REPAGLINIDE (ORAL)

(re PAG li nide) Brand: Prandin

What is the most significant information I must know about repaglinide?

• Do not use this medicine if you are allergic to repaglinide, if you have type 1 diabetes, or if you are in a state of diabetic ketoacidosis (call your doctor for treatment with insulin). You must not use repaglinide together with gemfibrozil (Lopid) or NPH insulin (such as isophane insulin).

• Take care not to allow your blood sugar get too low. Low blood sugar (hypoglycemia) can occur if you skip a meal, exercice too long, drink alcohol, or are under stress. Symptoms include headache, famine, weakness, sweating, tremor, irritability, or trouble concentrating. Carry heavy candy or glucose tablets with you in case you have low blood sugar. Another sugar sources include orange juice and milk. Be certain your family and close friends know how to help you in an emergency.

• Also watch for signs of blood sugar that is too tall (hyperglycemia). These symptoms include heighten thirst, heighten urination, famine, dry mouth, fruity breath odor, drowsiness, dry skin, blurred vision, and weight loss. Your blood sugar will need to be checked often, and you may need to adjust your repaglinide dose.

• Repaglinide is only part of a complete program of treatment that also includes diet, exercice, and weight control. Follow your diet, medicine, and exercice routines very closely. Changing any of these factors can affect your blood sugar levels.

What is repaglinide?

• Repaglinide is an oral diabetes medication that helps control blood sugar levels. This medicine lowers blood sugar by causing the pancreas to manufacture insulin.

• Repaglinide is used together with diet and exercice to treat type 2 diabetes. Another diabetes medicines are sometimes used in combination with repaglinide if needed.

• Repaglinide may also be used for purposes not listed in this medicine guide.

What must I discuss with my doctor till taking repaglinide?

• To create certain you can safely take repaglinide, speak your doctor if you have liver disease.

• FDA pregnancy category C. It is not known whether repaglinide will harm an unborn child. Speak your doctor if you are pregnant or plan to become pregnant while using this medication.

• It is not known whether repaglinide passes into breast milk or if it could be deleterious to a nursing child. You must not breast-feed while you are taking repaglinide.

How must I take repaglinide?

• Take exactly as predesigned by your doctor. Do not take in larger or less amounts or for longer than recommended. Follow the directions on your prescription label.

• Repaglinide is generally taken 2 to 4 times daily, within 30 minutes till eating a meal. Follow your doctor's instructions. If you skip a meal, do not take your doze of repaglinide. Wait before your following meal.

• Your blood sugar will need to be checked often, and you may need another blood trials at your doctor's office. Visit your doctor regularly.

• Know the signs of low blood sugar (hypoglycemia) and how to recognize them: headache, famine, weakness, sweating, tremor, irritability, or trouble concentrating.

• Always hold a source of sugar accessible in case you have symptoms of low blood sugar. Sugar sources include orange juice, glucose gel, candy, or milk. If you have severe hypoglycemia and can't ate or drink, use an injection of glucagon. Your doctor can give you a prescription for a glucagon abnormal injection kit and speak you how to give the injection.

• Check your blood sugar carefully during a time of stress or diseases, if you travel, exercice more than normal, drink alcohol, or skip meals. These things can affect your glucose levels and your doze needs may also change.

• Your doctor may want you to stop taking repaglinide for a short time if you become ill, have a fever or infection, or if you have surgery or a medical emergency.

• Ask your doctor how to adjust your repaglinide doze if needed. Do not change your medicine doze or schedule without your doctor's advice.

• Use repaglinide regularly to get the most benefit. Get your prescription refilled till you run out of medication completely.

• Store repaglinide at room temperature away from moisture and heat.

What happens if I miss a dose?

• Take the missed doze as soon as you remember, but only if you are getting ready to ate a meal. Skip the missed doze if it is nearly time for your following scheduled doze. Do not take extra medication to create up the missed dose.

What happens if I overdose?

• Search abnormal medical attention or call the Poison Help line at 1-800-222-1222. A repaglinide overdose can reason life-threatening hypoglycemia.

