Repaglinide

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Generic Name of Repaglinide - Learn More

Repaglinide

Repaglinide Precaution - What You Need to Know

Before initiating Repaglinide therapy, it is crucial for patients to consult their healthcare provider to ensure its suitability for their specific health condition. Some important precautions include:

- Hypoglycemia Risk: Repaglinide stimulates insulin release from the pancreas and may lead to hypoglycemia (low blood sugar). Patients should monitor their blood glucose regularly, especially when there are changes in diet, exercise, or other medications.
- Liver or Kidney Impairment: Repaglinide should be used with caution in patients with liver or renal dysfunction. In patients with severe liver impairment, dose reduction may be required, and renal impairment may necessitate careful monitoring of blood glucose.
- Alcohol Consumption: Excessive alcohol intake can increase the risk of hypoglycemia. It is advisable for patients taking Repaglinide to limit alcohol consumption or discuss alcohol use with their healthcare provider.
- Pregnancy and Lactation: The safety of Repaglinide during pregnancy and breastfeeding is not well established. It should only be used during pregnancy if clearly needed, and breastfeeding should be avoided unless absolutely necessary, as it is unclear whether it passes into breast milk.
- Surgical Procedures or Stress: Patients undergoing surgery or those experiencing severe stress (due to illness, fever, or trauma) may require adjustments in their diabetes treatment, including Repaglinide. Stress can elevate blood glucose levels, potentially requiring higher doses.

Repaglinide Indication - Uses and Benefits

Repaglinide is primarily prescribed for the treatment of type 2 diabetes to help control blood glucose levels. Key indications include:

- Type 2 Diabetes Mellitus: Repaglinide is used as a prandial (meal-time) medication, usually in combination with diet and exercise, to manage elevated blood glucose in individuals with type 2 diabetes. It helps control blood sugar levels after meals by stimulating insulin secretion from the pancreas.
- Monotherapy or Combination Therapy: It can be used alone (monotherapy) or in combination with other oral hypoglycemic agents, such as metformin or thiazolidinediones, when diet and exercise alone are not sufficient to control blood sugar levels.
- Postprandial Glucose Control: Repaglinide is particularly effective in controlling postprandial (after-meal) glucose levels, making it useful for patients whose blood sugar spikes primarily after eating.

Repaglinide Contraindications - Important Warnings

Repaglinide should not be used in the following circumstances:

- Type 1 Diabetes: Repaglinide is contraindicated in individuals with type 1 diabetes, as it is ineffective for controlling blood sugar in this condition.
- Diabetic Ketoacidosis: Patients with diabetic ketoacidosis (a life-threatening complication of diabetes) should not use Repaglinide. Treatment of diabetic ketoacidosis requires insulin therapy and other supportive measures.
- Hypersensitivity: Individuals who have a known hypersensitivity to Repaglinide or any of its components should avoid its use.
- Severe Liver Impairment: Repaglinide should be used with caution in individuals with severe liver disease, as its metabolism may be significantly affected, and dose adjustments may be required.
- Pregnancy and Lactation: Repaglinide is not recommended during pregnancy and lactation unless clearly indicated by a healthcare provider.

Repaglinide Side Effects - What to Expect

Repaglinide is generally well-tolerated, but it can cause both common and serious side effects. Patients should be alert for the following:

Common Side Effects:
- Hypoglycemia: The most common side effect of Repaglinide is low blood sugar (hypoglycemia), especially if meals are missed, after exercise, or with alcohol consumption.
- Weight Gain: Some patients may experience mild weight gain, which can occur due to better control of blood sugar levels and insulin secretion.
- Headache: Headaches may occur during treatment, particularly when blood sugar levels fluctuate.

