Repaglinide | Side Effects, Dosage, Uses & More
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Generic Name:

repaglinide, Oral tablet

All Brands

  • Prandin
SECTION 1 of 5

Highlights for repaglinide

Oral tablet
1

Repaglinide is an oral drug that’s used to help lower and control blood sugar levels in people with type 2 diabetes. It’s used along with diet, exercise, and sometimes other diabetes medications.

2

Repaglinide is taken 15–30 minutes before each meal or snack. Your dose will depend on your blood sugar levels and what other diabetes drugs you’re taking.

3

Common side effects include nausea, diarrhea, joint pain, back pain, headache, flu-like symptoms (upper respiratory infections), and low blood sugar (hypoglycemia).

4

Repaglinide can cause low blood sugar levels. Symptoms include sweating, shaking, dizziness, nausea, tiredness, fast heart rate, and hunger. Your risk may be higher if you skip meals, drink alcohol, exercise intensely or for a long time, or use other medications that can lower your blood sugar.

5

You shouldn’t use repaglinide if you have type 1 diabetes. If you have type 1 diabetes or diabetic ketoacidosis, you’ll need to use insulin.

IMPORTANT INFORMATION

Low blood sugar warning

This drug can cause low blood sugar (hypoglycemia). Symptoms include:

  • sweating
  • shaking
  • dizziness
  • nausea
  • tiredness
  • fast heart rate
  • hunger

Your risk may be higher if you skip meals, drink alcohol, exercise intensely or for a long time, or use other medications that can lower your blood sugar.

Not for type 1 diabetes

You shouldn’t use this drug if you have type 1 diabetes. This medicine requires that your pancreas makes some amount of insulin (a hormone). In type 1 diabetes, the pancreas doesn’t make any insulin at all. If you have type 1 diabetes or diabetic ketoacidosis, you’ll need to use insulin.

What is repaglinide?

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

This drug is available in its generic form. 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 drug may be used as part of a combination therapy. That means you need to take it with other drugs.

Why it's used

This drug is used to help lower and control blood sugar levels in people with type 2 diabetes. It’s used along with diet, exercise, and sometimes other diabetes drugs.

How it works

This drug belongs to a class of drugs called meglitinides. A class of drugs refers to medications that work similarly.

More Details

How it works

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

This drug increases the amount of insulin (a hormone in your body) released from your pancreas. Insulin helps your body remove extra sugar from your blood. This lowers your blood sugar levels.

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SECTION 2 of 5

repaglinide Side Effects

Oral tablet

Most Common Side Effects

The most common side effects that occur with repaglinide include:

  • nausea

  • diarrhea

  • joint pain

  • back pain

  • headache

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.

  • flu-like symptoms or upper respiratory tract infection. Symptoms include:

    • fever and chills
    • trouble breathing
  • low blood sugar (hypoglycemia). Symptoms include:

    • shakiness
    • nervousness or anxiety
    • sweating, chills, and clamminess
    • irritability or impatience
    • confusion, including delirium
    • 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 or crying out during sleep
    • seizures
    • loss of consciousness
Pharmacist's Advice
Healthline Pharmacist Editorial Team

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, such as lifesavers
  • Test your blood sugar 15 minutes after you treat the low sugar reaction. If your blood sugar is still low, 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, and 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 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 5

repaglinide May Interact with Other Medications

Oral tablet

Repaglinide 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

Limit your alcohol intake because it can affect your blood sugar.

If you drink alcohol while using repaglinide, your blood sugar levels may become too low. Alcohol can also be high in calories, especially when consumed in large amounts. These additional calories may increase your blood sugar levels.

Medications that might interact with this drug

Non-steroidal anti-inflammatory drugs (NSAIDs)
  • naproxen
  • ibuprofen

These drugs may increase the effect of repaglinide. This raises your risk of dangerously low blood sugar.  

Depression medications

Monoamine oxidase inhibitors (MAOIs), such as:

  • selegiline
  • phenelzine

These drugs may increase the effect of repaglinide. This raises your risk of dangerously low blood sugar.

