Repaglinide

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.

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.

Before taking repaglinide,

• tell your doctor and pharmacist if you are allergic to repaglinide or any other drugs.

• tell your doctor if you are taking gemfibrozil (Lopid). Your doctor will probably tell you not to take repaglinide if you are taking this medication.

• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: acetophenazine (Tindal), aspirin, blood pressure medicines, carbamazepine (Tegretol), chloramphenicol (Chloromycetin), chlorpromazine (Thorazine), corticosteroids, diuretics ('water pills'), drugs for arthritis, erythromycin, troglitazone (Rezulin), estrogens, fluphenazine (Prolixin), isoniazid (Rifamate), ketoconazole (Nizoral), mesoridazine (Serentil), oral contraceptives, perphenazine (Trilafon), phenelzine (Nardil), phenobarbital (Luminal), phenytoin (Dilantin), probenecid (Benemid), prochlorperazine (Compazine), promazine (Sparine), promethazine (Phenergan), rifampin (Rifadin, Rimactane), thioridazine (Mellaril), tranylcypromine (Parnate), trifluoperazine (Stelazine), triflupromazine (Vesprin), trimeprazine (Temaril), vitamins, or warfarin (Coumadin). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.

• tell your doctor if you have or have ever had liver or kidney disease or if you have been told you have type I diabetes mellitus.

• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking repaglinide, call your doctor.

• if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking repaglinide.

Be sure to follow all exercise and dietary recommendations made by your doctor or dietitian. It is important to eat a healthful diet.

Alcohol may cause a decrease in blood sugar. Ask your doctor about the use of alcoholic beverages while you are taking repaglinide.

If you have just begun to eat a meal, take the missed dose as soon as you remember it. However, if you have finished eating, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

This medication may cause changes in your blood sugar. You should know the symptoms of low and high blood sugar and what to do if you have these symptoms.

• You may experience hypoglycemia (low blood sugar) while you are taking this medication. Your doctor will tell you what you should do if you develop hypoglycemia. He or she may tell you to check your blood sugar, eat or drink a food or beverage that contains sugar, such as hard candy or fruit juice, or get medical care. Follow these directions carefully if you have any of the following symptoms of hypoglycemia:

  • shakiness

  • dizziness or lightheadedness

  • sweating

  • nervousness or irritability

  • sudden changes in behavior or mood

  • headache

  • numbness or tingling around the mouth

  • weakness

  • pale skin

  • hunger

  • clumsy or jerky movements

• If hypoglycemia is not treated, severe symptoms may develop. Be sure that your family, friends, and other people who spend time with you know that if you have any of the following symptoms, they should get medical treatment for you immediately.

  • confusion

  • seizures

  • loss of consciousness

• Call your doctor immediately if you have any of the following symptoms of hyperglycemia (high blood sugar):

  • extreme thirst

  • frequent urination

  • extreme hunger

  • weakness

  • blurred vision

• If high blood sugar is not treated, a serious, life-threatening condition called diabetic ketoacidosis could develop. Call your doctor immediately if you have any of these symptoms:

  • dry mouth

  • upset stomach and vomiting

  • shortness of breath

  • breath that smells fruity

  • decreased consciousness

• Repaglinide may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

  • headache

  • nasal congestion

  • joint aches

  • back pain

  • constipation

  • diarrhea

Keep this medication in the container it came in, tightly closed and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

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.

• Prandimet^® (containing Metformin, Repaglinide)