Repaglinide (Oral Route)

Repaglinide is used by people suffering from type II diabetes, and works by enhancing insulin production in the body.

Overview

Repaglinide (Prandin) is a medication that helps treat type II diabetes. It’s a prescription medication that’s in a group of medicines known as meglitinides, which help reduce the levels of blood sugar by making the pancreas secrete more insulin.

Repaglinide comes in the form of a tablet and is used before each meal. So if you miss a meal, you must miss your Repaglinide dose too.

Some common Repaglinide side effects include low levels of blood sugar, upper respiratory infections, and headaches.

Conditions treated

  • Type II diabetes mellitus

Type of medicine

  • Hypoglycemic

Side effects

Many medicines can bring about side effects, which may be very serious or less serious, long-lasting or temporary.

The Repaglinide side effects outlined below have been felt by at least 1% of people using this medicine. The majority of the side effects may be controlled, and some may vanish on their own eventually.

Contact your healthcare specialist if you suffer these effects and they’re troublesome or severe. Your pharmacist can give you advice on how to control the side effects.

  • Vomiting
  • Nausea
  • Diarrhea
  • Headache
  • Fatigue
  • Dizziness
  • Back pain
  • Constipation
  • Abdominal pain
  • Joint pain

While most of the following effects occur less often, they might result in serious issues if you don’t get medical attention.

Check with your healthcare professional promptly if you suffer any of the effects below:

  • Chills
  • Blood/cloudy urine
  • Difficult, painful, or burning urination
  • Fever
  • Cough

Signs of low blood sugar:

  • Anxious feeling
  • Excessive hunger
  • Cold sweats
  • Drunk-like behavior
  • Blurred vision
  • Confusion
  • Difficulty thinking
  • Cool pale skin
  • Drowsiness
  • Headache
  • Fast heartbeat
  • Nausea
  • Shakiness
  • Nervousness
  • Nightmares
  • Slurred speech
  • Restless sleep
  • Unusual weakness/tiredness
  • Shortness of breath
  • Runny/stuffy nose
  • Sinus congestion along with pain
  • Sore throat
  • Sneezing
  • Wheezing
  • Vision changes

Liver damage signs:

  • Fever
  • Fatigue
  • Loss of appetite
  • Dark urine
  • Yellow eyes/skin
  • Abdominal pain

Stop using Prandin and seek medical attention immediately if you suffer any of the effects below:

  • Chest pain
  • Fast/irregular heartbeat
  • Convulsions (seizures)
  • Unconsciousness

Signs of an allergic reaction:

  • Hives
  • Difficult breathing
  • Swelling of face/throat

Signs of bleeding:

  • Nosebleeds
  • Bleeding gums
  • Blood in urine
  • Vomiting blood
  • Easy bruising
  • Dark tarry stools

Some people may suffer other side effects not outlined above. See your doctor straight away if you have any symptom that bothers you while you’re taking Repaglinide.

Dosage

Follow all instructions on the prescription label. Sometimes your doctor may adjust your dose to ensure you have the best possible results. Don’t take Repaglinide for longer than directed or in smaller or larger quantities.

Repaglinide is normally taken two to four times a day, half an hour before your meal. Be sure to follow your physician’s directions. If you miss a meal, skip your Repaglinide dose. Wait to take it before your next meal.

You’ll need regular blood sugar tests, and you may require other blood exams at your physician’s office.

Hypoglycemia, more commonly known as low blood sugar, can occur in everybody with diabetes. It has symptoms like hunger, headache, sweating, irritability, confusion, feeling shaky, or dizziness. Always have some sugar source on hand in case you experience low blood sugar. Some good sources of sugar include hard candy, fruit juice, non-diet soda, raisins, and crackers. Make sure your loved ones and mates know how to assist you in case of an emergency.

If you have very serious hypoglycemia and can’t drink or eat, take a glucagon injection. You may be shown how to take this injection by your doctor.

Also watch out for signs of hyperglycemia (high blood sugar) such as hunger, dry mouth, increased thirst, fruity breath odor, increased urination, drowsiness, dry skin, blurred vision, and weight loss.

Carefully monitor your blood sugar during times of illness, stress, travel, vigorous exercise, medical emergency or surgery, or if you miss meals or take alcohol. These things may affect your levels of glucose and your dose requirements may change as well. Don’t change your dose of Repaglinide or schedule without consulting your doctor.

Repaglinide is just part of a treatment plan that can also include diet, weight control, exercise, special medical care, and blood sugar testing. Follow your doctor’s directions very carefully.

Take Repaglinide on a regular basis to maximize its benefit. Before you completely run out of Repaglinide, have your prescription refilled.

Taking excess Repaglinide may cause these symptoms: low blood sugar characterized symptoms like headache, dizziness, sweating, extreme weakness, trouble speaking, blurred vision, confusion, stomach pain, seizure (convulsions), and tremors.

