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this Repaglinide.

What is the dose of Repaglinide for an adult?

Usual Adult Dose for Diabetes Type 2

Individualize therapy:

Dose preprandially 2, 3, or 4 times a day

-For patients not previously treated with antidiabetic agents or whose glycosylated hemoglobin (HbA1c) is less than 8%:

Initial dose: 0.5 mg orally with each meal

-For patients previously treated with antidiabetic agents or whose HbA1c is 8% or higher:

Initial dose: 1 or 2 mg orally with each meal

Dose Adjustments: Based upon blood glucose response, double the preprandial dose up to a maximum meal time dose of 4 mg until satisfactory glycemic response is achieved; allow at least 1 week to assess response after each dose adjustment.

Recommended Dose Range: 0.5 to 4 mg orally with each meal

Maximum Daily Dose: 16 mg per day

Comments:

-Fasting blood glucose concentrations are generally used to adjust doses, however, postprandial glucose levels may be used in patients whose pre-meal blood glucose levels are satisfactory but whose overall glycemic control (HbA1c) is inadequate.

-When hypoglycemia occurs in patients taking this drug in combination with a thiazolidinedione or metformin, the dose of this drug should be reduced.

Use: As an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.

Renal Dose Adjustments

Use with caution; allow longer intervals between dose adjustments to fully assess response.

Liver Dose Adjustments

Use with caution; allow longer intervals between dose adjustments to fully assess response.

Dose Adjustments

Debilitated or malnourished patients: Initial and maintenance dose should be conservative with careful dose titration

Patients switching from other oral hypoglycemic agents:

-When switching to this drug from another oral antidiabetic agent, this drug may be started the day after the final dose of the other oral antidiabetic agent; monitor patients carefully for overlapping drug effects.

Combination Therapy:

-If monotherapy does not result in adequate glycemic control, metformin or a thiazolidinedione may be added.

-This drug is not indicated for use in combination with NPH-insulin.

Hypoglycemia:

-If hypoglycemia occurs with concomitant use of thiazolidinedione or with metformin, the dose of repaglinide should be reduced.

Dose adjustments may be necessary with concomitant use of CYP450 2C8 and CYP450 3A4 inhibitors and inducers.

Other Comments

Administration advice:

-Take orally before meals, usually within 15 minutes of a meal; however, may vary from immediately preceding meal to up to 30 minutes before a meal.

-Patients who skip a meal should be instructed to skip the dose for that meal; if an extra meal is taken, patients should be instructed to add a dose to cover the meal.

General:

-This drug may be used as monotherapy or in combination with metformin or a thiazolidinedione; this drug is not indicated for use in combination with NPH insulin.

-This drug is not indicated to treat patients with type 1 diabetes or diabetic ketoacidosis as these conditions should be treated with insulin.

-Short-term administration may be sufficient during periods of transient loss of control in patients usually well-controlled by diet.

-Secondary failure may occur; prior to classifying a patient as a secondary failure it is important to assess dose and dietary adherence.

Monitoring:

-Periodic measures of fasting blood glucose and glycosylated hemoglobin should be performed to assess efficacy.

Patient advice:

-Patients should understand the importance of adhering to dietary instructions and regular physical activity; during periods of stress such as fever, trauma, infection, or surgery, management of diabetes may change and patients should be advised to seek medical advice.

-Patients should be aware of the symptoms of hypoglycemia and be careful about driving and the use of machinery, especially when optimum stabilization has not been achieved, e.g., during a transition from other medications or during irregular use.

-Advise patient to speak to physician or health care professional if pregnant, intend to become pregnant, or are breastfeeding.

What is the dose of Repaglinide for a child?

The dosage has not been established in pediatric patients. It may be unsafe for your child. It is always important to fully understand the safety of the drug before using. Please consult with your doctor or pharmacist for more information.

How is Repaglinide available?

Repaglinide is available in the following dosage forms and strengths:

  • Oral tablet.

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Repaglinide, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Review Date: April 21, 2018 | Last Modified: April 21, 2018

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