Serious Side Effects:
- Severe Hypoglycemia: If blood sugar drops too low, it can cause severe symptoms like confusion, shakiness, sweating, dizziness, or even seizures and loss of consciousness. Immediate treatment with glucose or glucagon is required.
- Liver Dysfunction: Rarely, Repaglinide can cause liver problems, including elevated liver enzymes or hepatitis. Symptoms like jaundice, dark urine, or fatigue should be reported immediately.
- Allergic Reactions: Some patients may develop an allergic reaction, including rash, itching, or difficulty breathing. In rare cases, anaphylaxis could occur.
- Skin Rash: Some individuals may experience a mild skin rash, which should be monitored for further worsening.

Repaglinide Pregnancy Category ID - Safety Information

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Repaglinide Mode of Action - How It Works

Repaglinide works by stimulating the pancreas to release insulin, which helps reduce blood glucose levels. It does so through the following mechanism:

- Potentiation of Insulin Secretion: Repaglinide binds to ATP-sensitive potassium channels on the surface of pancreatic beta cells, leading to the opening of calcium channels. This influx of calcium stimulates insulin release.
- Meal-Dependent Insulin Release: Unlike other oral antidiabetic agents, Repaglinide has a rapid onset of action and is particularly effective in controlling postprandial glucose levels (the rise in blood sugar that occurs after eating).
- Short Duration of Action: The effects of Repaglinide are short-acting, making it useful for controlling blood sugar immediately after meals. It helps reduce the likelihood of large spikes in blood glucose levels after eating.

Repaglinide Drug Interactions - What to Avoid

Repaglinide may interact with various medications, which can impact its effectiveness or increase the risk of adverse effects. Key interactions include:

- CYP450 Enzyme Inhibitors/Inducers: Repaglinide is metabolized in the liver by the CYP3A4 enzyme, and its blood levels can be affected by CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin) or CYP3A4 inducers (e.g., rifampin, phenytoin). Inhibitors can increase Repaglinide levels, increasing the risk of hypoglycemia, while inducers may reduce its efficacy.
- Other Antidiabetic Drugs: When combined with insulin or other oral hypoglycemic agents (e.g., metformin, sulfonylureas), the risk of hypoglycemia is increased. Dose adjustments of these medications may be necessary to prevent low blood sugar.
- Beta-Blockers: Beta-blockers (e.g., atenolol, propranolol) can mask the symptoms of hypoglycemia, such as tachycardia, making it harder for patients to recognize low blood sugar episodes.
- Alcohol: Alcohol may enhance the hypoglycemic effect of Repaglinide and should be consumed cautiously. In some cases, alcohol can cause an unpredictable drop in blood sugar, especially in individuals with diabetes.
- Corticosteroids and Diuretics: Corticosteroids (e.g., prednisone) and diuretics (e.g., thiazides) may increase blood sugar levels, potentially counteracting the effects of Repaglinide and necessitating dose adjustments.

Repaglinide Adult Dose - Recommended Dosage

The recommended dose for Repaglinide in adults is as follows:

- Initial Dose: The typical starting dose is 0.5 mg before meals, usually for patients with blood glucose levels not well controlled with diet alone.
- Maintenance Dose: The dose can be adjusted based on the patient's blood sugar response. The usual dose ranges from 0.5 mg to 2 mg before each meal, up to a maximum of 4 mg per meal.
- Meal Timing: Repaglinide should be taken just before meals to control postprandial blood glucose levels. If a meal is skipped, the dose should also be skipped to avoid hypoglycemia.

Repaglinide Child Dose - Dosage for Children

Repaglinide is not recommended for use in children under 18 years of age, as its safety and efficacy have not been established in pediatric populations.

As always, it is critical for patients to consult their healthcare provider before starting Repaglinide to ensure it is appropriate for their individual health condition and needs.

Repaglinide Renal Dose - Dosage for Kidney Conditions

For patients with renal impairment, the dose of Repaglinide should be adjusted:

- Mild to Moderate Renal Impairment: The starting dose may be 0.5 mg before meals, and dosing should be adjusted based on blood glucose levels.
- Severe Renal Impairment: For patients with severe renal impairment (e.g., CrCl <30 mL/min), caution should be exercised. The dose may need to be reduced, and blood glucose should be closely monitored.