Home Drugs by Condition D Diabetes, Type 2 Repaglinide Alcohol & Food Interactions

Repaglinide and Alcohol / Food Interactions

There are 2 alcohol/food/lifestyle interactions with repaglinide which include:

Repaglinide and Alcohol (Ethanol)

Moderate Drug Interaction

GENERALLY AVOID: Alcohol may cause hypoglycemia or hyperglycemia in patients with diabetes. Hypoglycemia most frequently occurs with chronic drinking of large amounts of alcohol; however, it may also occur after binge drinking or moderate drinking, especially when the alcohol is ingested on an empty stomach. The mechanism is inhibition of gluconeogenesis and inhibition of the counterregulatory response to hypoglycemia. Hypoglycemia may last for 8 to 12 hours after ethanol ingestion. Chronic alcohol abuse may cause impaired glucose tolerance and hyperglycemia. Moderate alcohol consumption generally does not affect blood glucose levels in patients with well-controlled diabetes. In addition, a disulfiram-like reaction (flushing, headache, and nausea) has been reported frequently with chlorpropamide and very rarely with other sulfonylureas.

MANAGEMENT: Patients with diabetes should avoid alcohol if they experience flushing, headache, or nausea after alcohol ingestion, if their blood glucose is not well controlled, or if they have hypertriglyceridemia, neuropathy, or pancreatitis. Patients with well-controlled diabetes should limit their intake to one drink daily for women and two drinks daily for men (1 drink = 5 oz. wine, 12 oz. beer, or 1.5 oz. distilled spirits) in addition to their meal plan. The alcohol should be consumed with a meal.

Moderate Food Interaction

 

MONITOR: Grapefruit juice may increase the plasma concentrations of orally administered drugs that are substrates of the CYP450 3A4 isoenzyme. However, the interaction seems to affect primarily those drugs that undergo significant presystemic metabolism by CYP450 3A4 (i.e., drugs with low oral bioavailability), presumably due to the fact that grapefruit juice inhibits intestinal rather than hepatic CYP450 3A4. Because pharmacokinetic interactions involving grapefruit juice are often subject to a high degree of interpatient variability, the extent to which a given patient may be affected is difficult to predict.

MANAGEMENT: Patients who regularly consume grapefruit or grapefruit juice should be monitored for adverse effects and altered plasma concentrations of drugs that undergo significant presystemic metabolism by CYP450 3A4. Grapefruit and grapefruit juice should be avoided if an interaction is suspected. Orange juice is not expected to interact with these drugs.

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repaglinide drug Interactions

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Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.

Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.

Do not stop taking any medications without consulting your healthcare provider.


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