Repaglinide Generic Name & Formulations
Repaglinide 0.5mg, 1mg, 2mg; tabs.
Adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.
Limitations of Use
Not for treatment of type 1 diabetes or diabetic ketoacidosis.
Repaglinide Dosage and Administration
Take within 30 minutes before meals (skip dose if meal is skipped; add dose if meal is added). Treatment-naive, or HbA1c <8%, or severe renal dysfunction (CrCl 20–40mL/min): initially 0.5mg with 2–4 meals daily. Previously treated with antidiabetic agents and HbA1c ≥8%: initially 1–2mg with 2–4 meals daily. For both: titrate by doubling dose at intervals of at least 1 week; range 0.5–4mg with 2–4 meals daily; max 16mg/day. Concomitant clopidogrel: avoid; if unavoidable, initiate 0.5mg before each meal (max 4mg daily). Concomitant cyclosporine: max 6mg daily.
Repaglinide Boxed Warnings
Not for use with NPH-insulin (possible myocardial ischemia). Increased risk of hypoglycemia with changes in physical activity, meal patterns, renal or hepatic impairment: monitor glucose more frequently and may need to adjust dose. Reduced symptomatic awareness of hypoglycemia in longstanding diabetes, diabetic nerve disease, or recurrent hypoglycemia. Hemodialysis or CrCl <20mL/min. Pregnancy. Nursing mothers: not recommended.
See Contraindications. Potentiated by clopidogrel, cyclosporine, CYP3A4 inhibitors (eg, ketoconazole, itraconazole, erythromycin, clarithromycin), other CYP2C8 inhibitors (eg, trimethoprim, montelukast, deferasirox); adjust dose and monitor (see Adult). Antagonized by CYP3A4 and/or CYP2C8 inducers (eg, carbamazepine, rifampin, barbiturates), atypical antipsychotics, CCBs, corticosteroids, danazol, diuretics, estrogens, glucagon, isoniazid, niacin, oral contraceptives, phenothiazines, progestogens (in oral contraceptives), protease inhibitors, somatropin, sympathomimetics, thyroid hormones; adjust dose and monitor. Antidiabetic agents, ACE inhibitors, ARBs, disopyramide, fibrates, fluoxetine, MAOIs, NSAIDs, pentoxifylline, pramlintide, propoxyphene, salicylates, somatostatin analogs, sulfonamide antibiotics increase risk of hypoglycemia. β-blockers, clonidine, guanethidine, reserpine may mask hypoglycemia.
Repaglinide Adverse Reactions
Hypoglycemia, upper respiratory infection, headache, diarrhea, constipation, arthralgia, back or chest pain.
Repaglinide Clinical Trials
Formerly known under the brand name Prandin.
Repaglinide Patient Counseling