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PrandiMet Side Effects

Generic Name: metformin / repaglinide

Note: This page contains side effects data for the generic drug metformin / repaglinide. It is possible that some of the dosage forms included below may not apply to the brand name PrandiMet.

In Summary

Common side effects of PrandiMet include: lactic acidosis, diarrhea, hypoglycemia, and nausea. Other side effects include: decreased vitamin b12 serum concentrate. See below for a comprehensive list of adverse effects.

For the Consumer

Applies to metformin / repaglinide: oral tablet

As well as its needed effects, metformin / repaglinide may cause unwanted side effects that require medical attention.

Major Side Effects

If any of the following side effects occur while taking metformin / repaglinide, check with your doctor immediately:

More common:
  • Anxiety
  • blurred vision
  • body aches or pain
  • chills
  • cold sweats
  • coma
  • confusion
  • cool, pale skin
  • cough
  • depression
  • difficulty in breathing
  • dizziness
  • ear congestion
  • fast heartbeat
  • fever
  • headache
  • increased hunger
  • loss of voice
  • nasal congestion
  • nausea
  • nervousness
  • nightmares
  • runny nose
  • seizures
  • shakiness
  • slurred speech
  • sneezing
  • sore throat
  • unusual tiredness or weakness

Minor Side Effects

Some metformin / repaglinide side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Your health care professional may be able to help you prevent or reduce these side effects, but do check with them if any of the following side effects continue, or if you are concerned about them:

More common:
  • Diarrhea
  • vomiting

For Healthcare Professionals

Applies to metformin / repaglinide: oral tablet


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

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

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


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

Nervous system

Frequency not reported: Headache[Ref]


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

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

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


Postmarketing reports: Hemolytic anemia[Ref]


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


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.

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


The most frequently reported adverse reactions included hypoglycemia and headache.


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

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

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


1. "Product Information. PrandiMet (metformin-repaglinide)." Novo Nordisk Pharmaceuticals Inc, Princeton, NJ.

It is possible that some side effects of PrandiMet may not have been reported. These can be reported to the FDA here. Always consult a healthcare professional for medical advice.

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.