repaglinide at a glance
Medicine class
Short-acting oral insulin secretagogue
Usual use
Type 2 diabetes in adults, alone or with metformin
Administration
Taken before a main meal; skip the meal-related tablet if that meal is skipped
Main safety concern
Low blood sugar, particularly with missed food, alcohol or interacting treatments
What is repaglinide used for?
Licensed uses include:
Treatment of adults with type 2 diabetes whose high blood glucose is not controlled adequately by diet, weight reduction and exercise.
Use with metformin in adults whose diabetes is not controlled adequately by metformin alone.
How does repaglinide work?
Repaglinide closes ATP-sensitive potassium channels in functioning pancreatic beta cells. This opens calcium channels and triggers a short-lived release of insulin, helping reduce the rise in blood glucose associated with a meal.
repaglinide preparations and strengths
Tablet
Route: Oral
Strengths: 0.5 mg, 1 mg, 2 mg
How to take repaglinide
Follow the prescribed instructions and swallow the tablet with water before a main meal.
Link each tablet to the relevant main meal.
If a main meal is skipped, skip the tablet linked to that meal.
Do not change treatment without discussing it with the prescriber.
repaglinide side effects
Common or expected effects
- Low blood sugar, which may cause hunger, sweating, shaking, dizziness, palpitations, weakness, visual changes or confusion
- Abdominal pain
- Diarrhoea
Get urgent medical advice
- Severe hypoglycaemia causing a seizure, unconsciousness or coma
- Serious allergic reaction with swelling or breathing difficulty
- Severe liver dysfunction, potentially with jaundice or dark urine
- Chest pain or other possible symptoms of acute coronary syndrome
repaglinide in pregnancy
Repaglinide should be avoided during pregnancy because adequate studies in pregnant women are unavailable. Anyone planning pregnancy or who becomes pregnant should contact their diabetes team promptly for a treatment review.
repaglinide while breastfeeding
Repaglinide should not be used while breastfeeding because there are no studies in breastfeeding women. A prescriber or specialist diabetes team should review alternative glucose-lowering treatment.
repaglinide interactions
Repaglinide has clinically important metabolic and blood-glucose interactions. Check prescribed, non-prescription and herbal products before use.
Gemfibrozil
Markedly increases repaglinide exposure and can cause prolonged hypoglycaemia; concurrent use is contraindicated.
Clopidogrel
Increases repaglinide exposure and may increase hypoglycaemia risk, requiring clinical review and glucose monitoring.
Trimethoprim, ciclosporin or deferasirox
May increase repaglinide exposure; combinations should generally be avoided or monitored closely when necessary.
Common questions about repaglinide
Answers are fully visible for fast scanning and source review.
What is repaglinide used for?
It treats type 2 diabetes in adults when lifestyle measures alone are insufficient. It may also be used with metformin when metformin alone does not provide adequate control.
How does repaglinide lower blood sugar?
It briefly stimulates functioning pancreatic beta cells to release more insulin around meals.
Should repaglinide be taken with food?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.