Generic Name: repaglinide (Oral route)

re-PAG-li-nide

Commonly used brand name(s)

In the U.S.

  • Prandin

Available Dosage Forms:

  • Tablet

Therapeutic Class: Hypoglycemic

Chemical Class: Meglitinide

Uses For Prandin

Repaglinide is used to treat type 2 diabetes. When you have type 2 diabetes, insulin is still being produced by your pancreas. Sometimes the amount of insulin you produce may not be enough or your body may not be using it properly and you may still need more. Repaglinide works by causing your pancreas to release more insulin into the blood stream. Repaglinide may be used alone or with another oral diabetes medicine called metformin.

Slideshow: Flashback: FDA Drug Approvals 2013

This medicine is available only with your doctor's prescription.

Before Using Prandin

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Studies on this medicine have been done only in adult patients, and there is no specific information comparing use of repaglinide in children with use in other age groups.

Geriatric

This medicine has been tested in a limited number of patients 65 years of age or older and has not been shown to cause different side effects or problems in older people than it does in younger adults. However, the first signs of low blood sugar are not easily seen or do not occur at all in older patients. This may increase the chance of low blood sugar developing during treatment.

Pregnancy

Pregnancy Category Explanation
All Trimesters C Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Gemfibrozil

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Abiraterone Acetate
  • Itraconazole
  • Metreleptin
  • Pixantrone

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Acebutolol
  • Alprenolol
  • Atenolol
  • Betaxolol
  • Bevantolol
  • Bisoprolol
  • Bitter Melon
  • Bucindolol
  • Carteolol
  • Carvedilol
  • Celiprolol
  • Clarithromycin
  • Cyclosporine
  • Deferasirox
  • Dilevalol
  • Eltrombopag
  • Esmolol
  • Fenugreek
  • Glucomannan
  • Guar Gum
  • Iproniazid
  • Isocarboxazid
  • Ketoconazole
  • Labetalol
  • Levobunolol
  • Linezolid
  • Mepindolol
  • Methylene Blue
  • Metipranolol
  • Metoprolol
  • Moclobemide
  • Nadolol
  • Nebivolol
  • Nialamide
  • Oxprenolol
  • Penbutolol
  • Phenelzine
  • Pindolol
  • Procarbazine
  • Propranolol
  • Psyllium
  • Rasagiline
  • Rifampin
  • Rifapentine
  • Selegiline
  • Sotalol
  • Talinolol
  • Telithromycin
  • Teriflunomide
  • Tertatolol
  • Timolol
  • Tranylcypromine
  • Trimethoprim

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Infection or
  • Ketones in the blood (diabetic ketoacidosis) or
  • Surgery or
  • Trauma or
  • Type 1 (insulin-dependent) diabetes or
  • Unusual stress—Insulin may be needed to control diabetes in patients with these conditions
  • Kidney disease or
  • Liver disease—Higher blood levels of repaglinide may occur; this may change the amount of medicine you need
  • Underactive adrenal gland or
  • Underactive pituitary gland or
  • Undernourished condition or
  • Weakened physical condition—Patients with these conditions may be more likely to develop low blood sugar while taking repaglinide

Proper Use of Prandin

Follow carefully the special meal plan your doctor gave you. This is the most important part of controlling your condition, and is necessary if the medicine is to work properly. Also, exercise regularly and test for sugar in your blood or urine as directed.

This medicine usually is taken 15 minutes before a meal but may be taken up to 30 minutes before a meal.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (tablets):
    • For type 2 diabetes:
      • Adults:
        • For patients who have never taken medicine to lower their blood sugar or who have a glycosylated hemoglobin (hemoglobin A 1c) measurement that is less than 8%: At first the dose is 0.5 milligram (mg) fifteen to thirty minutes before each meal. The dose may then be adjusted by your doctor based on your fasting blood sugar level.
        • For patients who have taken medicine to lower their blood sugar and who have a hemoglobin A 1c measurement that is higher than 8%: At first the dose is 1 or 2 mg fifteen to thirty minutes before each meal. The dose may then be adjusted by your doctor based on your fasting blood sugar level.
      • Children: Use and dose must be determined by your doctor.

Missed Dose

Call your doctor or pharmacist for instructions.

You should skip a dose of repaglinide if a meal is skipped and add a dose of repaglinide if you eat an extra meal.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Precautions While Using Prandin

Your doctor will want to check your progress at regular visits , especially during the first few weeks you take this medicine.

