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Repaglinide

Repaglinide

What is repaglinide, and how does it work (mechanism of action)?

Repaglinide is an oral medication for lowering blood sugar (glucose) in individuals with type 2 diabetes. It is in a class of drugs for treating diabetes type 2 called meglitinides that are chemically unlike other anti-diabetic medications. Nateglinide (Starlix), is another currently available meglitinide. Approximately 90% of patients with diabetes have type 2 or non-insulin dependent diabetes mellitus. Type 2 diabetes usually occurs in adulthood, and is associated with obesity, and a strong family history of diabetes. Glucose intolerance that causes diabetes type 2 is caused by reduced insulin secretion from the pancreas after meals and resistance of the body's cells to insulin's effect which is to stimulate the cells to remove glucose from the blood. This leads to high levels of glucose in the blood.

Why is this medication prescribed?

Repaglinide is used to treat type 2 diabetes (condition in which the body does not use insulin normally and, therefore, cannot control the amount of sugar in the blood). Repaglinide helps your body regulate the amount of glucose (sugar) in your blood. It decreases the amount of glucose by stimulating the pancreas to release insulin.

Over time, people who have diabetes and high blood sugar can develop serious or life-threatening complications, including heart disease, stroke, kidney problems, nerve damage, and eye problems.Taking medication(s), making lifestyle changes (e.g., diet, exercise, quitting smoking), and regularly checking your blood sugar may help to manage your diabetes and improve your health. This therapy may also decrease your chances of having a heart attack, stroke, or other diabetes-related complications such as kidney failure, nerve damage (numb, cold legs or feet; decreased sexual ability in men and women), eye problems, including changes or loss of vision, or gum disease. Your doctor and other healthcare providers will talk to you about the best way to manage your diabetes.

This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

How should this medicine be used?

Repaglinide comes as a tablet to take by mouth. The tablets are taken before meals, any time from 30 minutes before a meal to just before the meal. If you skip a meal, you need to skip the dose of repaglinide. If you add an extra meal, you need to take an extra dose of repaglinide. Your doctor may gradually increase your dose, depending on your response to repaglinide. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take repaglinide exactly as directed. Do not take more or less of it or take it more often than directed by the package label or prescribed by your doctor.

Continue to take repaglinide even if you feel well. Do not stop taking repaglinide without talking to your doctor.

What other information should I know?

Keep all appointments with your doctor and the laboratory. Your blood sugar and glycosylated hemoglobin (HbA1c) should be checked regularly to determine your response to repaglinide. Your doctor will also tell you how to check your response to this medication by measuring your blood or urine sugar levels at home. Follow these instructions carefully.

You should always wear a diabetic identification bracelet to be sure you get proper treatment in an emergency.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

Dosing Considerations

Combination therapy

If monotherapy does not result in adequate glycemic control, may add metformin or thiazolidinedione

If thiazolidinedione and metformin do not result in adequate glycemic control, repaglinide may be added

Starting dose and dose adjustments for combination therapy are the same as those for repaglinide monotherapy.

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