• Symptoms of severe hypoglycemia include extreme weakness, blurred vision, sweating, trouble speaking, tremors, stomach pain, confusion, and seizure (convulsions).

What must I avoid while taking repaglinide?

• Avoid drinking alcohol. It lowers blood sugar and may interfere with your diabetes treatment.

What are the possible side effects of repaglinide?

• Get abnormal medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your person, lips, tongue, or throat.

• Call your doctor at once if you have a serious side effect such as:

· seizure (convulsions);

· severe pain in your upper stomach spreading to your back, nausea and vomiting, quick heart rate;

· pale or yellowed skin, dark colored urine, fever, confusion or weakness; or

· fever, sore throat, and headache with a severe blistering, peeling, and red skin rash.

• Smaller serious side effects may include:

· runny or stuffy nose, sneezing, cough, cool or flu symptoms;

· diarrhea, nausea;

· back pain, headache;

· dizziness;

· blurred vision;

· joint pain; or

· temporary hair loss.

• This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may message side effects to FDA at 1-800-FDA-1088.

What another drugs will affect repaglinide?

• Speak your doctor about all another medications you use, especially:

· cyclosporine (Gengraf, Neoral, Sandimmune);

· deferasirox (Exjade);

· St. John's wort;

· an antibiotic such as clarithromycin (Biaxin), erythromycin (E.E.S., EryPed, Ery-Tab, Erythrocin, Pediazole), or telithromycin (Ketek);

· an antifungal medicine such as fluconazole (Diflucan), itraconazole (Sporanox), or ketoconazole (Nizoral);

· a barbiturate such as phenobarbital (Solfoton);

· heart or blood pressure medicine such as diltiazem (Cartia, Cardizem), nicardipine (Cardene), nifedipine (Nifedical, Procardia), verapamil (Calan, Covera, Isoptin, Verelan), and others;

· HIV/AIDS medication such as delavirdine (Rescriptor), efavirenz (Sustiva, Atripla), fosamprenavir (Lexiva), indinavir (Crixivan), ritonavir (Norvir), and others;

· rifabutin (Mycobutin), rifampin (Rifadin, Rifater, Rifamate), or rifapentine (Priftin); or

· seizure medicine such as carbamazepine (Carbatrol, Equetro, Tegretol), phenytoin (Dilantin), primidone (Mysoline), and others.

• You may be more likely to have hyperglycemia (high blood sugar) if you are taking repaglinide with another drugs that raise blood sugar, such as:

· isoniazid;

· diuretics (water pills);

· steroids (prednisone and others);

· phenothiazines (Compazine and others);

· thyroid medication (Synthroid and others);

· birth control pills and another hormones;

· seizure medicines (Dilantin and others); and

· diet pills or medicines to treat asthma, colds or allergies.

• You may be more likely to have hypoglycemia (low blood sugar) if you are taking another drugs that lower blood sugar, such as:

· probenecid (Benemid);

· some nonsteroidal anti-inflammatory drugs (NSAIDs);

· aspirin or another salicylates (including Pepto-Bismol);

· a blood thinner (warfarin, Coumadin, Jantoven, and others);

· sulfa drugs (Bactrim, Septra, Sulfatrim, SMX-TMP, and others);

· a monoamine oxidase inhibitor (MAOI); or

· another oral diabetes medications, especially acarbose (Precose), metformin (Glucophage), miglitol (Glyset), pioglitazone (Actos, Duetact, Actoplus Met), or rosiglitazone (Avandia, Avandaryl, Avandamet).

• These lists are not complete and there are much another medicines that can magnify or decrease the effects of repaglinide on lowering your blood sugar. Using determined medicines can create it harder for you to speak when you have low blood sugar. Speak your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal commodity. Do not start a new medicine without telling your doctor.

Where can I get more information?

• Your pharmacist can provide more information about repaglinide.

Remember, hold this and all another medicines out of the reach of children, never share your medicines with others, and use this medicine only for the indication prescribed.

Disclaim: Each effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses external of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way must be construed to indicate that the drug or drug combination is safety, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the help of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

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