Premil 1

Generic

Repaglinide

 

Indications

Repaglinide is shown as an aide to count calories and work out to lower the blood glucose in patients with sort 2 diabetes mellitus (NIDDM) whose hyperglycemia cannot be controlled palatably by count calories and work out alone. It is additionally demonstrated for utilizing in combination with Metformin to lower blood glucose in patients whose hyperglycemia cannot be controlled by work out, eat less, and either Repaglinide or Metformin alone.

 

Pharmacology

Repaglinide binds to specific receptors in the cell membrane, causing ATP-dependent K+ channels to close and the cell membrane to depolarize. This results in Ca++ inflow, increased intracellular Ca++, and insulin secretion stimulation.

 

Dosage & Administration

For patients not previously treated or whose HbA1c is <8%, the starting dose should be 0.5 mg before each meal.

For patients previously treated with blood glucose-lowering drugs and whose HbA1c is >8%, the initial dose is 1 or 2 mg before each meal.

Repaglinide should be taken immediately or up to 30 minutes before each meal. Dosage should be adjusted according to response at intervals of 1-2 weeks; up to 4 mg may be given as a single dose, maximum 16 mg daily.

 

Interaction

The dose of Repaglinide may need to be adjusted if taken with other medications. The possible interactions of Repaglinide with other drugs are:

• Inhibitors of the cytochrome P450 enzyme system (azole antifungals and macrolides) may lead to lower Repaglinide clearance and a longer half-life.
• Inducers of the cytochrome P450 enzyme system (Rifampin, Phenobarbital, Carbamazepine, Troglitazone, etc.) may accelerate Repaglinide metabolism and shorten its effect.
• Cimetidine has no significant effect on Repaglinide absorption or clearance.
• Repaglinide has no significant effect on Digoxin, Theophyllin, or Warfarin.
• Highly protein bound drugs (e.g., NSAIDs) may increase the plasma level of unbound Repaglinide and potentiate its glucose lowering effect. Thus, co-administration of these drugs with Repaglinide may increase the risk of hypoglycaemia.
• The risk of hypoglycaemia may also be increased when hypoglycaemic agents are co-administered with certain drugs such as salicylates, sulphonamides, Chloramphenicol, coumarins, Probenecid, monoamine oxidase (MAO) inhibitors, and adrenergic blockers.

 

Contraindications

Repaglinide is contraindicated in patients with:

• Diabetic ketoacidosis, with or without coma.
• Type 1 diabetes mellitus and Known touchiness to the medicate or its inert fixings.

 

Side Effect

Hypoglycemia and associated symptoms are the most common Repaglinide adverse effects. Upper respiratory infections, diarrhea, constipation, nausea, and vomiting are among the other symptoms. Rashes and urticaria are examples of hypersensitivity reactions.

 

Pregnancy & Lactation

Security in pregnant ladies has not been built up. Repaglinide ought to be utilized amid pregnancy as it were in case it is clearly required. It isn't known whether Repaglinide is excreted in the human drain. Since numerous drugs are excreted in human milk as a result of the potential for genuine unfavorable responses in nursing newborn children from Repaglinide, a decision ought to be made whether to suspend nursing or the medicate, taking into consideration the significance of the sedate to the mother.

 

Precautions & Warnings

During concomitant illness (such as myocardial infarction, unconsciousness, infection, and trauma) and surgery, insulin should be substituted. Hypoglycemia can be caused by any oral blood glucose-lowering medication. To reduce the risk of hypoglycemia, repaglinide should be taken with meals.

 

Therapeutic Class

Analogues of Meglitinide.

 

Storage Conditions

Do not store at temperatures above 30°C. Keep out of the reach of youngsters and away from light.

 

Pharmaceutical Name

Beximco Pharmaceuticals Ltd.