repaglinide
Brand names: Prandin
Repaglinide (Prandin) helps control blood sugar in adults with type 2 diabetes. It works best when used with diet and exercise.
Drug Pricing (NADAC)
Generic Price
$0.08/unit
Generic Available
Yes (3 manufacturers)
Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →
What it does
Repaglinide is used to lower blood sugar in adults with type 2 diabetes.
Common side effects
Low blood sugar, Upper respiratory infection, Headache
Key warnings
Repaglinide can cause low blood sugar (hypoglycemia).
How It Works
Repaglinide helps your pancreas release insulin after you eat. Insulin helps move sugar from your blood into your cells. This lowers your blood sugar levels.
How to Take It
Take repaglinide up to 30 minutes before each meal. The usual starting dose is 0.5 mg if your HbA1c is less than 8%. If your HbA1c is 8% or higher, your starting dose may be 1 mg or 2 mg. Your doctor may adjust your dose up to 4 mg per meal to control your blood sugar. Do not take more than 16 mg per day.
Pregnancy & Breastfeeding
Tell your doctor if you are pregnant or plan to become pregnant. Poorly controlled diabetes during pregnancy can harm both the mother and the baby. Repaglinide is not recommended while breastfeeding due to the risk of low blood sugar in the baby.
Missed Dose
If you skip a meal, skip your dose of repaglinide. Do not take an extra dose to make up for a missed one.
Storage
Store repaglinide at room temperature (68° to 77°F) away from moisture. Keep the bottle tightly closed.
Side Effects (from patient reports)
Based on 3,718 FDA adverse event reports.
FDA Adverse Event Report Analysis
Detailed analysis of 7,180 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 2004–2025.
Total Reports
7,180
Death-Related Reports
688
Hospitalization Reports
4,308
Top Indication
Product Used For Unknown Indication
Gender Distribution
Age Distribution
Most Reported Adverse Reactions (FAERS)
| # | Reaction | Reports |
|---|---|---|
| 1 | HYPOGLYCAEMIA | 765 |
| 2 | ACUTE KIDNEY INJURY | 548 |
| 3 | DRUG INTERACTION | 418 |
| 4 | DIARRHOEA | 365 |
| 5 | LACTIC ACIDOSIS | 364 |
| 6 | DYSPNOEA | 277 |
| 7 | NAUSEA | 259 |
| 8 | ASTHENIA | 251 |
| 9 | ANAEMIA | 237 |
| 10 | VOMITING | 235 |
| 11 | FALL | 229 |
| 12 | OFF LABEL USE | 225 |
| 13 | FATIGUE | 212 |
| 14 | BLOOD GLUCOSE INCREASED | 206 |
| 15 | HYPERKALAEMIA | 195 |
Reactions in Death Reports
Reactions in Hospitalization Reports
Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation
Serious Warnings
Repaglinide can cause low blood sugar (hypoglycemia). If you skip a meal, skip your dose of repaglinide to avoid low blood sugar. Do not use repaglinide with NPH-insulin. There is no proof that repaglinide lowers your risk of heart problems.
Known Drug Interactions
Table 3: Clinically Important Drug Interactions with Repaglinide Gemfibrozil Clinical Impact: Gemfibrozil significantly increased repaglinide exposures by 8.1 fold [see Clinical Pharmacology (12.3) ] Intervention: Do not administer repaglinide to patients receiving gemfibrozil [see Contraindications (4) ] . Clopidogrel Clinical Impact: Clopidogrel increased repaglinide exposures by 3.9 to 5.1 fold [see Clinical Pharmacology (12.3) ] Intervention: Avoid concomitant use of repaglinide with clopidogrel. Drugs that are known to inhibit CYP2C8 include trimethoprim, gemfibrozil, montelukast, defe...
Mechanism: Gemfibrozil stops your body from getting rid of repaglinide, which causes the level of repaglinide in your blood to become dangerously high.
What to do: You must not take repaglinide if you are also taking gemfibrozil.
Gastroprokinetic Agents: Cisapride Contraindicated Cisapride: [See Contraindications ( 4.2 )] Lipid-lowering agents: Lomitapide Lovastatin Simvastatin Contraindicated Lomitapide, Lovastatin, Simvastatin: Clarithromycin may increase the exposure of these drugs by inhibition of CYP3A metabolism, thereby increasing the risk of toxicities from these drugs [see Contraindications ( 4.5 ) and Warnings and Precautions ( 5.4 )] Atorvastatin, Pravastatin, Fluvastatin: [See Warnings and Precautions ( 5.4 )] Atorvastatin Pravastatin Use With Caution Fluvastatin No Dose Adjustment Hypoglycemic Agents: N...
Mechanism: Clarithromycin interferes with the enzyme that processes repaglinide, which can cause the medicine to stay in your system longer and drop your blood sugar too low.
