Repaglinide
PRANDIN
Pronunciation: re-PAG-lin-ide
“Repay gliding Panda (Brandon)”
sugar → insulin secretagogue
What it isMeglitinide closing the beta-cell KATP channel; postprandial hyperglycemia in type 2 diabetes.
Why this oneMeal-linked dosing can be omitted with a skipped meal, reducing prolonged hypoglycemia compared with sulfonylureas.
What limits itFrequent meal-time dosing burdens adherence. Gemfibrozil is contraindicated because CYP2C8 inhibition can cause severe hypoglycemia.
Repaglinide prescription history
Animated chart of estimated U.S. prescriptions per year, Diabetes meds (1923–2026). Repaglinide enters in 1998 (estimated).
FDA-approved for
- type 2 diabetes (1997)
Principal riskHypoglycemia; contraindicated with gemfibrozil
Classes and tags
Clinical profile
Legacy pregnancy categoryMultiple / indication-, trimester- or formulation-dependent
Defining liabilityAgent-specific hypoglycemia, ketoacidosis, volume, renal or gastrointestinal toxicity.
FDA label
Read the full label on DailyMed ↗
NO BOXED WARNINGS
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Type 2 diabetes | Adults, HbA1c <8% | 0.5 mg before each meal | 0.5-4 mg before meals | 16 mg/day |
| Type 2 diabetes | Adults, HbA1c >=8% | 1-2 mg before each meal | 0.5-4 mg before meals | 16 mg/day |
Titration At least 1 week between dose adjustments
Renal Severe impairment (CrCl 20-40): start 0.5 mg before each meal; CrCl <20/dialysis not studied
Hepatic Use caution; longer intervals between dose adjustments; higher hypoglycemia risk
Dose before each meal (2-4x daily)
Instructions
- Take within 30 min before meals
- Skip the dose if a meal is skipped; add a dose if a meal is added
- Reduce dose if hypoglycemia occurs
Available strengths
- tab 0.5, 1, 2 mg
Contraindications
- Concomitant use of gemfibrozil
Cautions
- Hypoglycemia (can be severe/life-threatening)
- Serious cardiovascular reactions with concomitant NPH-insulin (not indicated in combination)
- No conclusive macrovascular risk reduction
Adverse reactions
- Hypoglycemia
- Upper respiratory infection
- Headache
- Sinusitis
- Arthralgia
- Nausea
- Diarrhea
- Back pain
Pregnancy Limited data show no clear drug-associated risk; poorly controlled diabetes carries risk
Lactation Not recommended when breastfeeding
Cost
Generic entry2013
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Self-check
- Repaglinide: What happens to the dose when a meal is skipped?
It can be omitted. - Repaglinide: Which lipid drug is contraindicated?
Gemfibrozil.