Classes
DEA Class; Rx
Common Brand Names; Prandin
- Antidiabetics, Meglitinides Derivatives
Description
Meglitinide oral hypoglycemic agent; stimulates insulin secretion
Rapid onset and short duration of action replicates physiological insulin profiles around meals
Used for the treatment of type 2 diabetes mellitus in adults; not commonly used as monotherapy
Indications
Indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus
Contraindications
Hypersensitivity to repaglinide
Diabetic ketoacidosis
Type I diabetes mellitus
Coadministration of gemfibrozil results in increased repaglinide plasma concentration (8-fold increase); may lead to severe hypoglycemia
Adverse Effects
- Hypoglycemia (16-31%)
- Upper respiratory infection (10-16%)
- Headache (9-11%)
- Back pain (5-6%)
- Sinusitis (3-6%)
- Arthralgia (3-6%)
- Bronchitis (2-6%)
- Diarrhea (4-5%)
- Serious CV events (4%; versus 3% incidence with glyburide and glipizide)
- Chest pain (2-3%)
- Constipation (2-3%)
- Increased LFTs
- Thrombocytopenia
- Leukopenia
- Hemolytic anemia
- Pancreatitis
- Visual disturbances
- Anaphylactoid reactions
Warnings
Stress due to infection, fever, trauma, or surgery; may need to discontinue if exposed to stress
Hepatic/renal insufficiency
Patients at risk of severe hypoglycemia: Elderly, debilitated, or malnourished; adrenal or pituitary insufficiency
Myocardial ischemia reported in patients treated concomitantly with NPH-insulin; not indicated for use in combination with NPH-insulin
Use caution in elderly and malnourished patients
Pregnancy or lactation
The use of sulfonylureas may be associated with increased cardiovascular events
Drugs that inhibit organic anion transporting protein OATP1B1 (eg, cyclosporine) may increase plasma concentrations of repaglinide, which is a substrate for active hepatic uptake transporter OATP1B1
Pregnancy and Lactation
Limited available data from case reports and case series have not identified a drug-associated risk of major birth defects, miscarriage or adverse maternal, or fetal outcomes in women taking repaglinide while pregnant
Detected in breast milk of rat dams and lowered blood glucose levels were observed in the pups
Maximum Dosage
16 mg/day PO.
16 mg/day PO.
Safety and efficacy have not been established.
Safety and efficacy have not been established.
How supplied
Repaglinide
tablet
- 0.5mg
- 1mg
- 2mg
