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repaglinide

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Brand names: Prandin

Meglitinide Rx

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.

Low blood sugar
765
Sudden kidney damage
548
Interaction with another medicine
417
Diarrhea
365
Lactic acidosis (buildup of lactic acid)
364
Difficulty breathing
277
Nausea
259
Weakness
251
Anemia (low red blood cells)
237
Vomiting
235

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

Female 3,029 (46%)
Male 3,589 (54%)

Age Distribution

0–17 52
18–44 149
45–64 1,310
65–74 1,803
75+ 2,547

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

DEATH 116
LACTIC ACIDOSIS 78
ACUTE KIDNEY INJURY 48
HYPOGLYCAEMIA 44
DYSPNOEA 42
HYPOTENSION 41
SEPTIC SHOCK 40
PNEUMONIA 37
GENERAL PHYSICAL HEALTH DETERIORATION 34
ASTHENIA 32

Reactions in Hospitalization Reports

HYPOGLYCAEMIA 460
ACUTE KIDNEY INJURY 372
DRUG INTERACTION 308
DIARRHOEA 251
DYSPNOEA 202
LACTIC ACIDOSIS 200
ANAEMIA 187
FALL 183
ASTHENIA 182
VOMITING 160

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.

moderate clonidine

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.

moderate rifampin

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.

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Common Questions

What should I do if my blood sugar gets too low?
Talk to your doctor about how to treat low blood sugar. You may need to eat or drink something sugary.
Can I take repaglinide with other diabetes medicines?
Talk to your doctor before taking repaglinide with other diabetes medicines. Some combinations can increase your risk of low blood sugar.
Will repaglinide affect my weight?
Some people may gain a small amount of weight (around 3.3 pounds). Talk to your doctor if you are concerned about weight gain.
What if I am taking other medications?
Some medicines can affect how repaglinide works. Tell your doctor about all the medicines you take.
Can I drink alcohol while taking repaglinide?
Talk to your doctor about drinking alcohol while taking repaglinide. Alcohol can affect your blood sugar levels.
What happens if I take too much repaglinide?
Taking too much repaglinide can cause very low blood sugar. Get medical help right away.
How often should I check my blood sugar?
Your doctor will tell you how often to check your blood sugar. Follow their instructions carefully.
What are the symptoms of low blood sugar?
Symptoms of low blood sugar include shakiness, sweating, confusion, and dizziness.
Can I drive while taking repaglinide?
Repaglinide can cause low blood sugar, which can be dangerous while driving. Be sure your blood sugar is stable before driving.
What if I have kidney problems?
If you have severe kidney problems, your doctor may start you on a lower dose of repaglinide.
What are the common side effects of repaglinide?
The most commonly reported side effects of repaglinide include Low blood sugar, Upper respiratory infection, Headache, Sinus infection, Joint pain. Based on 3,718 FDA adverse event reports. Always consult your healthcare provider about potential side effects.
Does repaglinide interact with other medications?
Yes, repaglinide has 22 known drug interactions. Notable interactions include gemfibrozil, clarithromycin, clonidine. Always inform your doctor about all medications you are taking.
What drug class is repaglinide?
repaglinide belongs to the Meglitinide drug class. It requires a prescription (Rx). Repaglinide is used to lower blood sugar in adults with type 2 diabetes.
Is repaglinide safe during pregnancy?
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. Always consult your healthcare provider before using any medication during pregnancy or breastfeeding.

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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

All federal data sources used on this page