repaglinides FAQ

Repaglinide is an oral medication for lowering blood sugar (glucose) in individuals with type 2 diabetes. It is in a class of drugs for treating diabetes type 2 called meglitinides that are chemically unlike other anti-diabetic medications. Nateglinide (Starlix), is another currently available meglitinide. Approximately 90% of patients with diabetes have type 2 or non-insulin dependent diabetes mellitus. Type 2 diabetes usually occurs in adulthood, and is associated with obesity, and a strong family history of diabetes. Glucose intolerance that causes diabetes type 2 is caused by reduced insulin secretion from the pancreas after meals and resistance of the body's cells to insulin's effect which is to stimulate the cells to remove glucose from the blood. This leads to high levels of glucose in the blood. Like sulfonylureas, for example, glyburide (Diabeta, Glynase), glipizide (Glucotrol, Glucotrol XL), glimepiride (Amaryl), tolbutamide and tolazamide, repaglinide stimulates cells in the pancreas to produce insulin. Glyburide may be more potent than repaglinide at increasing insulin release in persons with low or high blood glucose levels, whereas repaglinide may be more potent in persons with more moderate abnormalities of blood glucose levels. Repaglinide is different because it has a rapid onset of action and a short duration of action. When taken just prior to meals, it promotes the release of insulin that normally occurs with meals and is responsible for preventing blood glucose levels from becoming high. It has been shown to lower hemoglobin A1c (HbA1c) levels by 1.6% to 1.9%. (Hemoglobin A1c is a blood test which measures the effectiveness of a drug in controlling high blood glucose levels over prolonged periods of time; the lower the hemoglobin A1c, the better the control.) Repaglinide was approved by the FDA in 1997.

Hypoglycemia (low blood glucose) is the most frequent side effect and it occurs somewhat less frequently with repaglinide than with sulfonylureas such as glyburide and glipizide. Some symptoms of hypoglycemia include:

Repaglinide is taken 15 to 30 minutes before a meal. It should be taken with meals and may be administered 2, 3, or 4 times a day.

No adequate human studies on the effects of repaglinide on the fetus have been done. Adverse effects have been reported in some animal studies. Animals given repaglinide during both lactation (nursing) and gestation (pregnancy) have developed skeletal defects. Therefore, physicians must weigh the potential benefits and risks of this medication when considering its use in pregnant women. It is not known whether repaglinide accumulates in breast milk. However, animals given repaglinide during pregnancy and lactation have developed skeletal defects. Because of the possibility of hypoglycemia in nursing infants and the skeletal effects in nursing animals, it is recommended that repaglinide not be used in women who are breastfeeding.

Repaglinide should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place protected from moisture and keep the lid tightly closed.

Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. In particular, make sure that you discuss if you are using any of the following before taking repaglinide.

The most common side effects of repaglinide are listed below. Tell your healthcare provider if you have any of these side effects that bother you.

While less common, the most serious side effects of repaglinide are described below, along with what to do if they happen. Severe Allergic Reactions. Repaglinide may cause allergic reactions, which can be serious. Stop taking repaglinide and get help right away if you have any of the following symptoms of a serious allergic reaction.

Allergies to Ingredients. People who are allergic to any of the following should not take repaglinide.

Repaglinide is commonly used to help lower blood sugar levels in people with type 2 diabetes. Repaglinide may also be used for other conditions as determined by your healthcare provider.

Repaglinide is available in the following dosage forms that are taken by mouth.

If you or someone else has used too much repaglinide, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

There are no known interactions between repaglinide and foods or drinks. It is unknown if drinking alcohol will affect repaglinide, but alcohol may affect blood sugar levels in people with diabetes. This may interfere with the effect of repaglinide. It is best to limit the amount of alcohol you drink.

Repaglinide works by increasing your body’s insulin levels. Insulin is a hormone that helps your body use glucose (sugar) as a source of energy.

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If you miss a dose, skip the missed dose and only take the next dose as scheduled. Do not take double or extra doses.

Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if repaglinide is right for you. In particular, make sure that you discuss any of the following. Kidney Problems. You may be at higher risk of certain side effects or need a lower dose of repaglinide if your kidneys are not working as well as they should be. Talk to your healthcare provider about your risks if you have kidney problems. Liver Problems. You may be at higher risk of certain side effects if your liver is not working as well as they should be. Your healthcare provider may do tests to check your liver. Talk to your healthcare provider about your risks if you have liver problems. Insulin. If you take repaglinide while you are also using insulin, it can cause reduced blood flow to your heart. This is a serious condition called myocardial ischemia. It can lead to symptoms such as chest pain, trouble breathing, or a fast or abnormal heartbeat. Repaglinide should not be taken if you are using insulin. Pregnancy. It is not known if or how repaglinide could affect pregnancy or harm an unborn baby. Tell your healthcare provider if you are or plan to become pregnant. Your healthcare provider will advise you if you should take repaglinide while you are pregnant or trying to get pregnant. Breastfeeding. It is not known if repaglinide passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should stop breastfeeding or stop repaglinide.

Do not take repaglinide unless it has been prescribed to you by a healthcare provider. Take it as prescribed. Do not share repaglinide with other people, even if they have the same condition as you. It may harm them. Keep repaglinide out of the reach of children. Certain conditions that cause increased stress on your body, like fever, trauma (such as a car accident), infection, or surgery, can change the amount of diabetes medicines you need to take to control your diabetes. Talk to your healthcare provider if you have any of these conditions to decide if your medicine needs to be changed. Talk to your healthcare provider about how to prevent, recognize, and manage low blood sugar (hypoglycemia), high blood sugar (hyperglycemia), and diabetes-related problems. Take repaglinide up to 30 minutes before each meal (up to 4 meals per day). You should skip your dose of repaglinide if you skip a meal. Repaglinide can affect your alertness or coordination, especially if your blood sugar drops too low. Do not drive or do other activities that require alertness or coordination until you know how repaglinide affects you.