Drug Name

Prandin (Repaglinide)

 Drug Uses

Prandin is used to treat Type 2 (non-insulin dependent) diabetes, either alone or in combination with other anti-diabetes medications, along with a diet and exercise program. Controlling high blood sugar helps prevent heart disease, strokes, kidney disease, circulation problems, and blindness.

This drug is taken by mouth, generally about 15 minutes before each meal. Follow all instructions exactly and consult your doctor or pharmacist regarding dosage and meal pattern advice, especially if your eating habits vary. Over time, this drug may not work as well as it did at the beginning of use. Consult your doctor or pharmacist.

 Drug Class and Mechanism

Prandin is an oral medication for lowering blood sugar (glucose) in diabetics. It is in a class of drugs for treating diabetes type 2 called meglitinides and is chemically unlike other anti-diabetic medication. Approximately 90% of patients with diabetes have type 2 or non-insulin dependent diabetes mellitus. (Type 2 diabetes usually occurs in adulthood, and is associated with obesity and a strong family history of diabetes.) Glucose intolerance in diabetes type II is caused by reduced insulin secretion from the pancreas after meals and resistance of the body's cells to insulin's effect which is to stimulate the cells to remove glucose from the blood. This leads to high levels of blood glucose. Like Sulfonylureas, e.g. glyburide (Diabeta; Glynase; Micronase), glipizide (Glucotrol), glimepiride (Amaryl), tolbutamide (Orinase), and tolazamide (Tolinase), prandin stimulates cells in the pancreas to produce insulin. Glyburide may be more potent than prandin at increasing insulin release in persons with low or high blood glucose levels, whereas prandin may be more potent in persons with moderate blood glucose levels. Prandin is unusual in that it has a rapid onset of action and a short duration of action. When taken just prior to meals, it promotes the release of insulin that normally occurs with meals and is responsible for preventing blood glucose levels from becoming high. It has been shown to lower hemoglobin A1c levels by 1.6-1.9%. (Hemoglobin A1c is a blood test which measures the effectiveness of a drug in controlling high blood glucose levels. The lower the hemoglobin A1c, the better the control).

Since this drug is generally given only before meals, consult your doctor or pharmacist regarding advice on a missed dose.

Store at room temperature below 77 degrees F (25 degrees C) away from light and moisture.

 Warnings/Precautions

Tell your doctor your medical history, including: kidney disease, liver disease, adrenal or pituitary gland problems, any allergies. Unusual stresses such as fever, serious infection, trauma or surgery may result in loss of blood sugar control. Consult your doctor or pharmacist. Limit alcohol intake, as it may aggravate drug side effects. This medication should be used only when clearly needed during pregnancy. Insulin therapy may be necessary during pregnancy. Discuss the risks and benefits with your doctor. It is not known whether this drug is excreted into breast milk. Because of the potential risk to the infant, breast-feeding while using this drug is not recommended. Consult your doctor before breast-feeding. Caution is advised when this drug is used in the elderly since side effects may be aggravated and more difficult to recognize.

 Possible Side Effects

Diarrhea or constipation, nausea and joint pains may occur. If these effects persist or worsen, notify your doctor. Unlikely but report promptly any chest pain. This medication can cause low blood sugar (hypoglycemia). The symptoms include: shaking, cold sweats, rapid heartbeat, weakness, headache, fainting. If these symptoms occur, eat a quick source of sugar such as glucose liquid, orange juice, honey, or non-diet soda. Tell your doctor or pharmacist about the reaction. To help prevent hypoglycemia, eat meals on a regular schedule (do not skip meals). In the unlikely event you have an allergic reaction to this drug, seek immediate medical attention. Symptoms of an allergic reaction include: rash, itching, swelling, dizziness, trouble breathing. If you notice other effects not listed above, contact your doctor or pharmacist.

 More Information

Do not share this medication with others. It is recommended you attend a diabetes education program to understand diabetes and all important aspects of its treatment including meals/diet, exercise, personal hygiene, medication and getting regular eye, foot and medical exams. Consult your doctor or pharmacist. Keep all medical appointments. Laboratory and/or medical tests (e.g., liver and kidney function tests, fasting blood glucose, hemoglobin A1c, complete blood counts) will be performed to monitor for side effects and response to therapy. Regularly check your blood or urine for sugar, as directed by your doctor or pharmacist.