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Repaglinide is an oral diabetes medicine that helps control blood sugar levels by causing the pancreas to produce insulin.
Repaglinide is used together with diet and exercise to improve blood sugar control in adults with type 2 diabetes mellitus. repaglinide is not for treating type 1 diabetes.
Repaglinide may also be used for purposes not listed in this medication guide.
You should not use repaglinide if you have type 1 diabetes, severe liver disease, or diabetic ketoacidosis.
You should not use repaglinide together with gemfibrozil (Lopid) or NPH insulin (such as isophane insulin).
You should not use repaglinide if you are allergic to it, or if you have:
severe liver disease;
diabetic ketoacidosis (call your doctor for treatment with insulin); or
if you also take gemfibrozil.
To make sure repaglinide is safe for you, tell your doctor if you have:
liver disease; or
if you also take metformin or other diabetes medicines.
Follow your doctor's instructions about using repaglinide if you are pregnant. Blood sugar control is very important during pregnancy, and your dose needs may be different during each trimester.
It is not known whether repaglinide passes into breast milk or if it could harm a nursing baby. You should not breast-feed while using this medicine.
Repaglinide is not approved for use by anyone younger than 18 years old.
Follow all directions on your prescription label. Your doctor may occasionally change your dose. Do not take this medicine in larger or smaller amounts or for longer than recommended.
Repaglinide is usually taken 2 to 4 times daily, within 30 minutes before eating a meal. Follow your doctor's instructions. If you skip a meal, do not take your dose of repaglinide. Wait until your next meal.
Your blood sugar will need to be checked often, and you may need other blood tests at your doctor's office.
Low blood sugar (hypoglycemia) can happen to everyone who has diabetes. Symptoms include headache, hunger, sweating, irritability, dizziness, nausea, fast heart rate, and feeling anxious or shaky. To quickly treat low blood sugar, always keep a fast-acting source of sugar with you such as fruit juice, hard candy, crackers, raisins, or non-diet soda.
Your doctor can prescribe a glucagon emergency injection kit to use in case you have severe hypoglycemia and cannot eat or drink. Be sure your family and close friends know how to give you this injection in an emergency.
Blood sugar levels can be affected by stress, illness, surgery, exercise, alcohol use, or skipping meals. Ask your doctor before changing your dose or medication schedule.
Repaglinide is only part of a treatment program that may also include diet, exercise, weight control, blood sugar testing, and special medical care. Follow your doctor's instructions very closely.
Store repaglinide at room temperature away from moisture and heat.
Take the missed dose as soon as you remember, but only if you are getting ready to eat a meal. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. A repaglinide overdose can cause life-threatening hypoglycemia.
Symptoms of severe hypoglycemia include extreme weakness, blurred vision, sweating, trouble speaking, tremors, stomach pain, confusion, and seizure (convulsions).
Avoid drinking alcohol. It lowers blood sugar and may interfere with your diabetes treatment.
Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have:
severe pain in your upper stomach spreading to your back, nausea and vomiting, fast heart rate;
pale or yellowed skin, dark colored urine, fever, confusion or weakness; or
severe skin reaction--fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.
Common side effects may include:
low blood sugar;
nausea, diarrhea;
headache, back pain;
joint pain; or
cold symptoms such as stuffy nose, sneezing, sore throat.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
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.
Many other medicines that can increase or decrease the effects of repaglinide on lowering your blood sugar. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.
Further informationRemember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Medically reviewed by USARx EDITORIAL TEAM Last updated on 1/1/2020.
Source: Drugs.com Repaglinide (www.drugs.com/mtm/repaglinide.html).
Commonly reported side effects of repaglinide include: hypoglycemia. See below for a comprehensive list of adverse effects.
For the ConsumerApplies to repaglinide: oral tablet
Along with its needed effects, repaglinide may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur while taking repaglinide:
More common
Less common
Incidence not known
Some side effects of repaglinide may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Less common
Incidence not known
For Healthcare Professionals
Applies to repaglinide: oral tablet
GeneralThe most frequently reported adverse reactions were changes in blood glucose levels; the occurrence of these reactions was dependent on individual factors such as dietary habits, dose, exercise, and stress.
MetabolicVery common (10% or more): Hypoglycemia (up to 31%)
In 12 to 24 week clinical trials, hypoglycemia occurred in 31% of patients receiving this drug compared to 7% of placebo-treated patients. In 1 year trials, hypoglycemia occurred in 16% of patients receiving this drug compared to 19% and 20% of glipizide and glyburide patients, respectively.
CardiovascularCardiovascular events were evaluated in trials comparing this drug to sulfonylureas. Serious cardiovascular events including ischemia with this drug were higher at 4% than for sulfonylurea drugs (3%). No excess mortality was associated with this increase. Selected cardiovascular events including hypertension, abnormal EKG, MI, arrhythmias, and palpitations were observed at 1% or less and no more frequently with this drug than with comparator drugs.
Trials of this drug in combination with NPH insulin found 6 serious events of myocardial ischemia.
Common (1% to 10%): Chest pain, angina, serious cardiovascular events including ischemia
Frequency not reported: Hypertension, abnormal EKG, MI, arrhythmias, palpitations
HypersensitivityCommon (1% to 10%): Allergy
Uncommon (0.1% to 1%): Allergic skin reactions such as rash, urticaria, and pruritus
Frequency not reported: Anaphylactoid reactions
Anaphylactoid reactions were reported in less than 1% of patients. Allergic skin reactions such as rash, urticaria, and pruritus have been observed. There is no reason to suspect cross-allergenicity with sulfonylurea drugs due to the difference in chemical structure.
GastrointestinalCommon (1% to 10%): Nausea, diarrhea, constipation, vomiting, dyspepsia, tooth disorder
Postmarketing reports: Pancreatitis
Nervous systemVery common (10% or more): Headache (up to 11%)
Common (1% to 10%): Paresthesia
MusculoskeletalCommon (1% to 10%): Arthralgia, back pain
RespiratoryVery common (10% or more): Upper respiratory infection (up to 16%)
Common (1% to 10%): Sinusitis, rhinitis, bronchitis
HepaticPostmarketing experience has included reports of severe hepatic dysfunction including jaundice and hepatitis.
Frequency not reported: Elevated liver enzymes
Postmarketing reports: Severe hepatic dysfunction including jaundice and hepatitis
HematologicThrombocytopenia or leukopenia have been reported in less than 1% of patients.
Frequency not reported: Thrombocytopenia, leukopenia
Postmarketing reports: Hemolytic anemia
OcularRare (less than 0.1%): Blurred vision
Very rare (less than 0.01%): Refraction disorder
Refraction disorders have been known to result due to changes in blood glucose levels.
DermatologicPostmarketing reports: Alopecia, Stevens-Johnson syndrome
GenitourinaryCommon (1% to 10%): Urinary tract infection
Medically reviewed by USARx EDITORIAL TEAM Last updated on 1/1/2020.
Source: Drugs.com Repaglinide (www.drugs.com/mtm/repaglinide.html).
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