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Repaglinide (Prandin)
(re- PAY-glin-eyed)
Pregnancy Category: C Prandin (Rx)

Classification: Oral antidiabetic

See Also: See also Antidiabetic Agents, Hypoglycemic Agents.

Action/Kinetics: Lowers blood glucose by stimulating release of insulin from pancreas. Action depends on functioning beta cells in pancreatic islets. Drug closes ATP-dependent potassium channels in beta-cell membrane due to binding at sites. Blockade of potassium channel depolarizes beta cell which leads to opening of calcium channels. This causes calcium influx which induces insulin secretion. Rapidly and completely absorbed from GI tract. Peak plasma levels: 1 hr. Completely metabolized in liver with most excreted in feces.

Uses: Adjunct to diet and exercise in type 2 diabetes mellitus. In combination with metformin to lower blood glucose where hyperglycemia can not be controlled by exercise, diet, or either drug alone.

Contraindications: Lactation. Diabetic ketoacidosis, with or without coma. Type 1 diabetes.

Special Concerns: Use with caution in impaired hepatic function. Safety and efficacy have not been determined in children.

Side Effects: CV: Chest pain, angina, ischemia. GI: Nausea, diarrhea, constipation, vomiting, dyspepsia. Respiratory: URI, sinusitis, rhinitis, bronchitis. Musculoskeletal: Arthralgia, back pain. Miscellaneous: Hypoglycemia, headache, paresthesia, chest pain, UTI, tooth disorder, allergy.

Overdose Management: Symptoms: Hypoglycemia. Treatment: Oral glucose. Also adjust drug dosage or meal patterns.

Drug Interactions: See Antidiabetic Agents, Hypoglycemic Agents.

How Supplied: Tablets: 0.5 mg, 1 mg, 2 mg

?Tablets Type 2 diabetes mellitus.
Individualize dosage. Initial: In those not previously treated or whose HbA1-C is less than 8%, give 0.5 mg. For those previously treated or whose HbA1-C is 8% or more, give 1 or 2 mg before each meal. Dose range: 0.5-4 mg taken with meals. Maximum daily dose: 16 mg.

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