repaglinide, Prandin (cont.)
Omudhome Ogbru, PharmD
Omudhome Ogbru, PharmD
Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Medical and Pharmacy Editor:
Anabolic steroids or androgens can increase the risk of developing hypoglycemia in diabetic patients taking glucose-lowering medications.
Some drugs increase blood sugar and therefore reverse the effects of repaglinide. Such drugs include amphetamines, glucocorticoids such as prednisone, estrogens, isoniazid, phenothiazines such as chlorpromazine (Thorazine), phenytoin (Dilantin), decongestants, and thyroid drugs.
Beta blockers, for example, propranolol (Inderal), atenolol (Tenormin), can cause hypoglycemia or hyperglycemia. Also, beta-blockers can blunt some of the body's responses to hypoglycemia such as rapid heart rate, thus making it difficult for patients to recognize (and treat) hypoglycemic reactions. This not withstanding, beta-blockers have been used successfully in diabetic patients. (Treatment with beta-blockers is associated with improved survival in diabetics who are treated with the beta-blocker for high blood pressure.)
Gemfibrozil (Lopid) should not be combined with repaglinide because gemfibrozil may significantly increase blood levels of repaglinide leading to side effects.
PREGNANCY: No adequate human studies on the effects of repaglinide on the fetus have been done; however, there have been no effects in animal studies in which the mother has received repaglinide during pregnancy. Nevertheless, animals given repaglinide during both lactation (nursing) and gestation (pregnancy) have developed skeletal defects. Therefore, physicians must weight the potential benefits and risks of this medication when considering its use in pregnant women.
NURSING MOTHERS: 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.
SIDE EFFECTS: 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 hunger, nausea, tiredness, perspiration, headache, heart palpitations, numbness around the mouth, tingling in the fingers, tremors, muscle weakness, blurred vision, cold temperature, excessive yawning, irritability, confusion, or loss of consciousness.
Other common side effects include headache, nausea, vomiting, diarrhea, constipation, stomach pain, back pain, upper respiratory infections, and chest pain. Hair loss, pancreatitis, liver failure, sever skin reactions, and anemia have also been reported in post marketing reports.
Reference: FDA Prescribing Information
Last Editorial Review: 11/12/2012
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