Prandin

Generic name: Repaglinide

What is Prandin?

Prandin is used to reduce blood sugar levels in people with type 2 diabetes (also known as non-insulin dependent diabetes mellitus or NIDDM). It is prescribed when diet and exercise alone fail to correct the problem. Prandin may be prescribed alone or in combination with other diabetes medications, such as metformin.

What is the most important information I should know about Prandin?

Chronically high glucose levels have been implicated in the kidney failure, blindness, and loss of sensation that plague many people with long-standing diabetes. A low-calorie diet, weight loss, and exercise are your first line of defense against these problems. Medications such as Prandin are prescribed only as a back-up when these other measures still leave your blood sugar too high. If diet, exercise, and a combination of Prandin and metformin all fail to do the job, your doctor may have to start you on insulin.

While taking Prandin, you should check your blood sugar regularly. Your doctor will also watch it; and to measure long-term glucose control, he will probably give you a glycosylated hemoglobin (HbA1C) test as well.

Too much Prandin can cause low blood sugar (hypoglycemia), which is marked by shaking; sweating; and cold, clammy skin. If you develop these symptoms, drink some orange juice or suck on a hard candy. The problem is more likely to surface if you are elderly, debilitated, or malnourished; have liver problems; or suffer from poor adrenal or pituitary function.

Who should not take Prandin?

If you have type 1 (insulin-dependent) diabetes, you cannot use Prandin. You cannot take Prandin for diabetic ketoacidosis (a life-threatening emergency first signaled by excessive thirst, nausea, fatigue, and fruity-smelling breath). This condition must be treated with insulin.

If you find that Prandin gives you an allergic reaction, you'll be unable to continue using it.

What should I tell my doctor before I take the first dose of Prandin?

Tell your doctor about all prescription, over-the-counter, and herbal medication you are taking before beginning treatment with Prandin. Also, talk to your doctor about your complete medical history, especially if you have kidney disease, liver disease, type 1 diabetes mellitus, diabetic ketoacidosis, a serious infection, illness, injury, or if you need surgery.

What is the usual dosage?

The information below is based on the dosage guidelines your doctor uses. Depending on your condition and medical history, your doctor may prescribe a different regimen. Do not change the dosage or stop taking your medication without your doctor's approval.

Adults: There is no fixed dosage regimen for the management of type 2 diabetes with Prandin.

Take Prandin before each meal. The recommended dose ranges from 0.5 milligram (mg) to 4 mg. If you have never taken a glucose-lowering medication before, you should start with the 0.5-mg dose. If you have taken these drugs in the past, the starting dose is 1 or 2 mg. Take no more than 16 mg a day.

Combination Therapy

Adults: If Prandin is being added to metformin therapy, you should begin with a 0.5-mg dose. Dosage will then be adjusted according to your blood glucose levels.

Dose Adjustment

Adults: Your dose of Prandin will be adjusted according to your fasting blood sugar levels. If your pre-meal glucose level appears normal and you are still experiencing glucose control problems, your doctor may test your glucose level after you have eaten a meal. Your doctor will wait at least a week after each change in dose to check your response.

Switching to Prandin

Adults : When Prandin replaces another oral glucose-lowering medicine, you should start taking it the day after your final dose or the previous drug. Be alert for signs of low blood sugar; effects of the drugs may overlap.

How should I take Prandin?

Prandin should be taken shortly before each meal. You can take it 30 minutes ahead of time or wait until just before starting to eat; a 15-minute period is typical. You can take Prandin 2, 3, or 4 times a day, depending on the number of meals you have. If you skip a meal (or add an extra meal), you should skip (or add) a dose of Prandin accordingly.

What should I avoid while taking Prandin?

Follow diet, medication, and exercise routines very closely. Changing any of these routines can affect your blood sugar levels.

Avoid alcohol; it lowers blood sugar and may interfere with your diabetes treatment.

What are possible food and drug interactions associated with Prandin?

If Prandin is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Prandin with the following: airway-opening medications such as metaproterenol and albuterol; alcohol; aspirin; barbiturates such as the sedatives secobarbital and pentobarbital; beta-blockers such as the blood pressure medications propranolol and atenolol; blood thinners such as dicumarol and anisindione; calcium channel blockers such as the blood pressure medications diltiazem and nifedipine; carbamazepine; chloramphenicol; clarithromycin; erythromycin; estrogens; ketoconazole; glucose-lowering agents such as glipizide and glyburide;isoniazid; itraconazole; major tranquilizers such as thioridazine and trifluoperazine; mao inhibitors such as the antidepressants isocarboxazid, phenelzine, and tranylcypromine; niacin; nonsteroidal anti-inflammatory drugs such as ibuprofen and naproxen; oral contraceptives; phenytoin; probenecid; rifampin; steroids such as prednisone; sulfa drugs such as sulfamethoxazole; thyroid medications such as levothyroxine; and diuretics such as hydrochlorothiazide.

Additionally, you should not start taking Prandin if you are already taking the triglyceride-lowering medication gemfibrozil. Conversely, you should not start taking gemfibrozil if you are already using Prandin. Combining the two drugs could lead to a dangerous drop in blood sugar. However, if you're already taking both drugs, the doctor will monitor your blood sugar levels closely and adjust the dosages as needed.

What are the possible side effects of Prandin?

Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking this drug.

Side effects may include: back pain, bronchitis, chest pain, constipation, diarrhea, headache, indigestion, joint pain, low blood sugar, nasal inflammation, nausea, sinus inflammation, skin tingling, upper respiratory tract infection, urinary tract infection, vomiting

Can I receive Prandin if I am pregnant or breastfeeding?

The effects of Prandin during pregnancy and breastfeeding are unknown. Tell your doctor immediately if you are pregnant, plan to become pregnant, or are breastfeeding.

Because abnormal blood sugar during pregnancy can cause fetal defects, your doctor will probably prescribe insulin injections until the baby is born.

What should I do if I miss a dose of Prandin?

Wait until your next meal, and then take your regular dose. Do not take 2 doses at once.

How should I store Prandin?

Store at room temperature in a tightly closed container, away from moisture and heat.