Heart medications (thiazides and calcium channel blockers)
  • hydrochlorothiazide
  • chlorthalidone
  • verapamil
  • diltiazem

These drugs may make repaglinide less effective. This means that it won’t work as well to control your diabetes.

Heart medications (beta blockers)
  • propranolol
  • carvedilol
  • timolol

These drugs may increase the effect of repaglinide. This raises your risk of dangerously low blood sugar.

Aspirin

Salicylates (such as aspirin) may increase the effect of repaglinide. This raises your risk of dangerously low blood sugar.

Seizure medications
  • carbamazepine

This drug may make repaglinide less effective. This means that it won’t work as well to control your diabetes.

Estrogens and oral birth control pills

These drugs may make repaglinide less effective. This means that it won’t work as well to control your diabetes.

Corticosteroids

These drugs may make repaglinide less effective. This means that it won’t work as well to control your diabetes.

Thyroid drugs
  • levothyroxine
  • liothyronine
  • liotrix

These drugs may make repaglinide less effective. This means that it won’t work as well to control your diabetes.

Drugs to treat tuberculosis
  • rifampin

These drugs may make repaglinide less effective. This means that it won’t work as well to control your diabetes. 

Other drugs
  • ketoconazole
  • itraconazole
  • erythromycin
  • trimethoprim
  • gemfibrozil
  • montelukast

These drugs increase the amount of repaglinide in your body. This raises your risk of dangerously low blood sugar. If you’re on one of these drugs and repaglinide, your doctor will monitor you closely for low blood sugar. 

You shouldn’t take gemfibrozil and repaglinide. This drug increases the amount of repaglinide in your body too much.

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
type 1 diabetes
People with type 1 diabetes

You shouldn’t use this drug if you have type 1 diabetes. This medicine requires that your pancreas makes some amount of insulin (a hormone). In type 1 diabetes, the pancreas doesn’t make any insulin at all. If you have type 1 diabetes or diabetic ketoacidosis, you’ll need to use insulin.

liver disease
People with liver disease

Talk to your doctor about whether repaglinide is safe for you to take. This medication is cleared out of your bloodstream by your liver. If you have liver problems, this drug may take longer to clear. This could increase your risk of side effects including low blood sugar (hypoglycemia).

infection or fever
People with an infection or fever

If you have a fever or infection, your blood sugar levels may increase temporarily. This drug may not work as well so your doctor may have you take insulin.

surgery
People who are injured or plan to have surgery

If you’re injured or plan to have surgery, your blood sugar levels may increase temporarily. This drug may not work as well, so your doctor may have you take insulin.

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

It isn’t known if this drug passes into breast milk. If it does, it may cause low blood sugar in a breastfeeding child.

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

For seniors
For seniors

As you age, your kidneys may not work as well as they did when you were younger. Your doctor should monitor your kidney function before starting and during your treatment with this medication to limit your risk of side effects.

For children
For children

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

Special Kid Safety:

  • Keep your medication in a secure place, like a locked medicine cabinet, even if you don't think your child can reach it.
  • Lancets are a pricking needle used to get drops of blood for blood sugar testing. Don’t throw out individual lancets into trash cans or recycling bins, and never flush them down the toilet. Ask your pharmacist for a safe container for disposing used lancets. Your community may have a program for throwing out lancets. If disposing the container in the trash, label it “do not recycle.”
call the doctor
When to call the doctor

When your body is under stress, you may need a different amount of your diabetes medication to control your blood sugar levels. Tell your doctor right away if you have any of these problems:

  • fever
  • trauma, such as a car accident
  • infection
  • plan to have surgery
SECTION 4 of 5

How to Take 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

Form: Oral tablet
Strengths: 0.5 mg, 1 mg, and 2 mg

Brand: Prandin

Form: Oral tablet
Strengths: 0.5 mg, 1 mg, and 2 mg
Adult dosage (ages 18–64 years)
  • If you haven’t been treated for type 2 diabetes with medication before or if your hemoglobin A1c is less than 8%, the starting dose is 0.5 mg taken by mouth before each meal.
  • If you’ve been treated for type 2 diabetes with medication before or your hemoglobin A1c is 8% or higher, the starting dose is 1 or 2 mg taken by mouth before each meal.
  • Your doctor will adjust your dose based on your blood sugar response. If your blood sugar isn’t responding as expected, your dose before each meal can be doubled up to 4 mg. Your doctor will wait at least a week in between dose adjustments.
  • Repaglinide may be taken 2, 3, or 4 times a day before meals. Your doctor will let you know how often to take your medicine. The maximum recommended dose per day is 16 mg.
Child dosage (ages 0–17 years)

This medicine hasn’t been studied in children and shouldn’t be used in children younger than 18 years.