It is very important to follow carefully any instructions from your health care team about:

  • Alcohol—Drinking alcohol may cause severe low blood sugar. Discuss this with your health care team.
  • Other medicines—Do not take other medicines during the time you are taking repaglinide unless they have been discussed with your doctor. This especially includes nonprescription medicines such as aspirin, and medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems.
  • Counseling—Other family members need to learn how to prevent side effects or help with side effects if they occur. Also, patients with diabetes may need special counseling about diabetes medicine dosing changes that might occur because of lifestyle changes, such as changes in exercise and diet. Furthermore, counseling on contraception and pregnancy may be needed because of the problems that can occur in patients with diabetes during pregnancy.
  • Travel—Keep a recent prescription and your medical history with you. Be prepared for an emergency as you would normally. Make allowances for changing time zones and keep your meal times as close as possible to your usual meal times.

In case of emergency—There may be a time when you need emergency help for a problem caused by your diabetes. You need to be prepared for these emergencies. It is a good idea to wear a medical identification (ID) bracelet or neck chain at all times. Also, carry an ID card in your wallet or purse that says that you have diabetes and a list of all of your medicines.

Too much repaglinide can cause low blood sugar (hypoglycemia). Low blood sugar also can occur if you use repaglinide with another antidiabetic medicine, delay or miss a meal or snack, exercise more than usual, drink alcohol, or cannot eat because of nausea or vomiting. Symptoms of low blood sugar must be treated before they lead to unconsciousness (passing out). Different people may feel different symptoms of low blood sugar. It is important that you learn which symptoms of low blood sugar you usually have so that you can treat it quickly.

Symptoms of low blood sugar include anxiety; behavior change similar to being drunk; blurred vision; cold sweats; confusion; cool, pale skin; difficulty in thinking; drowsiness; excessive hunger; fast heartbeat; headache (continuing); nausea; nervousness; nightmares; restless sleep; shakiness; slurred speech; or unusual tiredness or weakness.

If symptoms of low blood sugar occur, eat glucose tablets or gel, corn syrup, honey, or sugar cubes; or drink fruit juice, nondiet soft drink, or sugar dissolved in water to relieve the symptoms. Also, check your blood for low blood sugar. Get to a doctor or a hospital right away if the symptoms do not improve. Someone should call for emergency help immediately if severe symptoms such as convulsions (seizures) or unconsciousness occur. Food or drink should not be forced because the patient could choke from not swallowing correctly.

Hyperglycemia (high blood sugar) may occur if you do not take enough or skip a dose of your antidiabetic medicine, overeat or do not follow your meal plan, have a fever or infection, or do not exercise as much as usual.

Symptoms of high blood sugar include blurred vision; drowsiness; dry mouth; flushed, dry skin; fruit-like breath odor; increased urination; ketones in urine; loss of appetite; stomachache, nausea, or vomiting; tiredness; troubled breathing (rapid and deep); unconsciousness; or unusual thirst.

If symptoms of high blood sugar occur, check your blood sugar level and then call your doctor for instructions.

Prandin Side Effects

Along with its needed effects, a medicine 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:

More common
  • Convulsions (seizures)
  • unconsciousness

Check with your doctor as soon as possible if any of the following side effects occur:

More common
  • Cough
  • fever
  • low blood sugar, including anxious feeling, behavior change similar to being drunk, blurred vision, cold sweats, confusion, cool pale skin, difficulty in thinking, drowsiness, excessive hunger, fast heartbeat, headache, nausea, nervousness, nightmares, restless sleep, shakiness, slurred speech, or unusual tiredness or weakness
  • pain in the chest
  • runny or stuffy nose
  • shortness of breath
  • sinus congestion with pain
  • sneezing
  • sore throat
Less common
  • Bloody or cloudy urine
  • burning, painful, or difficult urination
  • chest pain
  • chills
  • frequent urge to urinate
  • problems with teeth
  • skin rash, itching, or hives
  • tearing of eyes
  • tightness in chest
  • trouble in breathing
  • vomiting
  • wheezing
Rare
  • Black, tarry stools
  • blood in stools
  • fast or irregular heartbeat
  • hoarseness
  • lower back or side pain
  • pinpoint red spots on skin
  • unusual bleeding or bruising

Some side effects 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
  • Back pain
  • diarrhea
  • joint pain
Less common
  • Constipation
  • feeling of burning, numbness, tightness, tingling, warmth, or heat
  • indigestion

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

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