If you think someone you love or you have accidentally taken excess Repaglinide, make sure to contact your doctor or local hospital. A Repaglinide overdose may cause life-threatening low blood sugar.

Avoid taking alcohol while taking Prandin. It reduces blood sugar and can hinder your diabetes treatment.

Interactions

Repaglinide may interact with other drugs, vitamins, or herbs you may be using. That’s why your physician should carefully manage all of your medicines. If you want to know more about how Repaglinide might interact with other substances you’re using, consult your doctor and pharmacist.

Note: You may decrease your chances of medicine interactions by having one pharmacy fill all your prescriptions. That way, your pharmacist can monitor possible interactions.

Alcohol interaction

Limit your intake of alcohol as it may interfere with your blood sugar.

If you take alcohol while taking this medication, your levels of blood sugar may drop drastically. Alcohol may also contain lots of calories, especially when taken in copious amounts. These extra calories may raise your blood sugar.

Medicines that could interact with Repaglinide

  • NSAIDs (Non-steroidal anti-inflammatory drugs) (Ibuprofen, Naproxen)

These drugs can enhance the effect of Prandin. This increases your risk for dangerously low levels of blood sugar. Your doctor may have to decrease your Repaglinide dose and check your blood sugar quite often if you use either of the above drugs with Repaglinide.

Depression medicines (Monoamine oxidase inhibitors such as Phenelzine and Selegiline)

These drugs can enhance the effect of Prandin. This increases your risk for severely low blood sugar levels. If you use either of the above drugs with Prandin, your doctor may have to decrease your dosage and check your blood sugar quite often.

Heart medicines (calcium channel blockers and diuretics) (Diltiaze, Chlorthalidone, Hydrochlorothiazide)

These drugs can reduce the effectiveness of Prandin. This means Prandin won’t work properly to stem your diabetes. Your doctor may have to increase your Prandin dosage and check your blood sugar quite often if you use any of the above medicines.

Heart medicines (channel blockers) (Timolol, Propranolol, Carvedilol)

These drugs may hide low blood sugar symptoms. If you use any of them with Prandin, you might need to check your blood sugar quite often.

Aspirin

Salicylates like Aspirin may enhance the effect of Prandin. This increases your risk for severely low blood sugar. Your doctor may have to decrease your Prandin dosage and check your blood sugar quite often if you take Prandin with Aspirin.

Seizure medication (Carbamazepine)

Carbamazepine may reduce the effectiveness of Repaglinide. This means it won’t work that well to manage your diabetes. Your doctor may have to increase your Repaglinide dosage and check your blood sugar quite often if you take Repaglinide together with Carbamazepine.

Oral birth control medicines and estrogens

These drugs may decrease the effectiveness of Repaglinide. This means it won’t work well to relieve your diabetes. Your doctor may have to increase your Repaglinide dosage and check your blood sugar quite often if you take Repaglinide with these drugs.

Corticosteroids

These drugs reduce the effect of Repaglinide. This means it won’t work effectively to treat your diabetes. Your doctor may have to increase your Repaglinide dosage and check your blood sugar quite often if you take Corticosteroids together with Repaglinide.

Thyroid drugs (Liotrix, Liothyronine)

These drugs can reduce the effectiveness of Repaglinide. This means the drug won’t work as effectively to treat your diabetes. If you’re taking any of the above medications with Repaglinide, your doctor may have to increase your Repaglinide dosage and check your blood sugar quite often.

Medications to treat tuberculosis (Rifampin)

Rifampin can reduce the effectiveness of Repaglinide. This means the medication won’t work well to treat your diabetes. If you’re taking Repaglinide together with this medication, your doctor may have to increase your Repaglinide dosage and check your blood sugar quite often.

Other drugs (Cyclosporine, Clarithromycin, Montelukast, Trimethoprim, Erythromycin, Clopidogrel, Ketoconazole, Itraconazole)

These drugs can raise Repaglinide levels in the body. This increases your risk for severely low blood sugar. Your doctor will closely monitor your blood sugar if you use Repaglinide together with any of the above drugs. He or she may have to decrease your Repaglinide dosage if you take it with any of these drugs.

Gemfibrozil

You should not take Repaglinide together with gemfibrozil. This medication increases the level of Repaglinide in the body too much.

Warnings

Before you start taking any medication, make sure to notify your physician about any drugs you’re using, any allergies or medical issues you may have, whether you’re nursing a baby or are pregnant, and any other crucial details about your health. The following factors can affect how you take Repaglinide.

Before using Repaglinide, notify your pharmacist and doctor if you have allergies to the medication, to any of its ingredients, or if you’ve got any other allergies.

