Repaglinide Dosage

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Usual Adult Dose for:

Additional dosage information:

Usual Adult Dose for Diabetes Type 2

Patients who have not previously taken an oral hypoglycemic or patients who have an HbA1c less than 8%: 0.5 mg orally with meals.

Patients previously treated with an oral hypoglycemic or patients who have an HbA1c greater than or equal to 8%: 1 to 2 mg orally with meals.

All doses should be taken within 15 minutes of the meal or as much as 30 minutes before the meal. If a meal is skipped, the repaglinide dose should also be skipped. Likewise, if a meal is added during the day, so should a dose of repaglinide.

Renal Dose Adjustments

Initial dosage adjustment does not appear to be necessary in patients with mild to moderate renal insufficiency, but subsequent increases should be made carefully. Patients with creatinine clearance between 20 and 40 mL/min should be started with the 0.5 mg dose. There is no data for patients with creatine clearances below 20 mL/min.

Liver Dose Adjustments

Data not available

Dose Adjustments

The recommended dose range is 0.5 mg to 4 mg preprandially up to four times daily. Dosage adjustments should be determined by blood glucose response. The dose can be adjusted up to 4 mg until a satisfactory blood glucose response is achieved. At least one week should elapse after each dose adjustment to assess the patient's response. The maximum recommended daily dose is 16 mg. The starting dose and dose adjustments are the same for repaglinide when used in combination with metformin or a thiazolidinedione such as rosiglitazone or pioglitazone.

Precautions

Safety and effectiveness have not been established in pediatric patients (less than 18 years of age).

Dialysis

Data not available

Other Comments

When repaglinide is being used to replace therapy with other oral hypoglycemic agents, repaglinide may be started the day after the final dose of the other agent. Patients should be observed for hypoglycemic effects due to overlapping of therapy, especially when replacing a longer acting oral hypoglycemic agent.

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