Class: Meglitinide, Antidiabetic
Dosage Forms. Oral Tablet: 0.5 mg, 1 mg, 2 mg
Common FDA Label Indication, Dosing, and Titration.
1. Diabetes mellitus, Type II: 0.5-4 mg po bid-qid (with meal), may titrate to 16 mg po daily
Off-Label Uses. None
MOA. Repaglinide is a meglitinide agent that stimulates insulin release from the pancreas via inhibition of adenosine triphosphate (ATP)-potassium channels on the beta cell membrane and potassium efflux. The resulting depolarization and calcium influx induces insulin secretion.
Drug Characteristics: Repaglinide
Medication Safety Issues: Repaglinide
Drug Interactions: Repaglinide
Adverse Reactions: Repaglinide
Efficacy Monitoring Parameters. Preprandial blood glucose between 70 and 130 mg/dL, HbA1c <7%.
Toxicity Monitoring Parameters. Symptoms of hypoglycemia include nausea, sweating, loss of consciousness, severe skin rash, chest pain, unusual bruising or bleeding, severe abdominal pain, muscle weakness or pain, and decreased urine production. Monitor BP, HR, CBC, LFT.
Key Patient Counseling Points. Monitor blood glucose in frequent intervals (2-4 times per day). Take 15-30 min before each meal, up to 4 times a day. Do not take if skipping a meal.
Clinical Pearls. Compared with the sulfonylureas, repaglinide has a quicker onset and shorter duration of action, resulting in a lower risk of prolonged hypoglycemia. Not for use in children. Metformin is first-line therapy for Type II diabetes. Repaglinide is considered a third-line therapy.