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Generic Name:

metformin-repaglinide, Oral tablet

All Brands

  • PrandiMet (Discontinued)
A discontinued drug is a drug that has been taken off the market due to safety issues, shortage of raw materials, or low market demand.
SECTION 1 of 4

Highlights for metformin-repaglinide

Oral tablet
1

Repaglinide/metformin is a combination of two drugs in a single form. It’s used to treat high blood sugar levels caused by type 2 diabetes.

2

Common side effects include diarrhea, nausea, vomiting, headache, and low blood sugar (hypoglycemia).

3

Repaglinide/metformin is a generic drug. It’s also available in a brand-name version called PrandiMet.

4

You should take this drug 15–30 minutes before a meal. If you skip a meal, you should also skip your dose of repaglinide/metformin. 

5

Lactic acidosis is a rare but serious side effect of metformin. It’s a medical emergency that requires treatment in the hospital.

IMPORTANT INFORMATION

FDA warning

This drug has a Black Box Warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients to potentially dangerous effects.

Lactic acidosis warning. Lactic acidosis is a rare but serious side effect of metformin, one of the drugs in this combination product. In this condition, lactic acid builds up in your blood. This is a medical emergency that requires treatment in the hospital. Lactic acidosis is fatal in about half of people who develop it. If you have signs of lactic acidosis, you should stop taking metformin and call your doctor right away or go to the emergency room. Symptoms can include:

  • tiredness
  • weakness
  • unusual muscle pain
  • trouble breathing
  • unusual sleepiness
  • stomach pains, nausea, or vomiting
  • dizziness or lightheadedness
  • slow or irregular heart rate

Type 1 diabetes

This drug shouldn’t be used to treat type 1 diabetes.

X-ray procedures

You’ll need to stop taking this drug for a short time if you plan to have an injection of dye or contrast for an x-ray procedure. This can affect how your kidneys work and put you at risk for lactic acidosis.

What is repaglinide/metformin?

This drug is a prescription drug. It’s available as an oral tablet.

This drug is available as a generic drug. It’s also available as a brand-name drug called PrandiMet. Generic drugs usually cost less. In some cases they may not be available in every strength or form as the brand. Talk to your healthcare provider to see if the generic will work for you.

This is a combination of two or more drugs in a single form. It is important to know about all the drugs in the combination because they each may have unique traits.

This drug may be used as part of a combination therapy. That means you may need to take it with other drugs.

Why it's used

This drug is a combination of two drugs used to treat high blood sugar levels caused by type 2 diabetes. It works along with diet and exercise.

More Details

How it works

This drug is a combination of two prescription medications. Each drug works differently.

More Details

Why it's used

This drug is a combination of two drugs used to treat high blood sugar levels caused by type 2 diabetes. It works along with diet and exercise.

This drug is given to people who are being treated with medications in the same class or who have poor blood sugar control on repaglinide alone or metformin alone.

How it works

This drug is a combination of two prescription medications. Each drug works differently.

  • Repaglinide: Repaglinide belongs to a class of drugs called meglitinides. A class of drugs refers to medications that work similarly. They have similar chemical structure and are often used to treat similar conditions.

    Repaglinide lowers your blood sugar levels by stimulating the release of insulin from the pancreas. Insulin moves sugar (glucose) from the blood stream to the cells, where it belongs. This lowers your blood sugar levels.

  • Metformin: Metformin belongs to a class of drugs called biguanides.
  • Metformin reduces the amount of glucose made by your liver, lowers the amount of glucose your body absorbs, and increases the effect of insulin on your body.

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SECTION 2 of 4

metformin-repaglinide Side Effects

Oral tablet

Most Common Side Effects

The more common side effects that occur with repaglinide/metformin include:

  • diarrhea

  • nausea

  • vomiting

  • headache

  • low blood sugar (hypoglycemia). Symptoms include:

    • shakiness
    • nervousness or anxiety
    • sweating, chills, and clamminess
    • confusion
    • fast heart rate
    • lightheadedness or dizziness
    • hunger and nausea
    • sleepiness
    • blurred or impaired vision
    • tingling or numbness in your lips or tongue
    • headaches
    • weakness or fatigue
    • anger, stubbornness, or sadness
    • lack of coordination
    • nightmares of crying out during your sleep
    • seizures
    • loss of consciousness

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious Side Effects

If you experience any of these serious side effects, call your doctor right away. If your symptoms are potentially life-threatening or if you think you’re experiencing a medical emergency, call 9-1-1.

