Medications and Drugs
Pharmacy Author: Omudhome Ogbru, PharmD
Medical Editor: Jay Marks, MD
GENERIC NAME: repaglinide
BRAND NAME: Prandin
DRUG CLASS AND MECHANISM: Repaglinide is an oral medication for lowering blood sugar (glucose) in
individuals with diabetes. It is in a class of drugs for treating diabetes type 2 called meglitinides and is chemically unlike other anti-diabetic medication.
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 in diabetes type II 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 blood glucose.
Like Sulfonylureas, for example, glyburide (Diabeta; Glynase; Micronase), glipizide (Glucotrol), glimepiride
(Amaryl), tolbutamide (Orinase), and tolazamide (Tolinase), 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 moderate blood glucose levels. Repaglinide is
unusual in that 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 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. The lower the hemoglobin A1c, the better the control.) Repaglinide was approved by the FDA
in 1997.
GENERIC AVAILABLE: no
PRESCRIPTION: yes
PREPARATIONS: Tablets: 0.5mg, 1mg, 2mg.
STORAGE: Tablets should be stored at room temperature,
15-30 C (59-86 F).
PRESCRIBED FOR: Repaglinide is used in treating type 2 diabetes, together with diet and exercise. It
can be used alone (monotherapy) or combined with metformin (Glucophage).
DOSING: Repaglinide is taken immediately before a meal or 15 to
30 minutes before a meal. It should be taken with every meal up to 4
times a day. Doses are adjusted by the physician to achieve the best
effect.
DRUG INTERACTIONS: Repaglinide is metabolized (eliminated) in the liver by an
enzyme called CYP3A4. Drugs that affect this enzyme may affect the blood levels of repaglinide and thus alter its glucose
lowering effect. The metabolism of repaglinide
may be prevented by ketoconazole (Nizoral), itraconazole (Sporanox),
fluconazole (Diflucan), erythromycin (Ery-Tab), and clarithromycin (Biaxin). As a result, blood levels of repaglinide rise and there is an enhanced glucose-lowering
effect. Dangerous hypoglycemic (very low blood glucose) reactions could occur. On the other
hand, the elimination of repaglinide may be increased with drugs that increase levels of CYP3A4 in the liver, such as barbiturates,
carbamazepine (Tegretol), and rifampin (Rifadin). This can result in lower blood levels of repaglinide and hyperglycemia (high blood glucose).
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
- Drug Interactions - Learn about potential drug interactions you may be exposed to. Drug interactions can occur with prescription drugs, OTC medication, vitamins, herbs, and supplements.
- Hemoglobin A1c Test - Hemoglobin A1c test is used as a standard tool to determine blood sugar control for patients with diabetes
- Diabetes - Learn about type 1 and 2 diabetes (Diabetes Mellitus) symptoms including increased urination, thirst, weight loss, fatigue, nausea, vomiting, skin infections, and blurred vision. Causes and diagnosis information is provided in the information.
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