repaglinide


Also found in: Dictionary, Wikipedia.

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

(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

NovoNorm®, Prandin® Endocrinology An oral nonsulfonylurea hypoglycemic for Pts with type 2 DM, whose hyperglycemia does not respond to diet and exercise
References in periodicals archive ?
Nordisk, "Prandin[R] (repaglinide) tablets," July 2018, http://www.novo-pi.com/prandin.pdf/.
Liu, "Comparison of metformin and repaglinide monotherapy in the treatment of new onset type 2 diabetes mellitus in China," Journal of Diabetes Research, vol.
Dolff et al., "Repaglinide in the management of new-onset diabetes mellitus after renal transplantation," American Journal of Transplantation, vol.
Alpha glucosidase inhibitor, glucagon-like peptide 1 (GLP-1), Thiazolidinedione (TZDs) and Repaglinide are also alternate choice of drugs (Fig.1).
These include sulfonylureas, such as glipizide and glimepiride, and glinides, such as repaglinide (Prandin) and nateglinide (Starlix).
Nateglinide (Starlix) and repaglinide (Prandin) are the agents in this subclass.
Reddy, "In vitro characterization and in vivo toxicity study of repaglinide loaded poly (methyl methacrylate) nanoparticles," International Journal of Pharmaceutics, vol.
Ozkan, "Selective and sensitive determination of repaglinide in pharmaceuticals by voltammetric and LC methods," Revue Roumaine de Chimie, vol.
Han Chinese, (i) Serum [56] 2013 long standing (ii) No treatment with insulin (iii) Some patients received metformin and/or repaglinide He et al.
reported a higher risk for repaglinide (OR, 2.12; 95% CI, 1.38-3.26) than for sulfonylureas (OR, 1.39; 95% CI 0.98-1.99) [122].
for 14 days did not significantly affect the pharmacokinetics and pharmacodynamics of repaglinide in healthy volunteers, suggesting that St.