  • hair loss (alopecia)

  • anemia. Symptoms include:

    • fatigue
    • shortness of breath
    • dizziness
    • headache
    • cold hands and feet
    • pale skin
    • chest pain
    • irregular heart rate
    • yellowing of your skin or whites of the eyes (jaundice)
    • pain in your upper abdomen caused by gallstones or an enlarged spleen
  • pancreas inflammation (pancreatitis). Symptoms include:

    • upper stomach pain
    • nausea
    • vomiting
    • tenderness when touching the stomach
  • Stevens-Johnson syndrome. Symptoms include:

    • swelling of your face
    • tongue swelling
    • hives
    • skin pain
    • red or purple skin rash that can appear on the face, torso, arms, legs, or soles of the feet
    • blisters on your skin, mouth, nose, eyes, or genitals
    • severe peeling of your skin
  • liver problems. Symptoms include:  

    • yellowing of your skin or whites of eyes
    • darker-colored urine
    • tiredness
    • decreased appetite
    • fever
    • headache
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

This drug does not cause drowsiness.

If you have a low blood sugar reaction, you need to treat it.

  • For mild hypoglycemia (55–70 mg/dL), treatment is 15–20 grams of glucose (a type of sugar). You need to eat or drink one of the following:
    • 3–4 glucose tablets
    • a tube of glucose gel
    • ½ cup of juice or regular, non-diet soda
    • 1 cup of nonfat or 1% cow’s milk
    • 1 tablespoon of sugar, honey, or corn syrup
    • 8–10 pieces of hard candy
  • Test your blood sugar 15 minutes after you treat the low sugar reaction. If your blood sugar is still low, then repeat the above treatment again.
  • Once your blood sugar is back in the normal range, eat a small snack if your next planned meal or snack is more than 1 hour later. 

If you don’t treat low blood sugar, you can have a seizure, pass out, or possibly develop brain damage. Low blood sugar can even be fatal. If you pass out because of a low sugar reaction or cannot swallow, someone will have to give you an injection of glucagon to treat the low sugar reaction. You may need to go to the emergency room.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
SECTION 3 of 4

metformin-repaglinide May Interact with Other Medications

Oral tablet

Repaglinide/metformin can interact with other medications, herbs, or vitamins you might be taking. That’s why your doctor should manage all of your medications carefully. If you’re curious about how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Note: You can reduce your chances of drug interactions by having all of your prescriptions filled at the same pharmacy. That way, a pharmacist can check for possible drug interactions.

Alcohol interaction

Avoid drinking alcohol while taking repaglinide/metformin. Alcohol can lower or raise your blood sugar levels, and it may also increase your risk of lactic acidosis.

Medications that might interact with this drug

Acid-reducing drugs
  • ranitidine

Taking ranitidine with repaglinide/metformin can increase the levels of metformin in your body. This raises your risk of side effects, including lactic acidosis.

Antibiotics
  • vancomycin
  • trimethoprim

Taking these drugs with repaglinide/metformin can increase the levels of metformin in your body. This raises your risk of side effects, including lactic acidosis.

Antifungal drugs
  • itraconazole
  • ketoconazole

Taking these drugs with repaglinide/metformin can increase the levels of repaglinide in your body. This raises your risk of side effects, including hypoglycemia.

Cholesterol drugs
  • gemfibrozil

Gemfibrozil should not be taken with repaglinide/metformin. Taking gemfibrozil increases the levels of repaglinide in your body too much. This raises your risk of serious side effects, including hypoglycemia.

