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an oral hypoglycemic agent used in treatment of type 2 diabetes mellitus.


Gluconorm (CA), NovoNorm (UK), Prandin

Pharmacologic class: Meglitinide

Therapeutic class: Hypoglycemic

Pregnancy risk category C


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


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.


• Hypersensitivity to drug or its components

• Diabetic ketoacidosis

• Type 1 (insulin-dependent) diabetes mellitus

• Administration with gemfibrozil


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.


• 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


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.


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


An oral hypoglycemic drug, C27H36N2O4, that stimulates the release of insulin from the pancreas and is used to treat type 2 diabetes.


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.


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 ?
Improvement of insulin sensitivity and beta- cell traction by nateglinide and repaglinide in type 2 diabetic patients a randomized controlled double-blind and double-dummy muhicentre clinical trial.
The second 52-center study enrolled 306 patients whose diabetes was poorly controlled by a combination of two oral agents (either sulfonylurea or repaglinide, plus either a glitazone or metformin) for at least 2 months.
But, according to the company, studies also show that patients who skipped a meal were less likely to suffer hypoglycemia if they took short-acting drugs like repaglinide, which Novo Nordisk markets under the Prandin name in a copromotion with Schering-Plough Corp.
The use of the lipid-lowering drug gemfibrozil with the insulin secretagogue repaglinide increases the risk of hypoglycemia in patients with with type 2 diabetes.
Last summer the Food and Drug Administration granted expedited review status to Novo Nordisk's new drug application for repaglinide, its oral antidiabetes agent for the treatment of Type 2 diabetes.
Pharmacologic agents that counteract PPG excursions include rapid-acting insulin secretagogues (glinides, ie, repaglinide, nateglinide), alpha-glucosidase inhibitors (acarbose, miglitol), and rapid-acting insulin analogs.
SAN DIEGO -- Repaglinide is more effective than nateglinide for patients with type 2 diabetes, whether used as monotherapy or in combination with met-formin, according to results from two open-label multicenter studies presented at the annual meeting of the American Association of Clinical Endocrinologists.
The glinides, repaglinide, and nateglinide are administered close to a meal, thus increasing effectiveness in reducing postprandial glucose levels.