Repaglinide

Indications & Dose:

Oral hypoglycemic adjunct to diet and exercise; as monotherapy and combination therapy with metformin in patients with type 2 diabetes mellitus; affects primarily postprandial blood glucose; minimal effects on fasting blood glucose were observed

• BY MOUTH

Adult and Child >16 yr

• Initially 0.5mg, usually within 15 minutes before each main meal. Titrate at 1-2 weeks intervals according to response. Max;4mg as a single dose,before each meal , max total daily dose 16mg. If transferring from another oral hypoglycaemic, start therapy with 1mg before each meal

Elderly

Over 75 years not recommended. 

Contraindications:

Hypersesitivity to repaglinide, pergnancy, lactation, TypeI diabetes, diabetic ketoacidosis, severe  renal & hepatic function disorder. 

Side Effects:

Cautions:

Precautions:

Hypoglycemia;  insulin replacement may be necessary during stress (infection, fever, trauma, surgery)

Interaction:

Drugs

Aspirin. B-blockers, sulfa drugs. chloramphenicol, warfarin.

MAO Inhibitors: hypoglycemia

Ketoconazole, miconazole, erythromycin, troglitazone, rifampicin, carbamazepine, phenobarbital, butalbital. secobarbital, or primidone: potential increased repaglinide metabolism :secondary to cytochrome P450 enzyme induction

Thiazide diuretics, calcium channel blockers. beta blockers, cough, cold. or hay fever medicines, estrogen, birth control pills, corticosteroids, thyroid medicine, phenytoin, isoniazid, or nicotinic acid: hyperglycemia 

Warnings:

Adverse Effects:

Lactations:

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

GI: Nausea, diarrhea, constipation, vomiting, dyspepsia
METAB: Hypoglycemia 

Patient And Carer Advice: