Metformin / Repaglinide Side Effects

Medically reviewed by Drugs.com. Last updated on Oct 10, 2023.

Applies to metformin / repaglinide: oral tablet.

Important warnings This medicine can cause some serious health issues

You should not use this medicine if you have severe kidney disease, type 1 diabetes, or diabetic ketoacidosis.

You should not use metformin and repaglinide together with gemfibrozil or NPH insulin (such as isophane insulin).

If you need to have any type of x-ray or CT scan using a dye that is injected into your veins, you may need to temporarily stop taking metformin and repaglinide.

You may develop lactic acidosis, a dangerous build-up of lactic acid in your blood. Call your doctor or get emergency medical help if you have unusual muscle pain, trouble breathing, stomach pain, dizziness, feeling cold, or feeling very weak or tired.

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

• severe hypoglycemia--extreme weakness, blurred vision, sweating, trouble speaking, tremors, stomach pain, confusion, seizure; or

• lactic acidosis--unusual muscle pain, trouble breathing, stomach pain, vomiting, irregular heart rate, dizziness, feeling cold, or feeling very weak or tired.

Common side effects may include:

• low blood sugar;

• headache;

• nausea, vomiting; or

• diarrhea.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.

For healthcare professionals

Applies to metformin / repaglinide: oral tablet.

General

The most frequently reported adverse reactions included hypoglycemia and headache.

Hepatic

Repaglinide:

• Postmarketing reports: Severe hepatic dysfunction including jaundice and hepatitis^[Ref]

Nervous system

• Frequency not reported: Headache^[Ref]

Respiratory

Repaglinide-Metformin:

• Very common (10% or more): Upper respiratory tract infection (11%)

Repaglinide:

• Very common (10% or more): Upper respiratory tract infection (11%)

Metformin:

• Common (1% to 10%): Upper respiratory tract infection (11%)^[Ref]

Hematologic

Repaglinide:

• Postmarketing reports: Hemolytic anemia^[Ref]

Dermatologic

Repaglinide:

• Postmarketing reports: Stevens-Johnson syndrome, alopecia^[Ref]

Cardiovascular

Repaglinide:

• Common (1% to 10%): myocardial ischemia, angina, chest pain
• Frequency not reported: Hypertension, abnormal EKG, MI, arrhythmias, palpitations

Cardiovascular events were evaluated in trials comparing repaglinide to sulfonylureas. Serious cardiovascular events including ischemia with this drug were higher at 4% (51/1228) than for sulfonylurea drugs (3%; 13/498). No excess mortality was associated with this increase. Selected cardiovascular events including hypertension, abnormal EKG, MI, arrhythmias, and palpitations were observed at 1% or less and no more frequently with this drug than with comparator drugs.

Across 7 repaglinide clinical trials, 6 serious events of myocardial ischemia occurred in combination use with NPH-insulin compared with 1 event in patients using insulin alone. Repaglinide should not be used in combination with NPH insulin.

Gastrointestinal

Repaglinide-Metformin:

• Very common (10% or more): Gastrointestinal system disorder (33%), diarrhea (19%), nausea (15%)

Repaglinide:

• Very common (10% or more): Gastrointestinal system disorder (36%)
• Common (1% to 10%): Diarrhea, nausea
• Postmarketing reports: Pancreatitis

Metformin:

• Very common (10% or more): Gastrointestinal system disorder (48%), diarrhea (30%)
• Common (1% to 10%): Nausea^[Ref]

Metabolic

Repaglinide-Metformin:

• Very common (10% or more): Symptomatic hypoglycemia (33%)

Repaglinide:

• Very common (10% or more): Symptomatic hypoglycemia (11%)

Metformin:

• Common (1% to 10%): Subnormal vitamin B12 levels
• Rare (less than 0.1%): Lactic acidosis

Further information

Metformin/repaglinide side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.

Medical Disclaimer