Senior dosage (ages 65 years and older)

Because kidney function declines with age, your doctor may reduce your dose depending on how well your kidneys work.

Special considerations

Kidney disease: If you have severe kidney disease, repaglinide will be started at the 0.5 mg dose and increased more slowly.

Liver disease: Repaglinide should be used with caution if you have decreased liver function. Your doctor may wait longer in between dose adjustments to tell how your blood sugar is responding to this medication.

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
Healthline Pharmacist Editorial Team

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

If you don't take it at all or miss doses

If you stop taking this drug, miss doses, or don’t take it on schedule, your blood sugar levels will rise. People with uncontrolled diabetes can develop serious, life-threatening complications. If you skip or miss doses regularly, your risk for these problems may be higher. Complications include nerve, vision, kidney, foot, skin, and heart and blood vessel problems.

If you take too much

You may experience low blood sugar (hypoglycemia). Symptoms can include:

  • shakiness
  • nervousness or anxiety
  • sweating, chills, and clamminess
  • irritability or impatience
  • confusion, including delirium
  • 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 or crying out during sleep
  • seizures
  • loss of consciousness

If you think that you’ve taken too much or have symptoms of low blood sugar, treat it as your doctor has instructed. After 30 minutes, if symptoms do not go away or if they get worse, 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 as soon as you remember. If it’s just a few hours before the time for your next dose, then only take one dose at that time.

Never try to catch up by taking two doses at once. This could result in toxic side effects.

If you skip a meal or add an extra meal, you should skip or add an extra dose for that meal.

How to tell if the drug is working

You may be able to tell if this drug is working if your blood sugar is lower. Your doctor will also do tests to check what your average blood sugar has been over the past 2–3 months (A1c).

You may also have fewer symptoms of high blood sugar, such as less frequent urination and decreased thirst and appetite.

This drug is a long-term drug treatment.

Take this drug before eating meals

If you skip a meal, you should also skip your scheduled dose of this drug. This will reduce your chance of low blood sugar.

Don’t store this drug above 77°F (25°C)

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 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 clearly to 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.

Self-management

Your doctor may have you test your blood sugar with a home blood glucose monitor and keep a log of these readings. Based on your blood glucose results, your doctor may decide to adjust your diabetes medication.

You’ll need to learn how to do the following:

  • use a blood glucose monitor to test your blood sugar regularly at home
  • recognize the signs and symptoms of high and low blood sugar 
  • treat high and low blood sugar reactions

While taking this drug, you may need to purchase the following for testing your blood sugar levels:

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

Clinical monitoring

Your doctor will do tests to check your health and make sure that the drug is working for you. They include:

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

Your doctor may do other tests to check for complications of diabetes:

  • kidney function
  • eye exam at least once a year
  • foot exam at least once a year
  • dental exam at least once a year
  • nerve damage
  • cholesterol levels
  • blood pressure and heart rate

Your diet

Making healthy food choices and tracking your eating habits can help you manage your diabetes. Follow the nutrition plan that your doctor, registered dietician, or diabetes educator recommended.

Hidden costs

If your doctor tells you to test your blood sugar at home, you’ll need to purchase:

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

Insurance

Many insurance companies will require a prior authorization before they approve the prescription and pay for this drug.

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 possible alternatives.

SECTION 5 of 5

How Much Does repaglinide Cost?

Oral tablet

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Lowest price for repaglinide

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These prices represent the lowest priced national pharmacies for repaglinide on GoodRx. They may be lower than your insurance.

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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 19, 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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