Repaglinide
It is a novel insulin secretagogue which act by lowering of post prandial blood glucose as well as fasting blood glucose in patients with type 2 diabetes mellitus by acting on the beta cells of pancreas.Type 2 diabetes mellitus.
Repaglinide may be administered varying from immediately preceding the meal to as long as 30 minutes before the meal. Initial dose : For patients not previously treated with OHA or whose HbA1C is < 8%, the starting dose should be 0.5mg. For patients previously treated with blood glucose-lowering drugs or whose HbA1C is >8%, the starting dose is 1 or 2 mg with each meal preprandially. Maintenance dose : Depending on response the dose may be titrated from 0.25mg upto 4 mg preprandially until satisfactory response is achieved. At least one week should elapase to assess response after each dose adjustment. The recommended dose range is 0.5 mg to 4mg taken preceding each meal. Repaglinide may be dosed preprandially 2, 3, 4, times a day in response to changes in the patient's meal pattern. The maximum recommended daily dose is 16mg. In case of hepatic insufficiency, an initial 0.25mg dose is recommended.
Hypersensitivity, diabetic ketoacidosis, with or without coma, type 1 diabetes.
Hypoglycaemia : Proper patient selection, dosage, and instructions to the patients are important. Hypoglycaemia is more likely to occur in patients with hepatic insufficiency, when caloric intake is deficient, after severe or prolonged exercise, when alcohol is ingested, or when more than one glucose-lowering drug is used. Loss of control of blood glucose may occur when a patient stablized on any diabetic regimen is exposed to stress such as fever, trauma, infection, or srugery. At such times, discontinue repaglinide and administer insulin
Mild or moderate hypoglycaemia, URTIs, nausea, vomiting, arthralgia, back pain, and headache.
Ketoconazole, miconazole and erythromycin: metabolism of repaglinide inhibited. Troglitazone, rifampicin, barbiturates, and carbamazepine : Increase metabolism of repaglinide.
