Repaglinide

Generic name: repaglinide (oral)
Brand name: Prandin
Dosage form: oral tablet (0.5 mg; 1 mg; 2 mg)
Drug class: Meglitinides

Medically reviewed by A Ras MD.

What is repaglinide?

Repaglinide is a prescription medicine that is used to lower blood sugar in patients with high blood sugar (diabetes).

Description

Repaglinide is an oral blood glucose-lowering drug of the glinide class. Repaglinide, S(+)2-ethoxy-4(2((3-methyl-1-(2-(1-piperidinyl) phenyl)-butyl) amino)-2-oxoethyl) benzoic acid, is chemically unrelated to the oral sulfonylurea insulin secretagogues.

Structural Formula of Repaglinide

Repaglinide USP is a white to off-white solid with molecular formula C27 H36 N2 O4 and a molecular weight of 452.6. Repaglinide tablets, USP contain 0.5 mg, 1 mg, or 2 mg of repaglinide USP. In addition, each tablet contains the following inactive ingredients: anhydrous dibasic calcium phosphate, corn starch, glycerol, magnesium stearate, meglumine, microcrystalline cellulose, polacrillin potassium, poloxamer, and povidone. In addition, the 1 mg tablet contains ferric oxide (Sicovit Yellow 10) and 2 mg tablet contains ferric oxide (Sicovit Red 30).

Mechanism of Action

Repaglinide lowers blood glucose levels by stimulating the release of insulin from the pancreas. This action is dependent upon functioning beta (ß) cells in the pancreatic islets. Insulin release is glucose-dependent and diminishes at low glucose concentrations.

Repaglinide closes ATP-dependent potassium channels in the ß-cell membrane by binding at characterizable sites. This potassium channel blockade depolarizes the ß-cell, which leads to an opening of calcium channels. The resulting increased calcium influx induces insulin secretion. The ion channel mechanism is highly tissue selective with low affinity for heart and skeletal muscle.

Before taking repaglinide, tell your doctor:

If you are allergic to repaglinide; any part of this medicine; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.
If you have any of these health problems: Acidic blood problem or type 1 diabetes.
If you are taking any of these drugs: Clopidogrel, gemfibrozil, or insulin NPH.
If you are breast-feeding. Do not breast-feed while you take repaglinide.

This is not a list of all drugs or health problems that interact with repaglinide.

Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take repaglinide with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

What are some things I need to know or do while I take repaglinide?

Tell all of your health care providers that you take repaglinide. This includes your doctors, nurses, pharmacists, and dentists.
Do not drive if your blood sugar has been low. There is a greater chance of you having a crash.
Check your blood sugar as you have been told by your doctor.
Have blood work checked as you have been told by the doctor. Talk with the doctor.
Talk with your doctor before you drink alcohol.
Follow the diet and workout plan that your doctor told you about.
It may be harder to control blood sugar during times of stress such as fever, infection, injury, or surgery. A change in physical activity, exercise, or diet may also affect blood sugar.
Low blood sugar may happen with repaglinide. Very low blood sugar can lead to seizures, passing out, long lasting brain damage, and sometimes death. Talk with the doctor.
If you are 65 or older, use repaglinide with care. You could have more side effects.
Tell your doctor if you are pregnant or plan on getting pregnant. You will need to talk about the benefits and risks of using repaglinide while you are pregnant.

How is repaglinide best taken?

Use repaglinide as ordered by your doctor. Read all information given to you. Follow all instructions closely.

Take within 30 minutes before meals.
If a meal is skipped, skip the dose. If a meal is added, add a dose for that meal.

What do I do if I miss a dose?

Take a missed dose as soon as you think about it, with a meal.
If it is close to the time for your next dose, skip the missed dose and go back to your normal time.
Do not take 2 doses at the same time or extra doses.

What are the side effects of repaglinide that I need to call my doctor about immediately?

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
Low blood sugar can happen. The chance may be raised when repaglinide is used with other drugs for diabetes. Signs may be dizziness, headache, feeling sleepy or weak, shaking, fast heartbeat, confusion, hunger, or sweating. Call your doctor right away if you have any of these signs. Follow what you have been told to do for low blood sugar. This may include taking glucose tablets, liquid glucose, or some fruit juices.

What are some other side effects of repaglinide?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

Headache.
Signs of a common cold.
Diarrhea.
Joint pain.
Back pain.

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

You may report side effects to the FDA at 1-800-332-1088. You may also report side effects at https://www.fda.gov/medwatch.

If overdose is suspected:

If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

How do I store and/or throw out repaglinide?

Store at room temperature.
Store in a dry place. Do not store in a bathroom.
Keep lid tightly closed.
Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.