Repaglinide belongs to the class of medications called antidiabetes agents. It is an oral hypoglycemic (lowering of blood sugar) medication used by people with type 2 diabetes, along with proper diet and exercise, for the control of blood sugar. It is used when diet, exercise, and weight reduction alone have not been found to control blood sugar well enough.

Repaglinide may also be used in combination with metformin or rosiglitazone, two other medications that lower blood sugar, when medication (in addition to diet, exercise, and weight reduction) does not control blood sugar well enough on its own. Repaglinide helps to control blood sugar by increasing the amount of insulin released by the pancreas.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

The usual dose of repaglinide is based on response to the medication, but is usually started at 0.5 mg. It can be taken either immediately before a meal or up to 30 minutes before a meal. The dose is increased by your doctor based on your response to the medication. The maximum daily dose is 16 mg. Repaglinide may be used along with other medications that reduce blood sugar if one medication is not enough to reduce blood sugar levels to the desired range.

Repaglinide should only be taken with meals. Because it works by increasing the release of insulin into the blood, if a meal is delayed, wait until you are starting to eat before taking the medication. If you skip a meal, do not take repaglinide. Wait until your next meal to take a dose.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones given here, do not change the way that you are taking the medication without consulting your doctor.

It is important to take this medication exactly as prescribed by your doctor. If you miss a dose of this medication, skip the missed dose and continue with your regular schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not take this medication if you:

• are allergic to repaglinide or any ingredients of this medication
• are taking the medication gemfibrozil
• are taking the medication clopidogrel
• have diabetic ketoacidosis with or without coma (this condition should be treated with insulin)
• have severe liver disease
• have type 1 diabetes

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• abdominal pain
• constipation
• diarrhea
• dizziness
• gas
• nausea
• vomiting

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

Stop taking the medication and seek immediate medical attention if any of the following occur:

• chest pain or pressure
• convulsions (seizures)
• fast or irregular heartbeat
• signs of an allergic reaction, e.g.:
• difficulty breathing
• hives
• swelling of the face or throat
• sudden partial or complete loss of vision sudden severe headache or worsening headache with dizziness, tremors, fatigue, sweating
• unconsciousness

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Blood sugar control: If you are exposed to extra stress such as fever, trauma, infection, or surgery, your blood sugar control may vary. Monitor your blood sugar carefully and call the doctor if any important changes occur in your control.

Driving or operating machinery: Lowered blood sugar caused by repaglinide may cause decreased alertness affecting your ability to drive or operate machinery. Avoid driving, operating machinery, or performing other potentially hazardous tasks until you have determined how this medication affects you.

Hypoglycemia (low blood sugar): Hypoglycemia (low blood sugar) can occur when taking repaglinide. If you experience low blood sugar (e.g., headache, drowsiness, weakness, dizziness, confusion, irritability, hunger, fast heartbeat, sweating, and feeling jittery) while taking this medication, contact your doctor.

Kidney function: If you have decreased kidney function, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Liver function: Reduced liver function may cause higher levels of repaglinide in the body and increase the risk for low blood sugar levels (hypoglycemia). Make sure you report all your medical conditions to your doctor(s). People with severe liver disease should not take repaglinide.

Missed or delayed meals: This medication acts by promoting the secretion of insulin and should be taken before meals. If a meal is skipped or delayed, the dosing of repaglinide should be skipped or delayed as well.

Pregnancy: This medication should not be used during pregnancy. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: It is not known whether repaglinide passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: This safety and effectiveness of using this medication have not been established for children.

There may be an interaction between repaglinide and any of the following:

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than the ones listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.