Antihyperglycemics (meglitinides)
- Short-acting insulin secretagogues
- Repaglinide/nateglinide target meal glucose
- Dose with meals; skip if meal skipped
- Less prolonged hypoglycemia than sulfonylureas
- Still cause hypoglycemia + weight gain
- Repaglinide has important CYP/OATP DDIs
- Now niche drugs rather than default therapy
Class at a glance
- Short-acting insulin secretagogues
Practical pearls
- Less prolonged hypoglycemia than sulfonylureas
Pharmacology
- Repaglinide has important CYP/OATP DDIs
Members / distinctions
- Repaglinide/nateglinide target meal glucose
- Dose with meals; skip if meal skipped
- Now niche drugs rather than default therapy
Other practical pearls
- Still cause hypoglycemia + weight gain
Pearls
- Repaglinide lowers A1c more than nateglinide
- No CV or microvascular outcome benefit
Self-check
- Which meglitinide has important CYP/OATP interactions?
Repaglinide. - How should meglitinides be taken when a meal is skipped?
Skip the dose.
Drugs in this class (2)
Antihyperglycemics (meglitinides) prescription history
Animated chart of estimated U.S. prescriptions per year, Diabetes meds (1923–2026). Meglitinide highlighted from 1998.
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