Prandin (repaglinide) is an oral antidiabetic medication specifically designed to help manage type 2 diabetes by stimulating insulin release from the pancreas. It belongs to the meglitinide class of drugs and is used in conjunction with diet and exercise to improve glycemic control. This medication is particularly effective in regulating postprandial (after-meal) blood glucose levels, offering a flexible dosing regimen that aligns with meal patterns. Prandin is not indicated for type 1 diabetes or diabetic ketoacidosis and should be used under careful medical supervision.

Features

• Active ingredient: repaglinide
• Available in 0.5 mg, 1 mg, and 2 mg oral tablets
• Rapid onset of action, typically within 30 minutes of ingestion
• Short duration of effect, reducing the risk of prolonged hypoglycemia
• Flexible dosing schedule tied to meal consumption
• FDA-approved for the management of type 2 diabetes mellitus

Benefits

• Helps lower and stabilize blood sugar levels after meals
• Reduces the risk of long-term diabetes complications such as neuropathy, retinopathy, and nephropathy
• Provides dosing flexibility for individuals with irregular eating schedules
• Works quickly to address postprandial glucose spikes
• Can be used as monotherapy or in combination with other antidiabetic agents like metformin
• Supports overall diabetes management when combined with lifestyle modifications

Common use

Prandin is commonly prescribed for adults with type 2 diabetes who have not achieved adequate glycemic control through diet and exercise alone. It is often used when a rapid, short-acting insulin secretagogue is desired, particularly for patients who experience significant postprandial hyperglycemia. It may be used as a standalone treatment or in combination with other antidiabetic medications, such as biguanides (e.g., metformin), though concomitant use with insulin is generally not recommended unless under specialist supervision.

Dosage and direction

The dosage of Prandin should be individualized based on the patient’s metabolic needs, blood glucose levels, and meal patterns. The usual starting dose is 0.5 mg taken orally within 30 minutes before each main meal. Patients who have been previously treated with other glucose-lowering agents may begin with 1 mg or 2 mg preprandially. Doses can be titrated at weekly intervals based on blood glucose response, with a maximum recommended dose of 16 mg per day. It is essential that patients take Prandin only when they plan to eat; skipping a dose is advised if a meal is omitted to prevent hypoglycemia.

Precautions

Patients taking Prandin should monitor their blood glucose levels regularly to avoid both hyperglycemia and hypoglycemia. Renal or hepatic impairment may affect drug metabolism and necessitate dose adjustment or alternative therapy. Use with caution in elderly patients, malnourished individuals, or those with adrenal or pituitary insufficiency, as they may be more susceptible to hypoglycemia. Alcohol consumption should be limited, as it may increase the risk of hypoglycemia and mask its symptoms. Pregnancy and breastfeeding require careful risk-benefit assessment under medical guidance.

Contraindications

Prandin is contraindicated in patients with:

• Type 1 diabetes
• Diabetic ketoacidosis
• Known hypersensitivity to repaglinide or any component of the formulation
• Severe renal impairment
• Severe hepatic dysfunction
• Concomitant use with gemfibrozil

Possible side effect

Common side effects may include:

• Hypoglycemia (sweating, tremor, dizziness, hunger, confusion)
• Headache
• Upper respiratory tract infection
• Diarrhea
• Arthralgia
• Back pain

Less frequently, allergic reactions, visual disturbances, and gastrointestinal symptoms such as nausea and vomiting may occur. Severe hypoglycemia requires immediate medical attention.

Drug interaction

Prandin may interact with several medications, including:

• Gemfibrozil (contraindicated—significantly increases repaglinide levels)
• Other hypoglycemic agents (increased risk of hypoglycemia)
• Beta-blockers, which may mask hypoglycemia symptoms
• CYP3A4 inhibitors (e.g., ketoconazole, erythromycin) may increase repaglinide concentrations
• CYP3A4 inducers (e.g., rifampin) may decrease its efficacy
• NSAIDs, salicylates, sulfonamides, and MAO inhibitors may enhance hypoglycemic effect

Missed dose

If a meal is missed, the corresponding dose of Prandin should also be skipped. If a meal is consumed later than planned, the dose may be taken with the meal. Do not double the dose to make up for a missed tablet.

Overdose

Overdose of Prandin may lead to severe hypoglycemia. Symptoms include confusion, tremors, sweating, rapid heartbeat, and loss of consciousness. Management includes immediate intake of oral glucose or administration of intravenous glucose or glucagon. Medical supervision is essential, and blood glucose should be monitored until stable.

Storage

Store Prandin tablets at room temperature (15–30°C or 59–86°F) in a tightly closed container, away from light, moisture, and heat. Keep out of reach of children and pets. Do not use after the expiration date printed on the packaging.

Disclaimer

This information is intended for educational purposes and does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before starting or changing any medication regimen. Individual patient needs may vary.

Reviews

Clinical studies and patient reports indicate that Prandin is effective in controlling postprandial glucose levels with a favorable safety profile when used as directed. Many users appreciate the flexibility it offers with meal-based dosing. Some note the importance of strict timing to avoid hypoglycemia. Overall, it is considered a valuable option in the type 2 diabetes treatment arsenal.