Heart drugs
  • amiloride
  • procainamide
  • digoxin
  • triamterene

Taking these drugs with repaglinide/metformin can increase the levels of metformin in your body. This raises your risk of side effects, including lactic acidosis.

Malaria drugs
  • quinidine
  • quinine

Taking these drugs with repaglinide/metformin can increase the levels of metformin in your body. This raises your risk of side effects, including lactic acidosis.

Tuberculosis drugs
  • rifampin

Taking these drugs with repaglinide/metformin can increase the levels of repaglinide in your body. This makes it less able to control your blood sugar.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.
Drug warnings
kidney problems
People with kidney problems

This drug is removed from your body by your kidneys so it is important that they work well. Tell your doctor if you have kidney problems before starting this drug. Your doctor should check your kidney function regularly while you’re taking this drug. Kidney problems may also put you at higher risk of lactic acidosis.

liver problems
People with liver problems

Liver disease is a risk factor for lactic acidosis. You shouldn’t take this drug if you have liver problems.

heart failure
People with heart failure

If you have heart failure, you may have a higher risk of lactic acidosis.

pregnant women
Pregnant women

This drug is a category C pregnancy drug. That means two things:

  1. Research in animals has shown adverse effects to the fetus when the mother takes the drug.
  2. There haven’t been enough studies done in humans to be certain how the drug might affect the fetus.

Tell your doctor if you’re pregnant or plan to become pregnant. This drug should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

breast-feeding
Women who are breast-feeding

This drug may pass into breast milk. It can cause serious effects in a child who is breast-fed, such as low blood sugar (hypoglycemia).

You and your doctor may need to decide if you’ll take this drug or breast-feed.

for seniors
For seniors

As you age, your kidneys may not work as well as they once did. This could cause the drug to build up in your body and increase your risk of side effects, including lactic acidosis. Your doctor may start you on a lower dose of this drug. People 80 years and older should only start this drug if they have normal kidney function.

for children
For children

The safety and effectiveness of this drug in children younger than 18 years hasn’t been established.

allergies
Allergies

This drug can cause a severe allergic reaction. Symptoms include:

  • trouble breathing
  • swelling of your throat or tongue
  • hives

If you have these symptoms, call your doctor right away. If they are severe, call 9-1-1 or go to the nearest emergency room.

Don’t take this drug again if you’ve ever had an allergic reaction to it before. Taking it again could be fatal.

SECTION 4 of 4

How to Take metformin-repaglinide (Dosage)

Oral tablet

All possible dosages and forms may not be included here. Your dose, form, and how often you take it will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What are you taking this medication for?

Type 2 diabetes

Generic: repaglinide/metformin

Form: Oral tablet
Strengths:
  • 1 mg repaglinide/500 mg metformin
  • 2 mg repaglinide/500 mg metformin

Brand: PrandiMet

Form: Oral tablet
Strengths:
  • 1 mg repaglinide/500 mg metformin
  • 2 mg repaglinide/500 mg metformin
Adult dosage (ages 18–64 years)
  • You should take this drug 2–3 times per day, 15–30 minutes before meals. If you skip a meal, you should also skip your dose of repaglinide/metformin.
  • You shouldn’t take more than 4 mg repaglinide/1,000 mg metformin per meal. 
  • The maximum dose per day is 10 mg repaglinide/2,500 mg metformin.
Child dosage (ages 0–17 years)

Dosage for people younger than 18 years hasn’t been established. This drug is not recommended for use in children.

Senior dosage (ages 65 years and older)

Your body processes this drug more slowly. Your doctor may start you on a lower dose so that too much of this drug doesn’t build up in your body. Too much drug in your body can be dangerous.

Special considerations

Kidney problems: This drug is removed from your body by your kidneys, so it is important they work properly. Tell your doctor if you have kidney problems before starting repaglinide/metformin. Your doctor should check your kidney function regularly while you’re taking this drug. If your kidney function gets worse, your doctor may stop your treatment with this drug.

Liver problems: Liver disease is a risk factor for lactic acidosis. You shouldn’t take this drug if you have liver problems.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

This drug comes with serious risks if you don't take it as prescribed.

