Monograph Details
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Endocrine System
> Diabetes
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PRANDIN |
| Manufacturer |
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Novo Nordisk |
| Legal Classification |
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Rx
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| Pharmacological Class |
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Meglitinide analogue. |
| Generic Name |
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Repaglinide 0.5mg, 1mg, 2mg; tabs. |
| Indications |
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Adjunct to diet and exercise in type 2 diabetes, as monotherapy or with metformin or thiazolidinediones. |
| Children |
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Not recommended. |
| Adults |
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Take within 30 minutes before meals (skip dose if meal is skipped; add dose if meal is added). Treatment-naive, or HbA1c <8%, or severe renal dysfunction (CrCl 20–40 mL/min): initially 0.5 mg with 2–4 meals daily. Previously treated with antidiabetic agents and HbA1c ≥8%: initially 1–2 mg with 2–4 meals daily. For both: titrate by doubling dose at intervals of at least 1 week; range 0.5–4 mg with 2–4 meals daily; max 16 mg/day. Hemodialysis or CrCl <20 mL/min: not recommended. |
| Contraindications |
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Type 1 diabetes. Diabetic ketoacidosis. |
| Precautions |
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Not for use with NPH-insulin (serious cardiovascular events possible). Elderly, debilitated, malnourished, or adrenal, pituitary, hepatic or severe renal insufficiency: increased risk of hypoglycemia; titrate more slowly. Stress. Monitor for initial effect and for secondary failure. Pregnancy (Cat.C): consider using insulin instead. Nursing mothers: not recommended. |
| Interactions |
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Potentiated by gemfibrozil, itraconazole; do not start repaglinide if on gemfibrozil and vice versa; do not use itraconazole with gemfibrozil and repaglinide. β-blockers, alcohol, other antidiabetic agents increase risk of hypoglycemia. May be potentiated by CYP3A4 inhibitors (eg, ketoconazole, miconazole, erythromycin, clarithromycin), and by other highly protein-bound drugs (eg, NSAIDs, salicylates, sulfonamides), chloramphenicol, coumarins, probenecid, MAOIs. May be antagonized by other CYP3A4 inducers (eg, carbamazepine, rifampin, barbiturates), isoniazid, nicotinic acid, phenytoin, diuretics, corticosteroids, phenothiazines, sympathomimetics, calcium channel blockers, estrogens, thyroid drugs, others. β-blockers may mask hypoglycemia. |
| Adverse Reactions |
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Hypoglycemia, upper respiratory infection, headache, diarrhea, constipation, arthralgia, back or chest pain. Oral antidiabetics may increase risk of cardiovascular mortality; myocardial ischemia (w. NPH-insulin). |
| How Supplied |
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Tabs—100, 500, 1000 |
| Additional Resources |
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• Related Prescribing Note |
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