repaglinide

(redirected from Novonorm)
Also found in: Dictionary.
Related to Novonorm: repaglinide, Prandin

repaglinide

 [rĕ-pag´lĭ-nīd]
an oral hypoglycemic agent used in treatment of type 2 diabetes mellitus.

repaglinide

Gluconorm (CA), NovoNorm (UK), Prandin

Pharmacologic class: Meglitinide

Therapeutic class: Hypoglycemic

Pregnancy risk category C

Action

Inhibits alpha-glucosidases, enzymes that convert oligosaccharides and disaccharides to glucose. This inhibition lowers blood glucose level, especially in postprandial hyperglycemia.

Availability

Tablets: 0.5 mg, 1 mg, 2 mg

Indications and dosages

Adjunct to diet and exercise in type 2 (non-insulin-dependent) diabetes mellitus uncontrolled by diet and exercise alone, or combined with metformin in type 2 diabetes mellitus uncontrolled by diet, exercise, and either repaglinide or metformin alone

Adults: 0.5 to 4 mg P.O. before each meal; may adjust at 1-week intervals based on blood glucose response. Maximum daily dosage is 16 mg.

Contraindications

• Hypersensitivity to drug or its components
• Diabetic ketoacidosis
• Type 1 (insulin-dependent) diabetes mellitus
• Administration with gemfibrozil

Precautions

Use cautiously in:
• renal or hepatic impairment; adrenal or pituitary insufficiency; stress caused by infection, fever, trauma, or surgery
• concurrent use of CYP2C8 inhibitors (such as trimethoprim, gemfibrozil, montelukast)
• concurrent use of CYP3A4 inhibitors (such as ketoconazole, itraconazole, erythromycin)
• concurrent use of CYP3A4 or CYP2C8 inducers (such as rifampin, barbiturates, carbamazepine)
• elderly or malnourished patients
• pregnant or breastfeeding patients
• children.

Administration

• Give 15 to 30 minutes before meals. Administer two, three, or four times daily, if needed, to adapt to patient's meal pattern.

Adverse reactions

CNS: headache, paresthesia

CV: angina, chest pain

EENT: sinusitis, rhinitis

GI: nausea, vomiting, diarrhea, constipation, dyspepsia

GU: urinary tract infection

Metabolic: hyperglycemia, hypoglycemia

Musculoskeletal: joint pain, back pain

Respiratory: upper respiratory infection, bronchitis

Other: tooth disorder, hypersensitivity reaction

Interactions

Drug-drug.Barbiturates, carbamazepine, rifampin: decreased repaglinide blood level

Beta-adrenergic blockers, chloramphenicol, MAO inhibitors, nonsteroidal antiinflammatory drugs, probenecid, sulfonamides, warfarin: potentiation of repaglinide effects

Calcium channel blockers, corticosteroids, estrogens, hormonal contraceptives, isoniazid, phenothiazines, phenytoin, nicotinic acid, sympathomimetics, thyroid preparations: loss of glycemic control

Clarithromycin: increased repaglinide area under the curve and Cmax

Cyclosporine: increased repaglinide plasma concentration

Erythromycin, ketoconazole, miconazole: decreased repaglinide metabolism, increased risk of hypoglycemia

Gemfibrozil, itraconazole: significantly increased repaglinide exposure

Simvastatin: increased repaglinide level

Drug-food.Any food: decreased drug bioavailability

Drug-herbs.Aloe gel (oral), bitter melon, chromium, coenzyme Q10, fenugreek, gymnema sylvestre, psyllium, St. John's wort: additive hypoglycemic effects

Glucosamine: poor glycemic control

Patient monitoring

• Monitor blood glucose and glycosylated hemoglobin levels.
• Monitor patient's meal pattern. Consult prescriber about adjusting dosage if patient adds or misses a meal.
• Assess for angina, shortness of breath, or other discomforts.
• Watch for signs and symptoms of bronchitis and upper respiratory, urinary, and EENT infections.

Patient teaching

• Tell patient to take 15 to 30 minutes before each meal.
• Instruct patient to monitor blood glucose level carefully. Teach him to recognize signs and symptoms of hypoglycemia and hyperglycemia.
• Advise patient to report signs and symptoms of infection.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, foods, and herbs mentioned above.

repaglinide

/re·pag·li·nide/ (rĕ-pag´lĭ-nīd) an oral hypoglycemic agent used in the treatment of type 2 diabetes mellitus.

repaglinide

(rĭ-păg′lə-nīd′)
n.
An oral hypoglycemic drug, C27H36N2O4, that stimulates the release of insulin from the pancreas and is used to treat type 2 diabetes.

repaglinide

an antidiabetic.
indication It is used to treat stable type 2 diabetes mellitus.
contraindications Known hypersensitivity to meglitinides, diabetic ketoacidosis, and type 1 diabetes mellitus prohibit its use.
adverse effects Hypoglycemia is a life-threatening effect. Other adverse effects include paresthesia, nausea, vomiting, diarrhea, constipation, dyspepsia, rash, allergic reactions, back pain, arthralgia, upper respiratory infection, sinusitis, rhinitis, and bronchitis. Headache and weakness are common side effects.

repaglinide

NovoNorm®, Prandin® Endocrinology An oral nonsulfonylurea hypoglycemic for Pts with type 2 DM, whose hyperglycemia does not respond to diet and exercise

repaglinide

oral agent that stimulates insulin release from pancreatic beta cells; used as an alternative/adjunct to metformin therapy, in diabetes mellitus
References in periodicals archive ?
Following cardiovascular risk data from the DECODE study, the importance of post-prandial glucose is again highlighted as Prandial Glucose Regulator (PGR) NovoNorm is noted in Ramadan Guidelines for advantages of flexibility and reduced `HYPO' risk.
NovoNorm (repaglinide) is a PGR that is only taken when a meal is eaten (one meal, one dose - if no meal, then no dose is required - unlike all other insulin secretagogues) and works directly to combat the post-prandial glucose spike that follows a meal.
5) Long-term data with NovoNorm PGR have already indicated that it can substantially reduce post-prandial glucose, fasting glucose and HbA1c, (6) further studies are awaited to investigate the macrovascular advantages of PGR treatment.
NovoNorm (repaglinide) is a Prandial Glucose Regulator (PGR) which works by stimulating the physiological release of insulin every time a meal is eaten