If you stop taking the drug suddenly or don’t take it at all

You may still have high blood sugar levels and the symptoms caused by it. Over time, elevated blood sugar levels can harm your eyes, kidneys, nerves, or heart. This can lead to heart attack, stroke, blindness, kidney failure and dialysis, or limb amputations.

If you miss doses or don’t take the drug on schedule

Your medication may not work as well or may stop working completely. For this drug to work well, a certain amount needs to be in your body at all times.

If you take too much

Your blood sugar may fall too low (hypoglycemia). Symptoms include:

  • shakiness
  • nervousness or anxiety
  • sweating, chills, and clamminess
  • confusion
  • fast heart rate
  • lightheadedness or dizziness
  • hunger and nausea
  • sleepiness
  • blurred or impaired vision
  • tingling or numbness in your lips or tongue
  • headaches
  • weakness or fatigue
  • anger, stubbornness, or sadness
  • lack of coordination

It’s important to treat low blood sugar right away because it could get worse and you could pass out. If you think that you’ve taken too much of this medication or have symptoms of low blood sugar, treat your low blood sugar. If your symptoms continue to worsen, call your doctor or go to the emergency room right away.

What to do if you miss a dose

If you forget to take your dose, take it with you next meal.

Only take one dose at a time. Never try to catch up by taking two doses at once. This could cause low blood sugar.

How to tell if the drug is working

You may be able to tell if this drug is working if your blood sugar is near your target range as decided by your doctor. Your symptoms of diabetes may also get better.

This drug is a long-term treatment.

Take your dose 15–30 minutes before a meal

If you skip a meal, you should also skip your dose of this drug.

Don’t cut or crush the tablet

Doing so can raise your risk of side effects such as upset stomach, nausea, or vomiting.

This drug must be stored at the right temperature

  • Store this drug below 77°F (20°C).
  • Keep this drug away from light.
  • Keep your drugs away from areas where they could get wet, such as bathrooms. Store this drug away from moisture and damp locations.

Travel

When traveling with your medication:

  • Always carry your medication with you or in your carry-on bag.
  • Don’t worry about airport x-ray machines. They can’t hurt this medication.
  • You may need to show airport staff your pharmacy’s label to clearly identify the medication. Keep the original prescription label with you when traveling.
  • Don’t leave this medicine in the car, especially when the temperature is hot or freezing.
  • Lancets need to be used to test your blood sugar. Check for special rules about traveling with lancets.

Self-management

Your doctor may have you regularly test your blood sugar levels at home. This is done using a blood glucose meter.

Ask your doctor or pharmacist how to use your blood glucose meter. You need to know how to use this device to test your blood sugar.

To test your blood sugar levels at home, you’ll need to purchase the following:

  • sterile alcohol wipes
  • lancing device and lancets (a needle used to obtain drops of blood from your finger to test your blood sugar)
  • blood sugar test strips
  • blood glucose meter
  • needle container for safe disposal of lancets

Clinical monitoring

Before starting and during treatment with this drug, your doctor may check your:

  • blood sugar levels
  • glycosylated hemoglobin (A1C) levels. This test measures your blood sugar control over the last 2–3 months.
  • kidney function
  • blood cell counts

Your diet

This drug, when combined with lifestyle changes (diet, exercise, and not smoking), can help lower your blood sugar. Follow the nutrition plan that your doctor, registered dietitian, or diabetes educator recommended.

Hidden costs

While taking this drug, your doctor may have you regularly check your blood sugar levels. You may need to purchase the following:

  • sterile alcohol wipes
  • lancing device and lancets (a needle used to obtain drops of blood from your finger to test your blood sugar)
  • blood sugar test strips
  • blood glucose meter
  • needle container for safe disposal of lancets

Insurance

Many insurance companies require a prior authorization for this drug. This means your doctor will need to get approval from your insurance company before your insurance company will pay for the prescription.

Are there any alternatives?

There are other drugs available to treat your condition. Some may be more suitable for you than others. Talk to your doctor about other drugs that may work for you.


Show Sources

Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on August 20, 2015

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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