Classifications: hormone; antidiabetic agent; meglitinide; Therapeutic: antidiabetic
Pregnancy Category: C
0.5 mg, 1 mg, 2 mg tablets
Oral hypoglycemic agent that lowers blood glucose levels by stimulating release of insulin from the pancreatic islets.
Significantly reduces postprandial blood glucose in type 2 diabetes [preprandial blood glucose between 80 and 120 mg/dL
and HbA1C (glycosylated Hgb <6.5%)]. Minimal effects on fasting blood glucose were observed.
Adjunct to diet and exercise in type 2 diabetes. May also be used in combination with metformin.
Hypersensitivity to repaglinide; insulin-dependent diabetes, diabetic ketoacidosis, hypoglycemia; severe renal dysfunction;
pregnancy (category C), lactation.
Hypoglycemia; loss of glycemic control due to secondary failure; hepatic impairment; older adults, surgery, fever, systemic
infection, trauma. No studies have been done in children.
Route & Dosage
|Type 2 Diabetes
Adult: PO Initial dose: 0.5 mg 1530 min a.c.; initial dose for patients previously using glucose-lowering agents: 12
mg 1530 min a.c. (24 doses/d depending on meal pattern; max: 16 mg/d); dosage range: 0.54 mg 1530
- Give within 30 min of beginning a meal.
- Store at 15°30° C (59°86° F) in a tightly closed container and protect from moisture.
Adverse Effects (≥1%)Body as a Whole:
Arthralgia, back pain, paresthesia, allergy. CNS:
Chest pain, angina. GI:
Nausea, diarrhea, constipation
, vomiting, dyspepsia. Respiratory:
, rhinitis, bronchitis
. Metabolic: Hypoglycemia.
InteractionsDrug: Erythromycin, ketoconazole
may inhibit metabolism and potentiate hypoglycemia; barbiturates
, carbamazepine, rifabutin, rifampin, rifapentine, pioglitazone
may induce metabolism and cause hyperglycemia; gemfibrozil
may increase risk of hypoglycemia
and duration of action. Herbal: Ginseng, garlic
may increase hypoglycemic effects. Food: Grapefruit juice
(>1 qt/d) may increase plasma
concentrations and adverse effects.
Rapidly from GI tract, 56% bioavailability. Peak:
1 h. Distribution:
98% protein bound. Metabolism:
In liver (CYP3A4). Elimination:
90% in feces. Half-Life:
Assessment & Drug Effects
- Lab tests: Frequent FBS and postprandial blood glucose monitoring and HbA1C q3mo to determine effective dose.
- Monitor carefully for S&S of hypoglycemia especially during the 1-wk period following transfer from a longer-acting sulfonylurea
such as chlorpropamide.
Patient & Family Education
- Take only with meals to lessen the chance of hypoglycemia. If a meal is skipped, skip a dose; if a meal is added, add a
- Start repaglinide the morning after the other agent is stopped when changing from another oral hypoglycemia drug.
- Be alert for S&S of hyperglycemia or hypoglycemia (see Appendix F); report poor blood glucose control to physician.