If you suffer from certain medical problems, you shouldn’t use Repaglinide. Before taking this medicine, talk to your pharmacist and doctor if you have:

  • Type I diabetes
  • Allergy (Hypersensitivity) to Prandin, or any of its ingredients
  • Severe liver problems
  • C-peptide negative (type I diabetes with so little insulin made)
  • Diabetes complication with your body making ketone bodies with/without coma (symptoms may include weight loss, vomiting, or nausea)

Before using Repaglinide, share your medical history with your doctor and pharmacist, especially any of these problems: poor nutrition or weakness.

Before you have an operation, notify your dentist or doctor that you’re using Repaglinide.

Alcohol may affect the action of Prandin and reduce your blood sugar levels.

This medicine shouldn’t be taken during pregnancy. Contact your doctor at once if you get pregnant while using Repaglinide.

It’s unclear whether Repaglinide gets into human milk. If you’re using Repaglinide and are breastfeeding, it could affect your little one. Consult your doctor on whether you should keep breastfeeding or not.

The safety and efficacy of taking Repaglinide haven’t been determined in children.

As you grow older, your kidneys might not function as effectively as they did in your youth. Your doctor should test your kidney function prior to and during your Repaglinide treatment to minimize your risk of side effects.

Low blood sugar/hypoglycemia

Low blood sugar, aka hypoglycemia, can happen when you take Repaglinide. If you have symptoms of low blood sugar (such as headache, drowsiness, dizziness, weakness, irritability, confusion, hunger, sweating, feeling jittery, and fast heartbeat) while taking Repaglinide, call up your doctor.

Kidney function

If you’ve got reduced kidney function, talk to your physician about how Repaglinide can affect your medical problem, how your medical problem can affect the dosage and efficacy of Repaglinide, and whether you’ll require any special monitoring.

Liver function

Decreased liver function can raise your Repaglinide levels and increase your risk for low levels of blood sugar (hypoglycemia). Be sure to notify your doctor about all your medical problems. If you have severe liver disease, don’t take Repaglinide.

Blood sugar management

If you’re exposed to additional stress like trauma, surgery, fever, or infection, your control of blood sugar may vary. Carefully check on your blood sugar and call up your doctor if any significant changes happen in your control.

Missed/delayed meals

Repaglinide works by stimulating insulin secretion and should be used before meals. If you delay or skip a meal, you should also delay or skip the dose of Repaglinide.

Type I diabetes

If you suffer from type I diabetes, you shouldn’t take Repaglinide. In this type of diabetes, your pancreas produces no insulin at all. If you’ve got this type of diabetes or are in a diabetic ketoacidosis situation, you should take insulin instead.

Injury/surgery

If you’re hurt or plan to undergo surgery, your levels of blood sugar may temporarily increase. Repaglinide may not work that effectively, so your doctor may ask you to take insulin.

Storage

  • Keep this drug at room temperature.
  • Keep Repaglinide away from moisture and heat.
  • Keep Repaglinide and all drugs out of children’s reach.
  • Don’t dispose of Repaglinide in the toilet or down the sink (wastewater) or in household trash.
  • Ask your chemist how to discard medicines you no longer take or those that have expired.

Summary

Don’t use Repaglinide if you suffer from type I diabetes, if you have allergies to it, or if you’re in a diabetic ketoacidosis condition (call up your physician for insulin treatment). You shouldn’t take Repaglinide with Lopid (Gemfibrozil) or NPH insulin (e.g. isophane insulin).

Be careful to not allow your blood sugar to drop too low. Hypoglycemia, more commonly called low blood sugar, can happen if you exercise too long, skip a meal, or if you’re under stress. It has symptoms like headache, hunger, sweating, weakness, tremor, trouble concentrating, or irritability. Have glucose tablets or hard candy in case you develop low blood sugar. Milk and orange juice are other good sources of sugar. Make sure your close friends and relatives know how to assist you in case of an emergency.

Also watch out for signs of excess blood sugar (hyperglycemia). The symptoms include increased urination, dry mouth, increased thirst, hunger, dry skin, fruity breath odor, weight loss, drowsiness, and blurred vision. Your doctor may have to check your blood sugar quite often, and you might need to change your dose of Repaglinide.

You should be extra cautious if you’re a driver and have diabetes. This is because your ability to focus could be affected if you don’t properly control your diabetes. Your doctor may advise you to monitor your levels of blood sugar before traveling and to carry a snack on long journeys.

If you get abnormally thirsty, feel extremely tired, or urinate more often than normal, you should report it to your doctor. This may be a sign that your blood has too much sugar and your treatment may have to be adjusted.

If you’re due to receive dental treatment or have an operation, you should inform the person treating you that you suffer from diabetes and share with them a list of medications you’re using. This is due to the fact that if you aren’t able to have a meal for a while, you’ll be asked to skip your Repaglinide doses until you’re able to eat normally again.

Repaglinide is just part of a comprehensive treatment program that also includes exercise, diet, and weight control. Be sure to follow your diet, exercise, and medication routines very closely. Your levels of blood sugar may be affected if you change any of these things.