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At a glance

Repaglinide is a meglitinide analog used as an adjunct to diet and exercise to lower blood glucose in patients with type 2 diabetes mellitus. It stimulates insulin release from pancreatic beta-cells with rapid onset and rapid elimination.

Indications
  • Type 2 diabetes mellitus (not controlled by diet and exercise alone)
  • In combination with metformin (when not controlled by either agent alone)
Pharmacology

Repaglinide closes ATP-dependent K+ channels on pancreatic beta-cells, causing depolarization, increased Ca²⁺ influx, and insulin secretion. It has rapid onset and rapid elimination, helping control glucose spikes associated with meals.

Dosage

Adult Dose (Oral):

  • No prior treatment or HbA1c <8%: 0.5 mg before each meal
  • Prior treatment or HbA1c >8%: 1-2 mg before each meal
  • Take immediately or up to 30 minutes before each meal
  • Adjust dose at 1-2 week intervals; single dose max 4 mg; max 16 mg/day
  • Hepatic impairment: May require longer intervals between adjustments
  • Renal impairment (CrCl 20-40): 0.5 mg with meals; titrate slowly
Side effects

Common Side Effects:

  • Hypoglycemia (low blood sugar)
  • Upper respiratory tract infection
  • Diarrhea
  • Constipation
  • Nausea
  • Vomiting
  • Joint pain
  • Dizziness
  • Back pain
Use in pregnancy

Use in Pregnancy: May be unsafe during pregnancy; animal studies have shown harmful effects; use only if clearly needed.

Pregnancy Category: C — always consult a doctor before taking during pregnancy.

Precautions & warnings
  • May affect driving ability (hypoglycemia or hyperglycemia)
  • Risk of hypoglycemia: delayed/missed meals, alcohol, other antidiabetic medications
  • Carry sugar or fruit juice
  • Caution in liver and kidney disease
Overdose effects

Overdose (up to 80 mg): Few adverse effects other than lowering of blood glucose; hypoglycemia did not occur when meals were given; severe hypoglycemic reactions (coma, seizure) are infrequent; treatment: glucose administration, symptomatic supportive care.

Storage conditions

Do not store above 30°C; keep away from light; keep out of reach of children.

Repaglinide — see the full informationPharmacology, precautions, pregnancy, overdose and the rest on the generic page
⚠️ This information is for educational purposes only — not a substitute for medical advice. Consult a registered physician before taking any medicine.