What to do: Your healthcare provider may need to adjust your diabetes medication dose or have you check your blood sugar more often.
Examples: beta-blockers, clonidine, guanethidine, and reserpine Clopidogrel : Avoid concomitant use; if used concomitantly initiate at 0.5 mg before each meal and limit total daily dose to 4 mg (7) Cyclosporine : Limit daily dose of repaglinide to 6 mg and increase frequency of glucose monitoring when co-administered (7) CYP2C8 and CYP3A4 Inhibitors and Drugs That May Increase the Risk of Hypoglycemia : Co-administration may require repaglinide dose reductions and increased frequency of glucose monitoring (7) CYP2C8 and CYP3A4 Inducers and Drugs That May Decrease the Blood Glucose Lowering ...
Mechanism: Clonidine can hide the warning signs of low blood sugar and may also cause blood sugar to drop further when taken with repaglinide.
What to do: Your doctor may need to lower your repaglinide dose and you should check your blood sugar levels more often.
Cyclosporine Clinical Impact: Cyclosporine increased low dose repaglinide exposures by 2.5 fold [see Clinical Pharmacology (12.3) ] Intervention: Daily maximum repaglinide dose should be limited to 6 mg, and increased frequency of glucose monitoring may be required when repaglinide is co-administered with cyclosporine. Examples: beta-blockers, clonidine, guanethidine, and reserpine Clopidogrel : Avoid concomitant use; if used concomitantly initiate at 0.5 mg before each meal and limit total daily dose to 4 mg (7) Cyclosporine : Limit daily dose of repaglinide to 6 mg and increase frequency ...
Mechanism: Cyclosporine causes the amount of repaglinide in your blood to increase, which can make your blood sugar drop too low.
What to do: Limit your total daily dose of repaglinide to 6 mg and check your blood sugar more frequently.
Examples: Drugs that induce the CYP3A4 and/or 2C8 enzyme systems include rifampin, barbiturates, and carbamezapine Drugs That May Increase the Risk of Hypoglycemia Intervention: Repaglinide dose reductions and increased frequency of glucose monitoring may be required when co-administered.
Mechanism: Rifampin changes how your body processes repaglinide, which can increase the risk of your blood sugar dropping too low.
What to do: Your doctor may need to adjust your repaglinide dose and you should monitor your blood sugar more closely.
Common Questions
What should I do if my blood sugar gets too low?
Can I take repaglinide with other diabetes medicines?
Will repaglinide affect my weight?
What if I am taking other medications?
Can I drink alcohol while taking repaglinide?
What happens if I take too much repaglinide?
How often should I check my blood sugar?
What are the symptoms of low blood sugar?
Can I drive while taking repaglinide?
What if I have kidney problems?
What are the common side effects of repaglinide?
Does repaglinide interact with other medications?
What drug class is repaglinide?
Is repaglinide safe during pregnancy?
Related Medications in Meglitinide
Other drugs grouped near repaglinide — same-class peers and common alternatives.
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bromocriptine
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Medication Guides
Understanding Drug Interactions
How CYP450 enzymes, inhibitors, and inducers affect your medications
Generic vs Brand Name Drugs
FDA requirements, cost savings, and when the difference matters
Narrow Therapeutic Index Drugs
Why some drugs demand precise dosing and monitoring
Common Drug Interactions
Dangerous medication combinations and how to protect yourself
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What the FDA Data Shows for repaglinide
The FDA label for repaglinide (sold under brand names such as Prandin) classifies it as a prescription-only medication in the Meglitinide class. Repaglinide is used to lower blood sugar in adults with type 2 diabetes. Official labeling lists 8 commonly reported side effects, including Low blood sugar, Upper respiratory infection, Headache.
Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 3,718 voluntary reports. The database also lists 22 documented drug interactions derived from FDA labeling, with the top-flagged interaction rated major severity. NADAC pricing from CMS shows a generic unit cost of $0.08.
Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history, and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.
Data Sources
Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC).
FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.
Last updated: January 16, 2025
Read our methodology — how this data is sourced, computed, and verified.
All federal data sources used on this page
- FDA Orange Book — approved drug products with therapeutic equivalence. accessdata.fda.gov/cder/ob
- FDA DailyMed — NIH-hosted drug labeling for FDA-approved meds. dailymed.nlm.nih.gov
- FDA Adverse Event Reporting System (FAERS) — post-marketing safety surveillance. fda.gov/drugs/faers
- NLM RxNorm — standardized clinical drug nomenclature. nlm.nih.gov/research/umls/rxnorm
- CMS Medicare Part B Drug Average Sales Price Files — federal drug pricing data. cms.gov/medicare/part-b-drugs/asp
- FDA Drug Shortages Database — current and resolved drug shortage tracking. accessdata.fda.gov/drugshortages