Indications
Therapeutic Class
Pharmacology
Dosage & Administration
Repaglinide has to be taken just before or up to 30 minutes before the meal. Repaglinide can be taken two, three or four times a day, depending on how many meals are taken. If a meal is missed, Repaglinide should also be avoided. If an extra meal is taken, an extra dose of Repaglinide should be taken with that meal. If a dose of Repaglinide is missed, it should not be taken between meals.
Rather the usual dose should be taken before the next meal. The dose ranges from 0.5 to 4 mg before each meal. The starting dose of Repaglinide in patients with HbA1c <8% is 0.5 mg before each meal. In patients with HbA1c >8% the starting dose is 1 or 2 mg before each meal. The dose may be increased gradually up to 4 mg before each meal.
Interaction
The dose of Repaglinide may need to be adjusted, if taken with other medications. The possible interactions of Repaglinide with other drugs are:
i) Inhibitors of the cytochrome P450 enzyme system (azole antifungals and macrolides) may lead to lower Repaglinide clearance and longer half life.
ii) Inducers of the cytochrome P450 enzyme system (Rifampin, Phenobarbital, Carbamazepine, Troglitazone, etc.) may accelerate Repaglinide metabolism and shorten its effect.
iii) Cimetidine has no significant effect on Repaglinide absorption or clearance.
iv) Repaglinide has no significant effect on Digoxin, Theophyllin, or Warfarin.
v) Highly protein bound drugs (e.g., NSAIDs) may increase the plasma level of unbound Repaglinide and potentiate its glucose lowering effect. Thus, co-administration of these drugs with Repaglinide may increase the risk of hypoglycaemia.
vi) The risk of hypoglycaemia may also be increased when hypoglycaemic agents are co-administered with certain drugs such as salicylates, sulphonamides, Chloramphenicol, coumarins, Probenecid, monoamine oxidase (MAO) inhibitors, and adrenergic blockers.
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