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Prandin (Rapaglinide)

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Repaglinide or Prandin is indicated for use in type 2 diabetes:virtualdrugstore:"Repaglinide or Prandin stimulates the pancreas to secrete insulin. This action is similar to sulfonylurea's, but Repaglinide or Prandin represents a structurally different group - the meglitinides. In type 2 diabetes, the pancreas does still function to produce some insulin - just not enough. In type 1 diabetes, the pancreas does not produce any insulin, thus Repaglinide or Prandin is not indicated for type 1 diabetes"
http://www.virtualdrugstore.com/diabetes/repaglinide.html

Most important fact about Prandin (Repaglinide):healthsquare:"Chronically high glucose levels have been implicated in the kidney failure, blindness, and loss of sensation that plague many people with long-standing diabetes. A low-calorie diet, weight loss, and exercise are your first line of defense against these problems. Medications such as Prandin are prescribed only as a back-up when these other measures still leave sugar too high. If diet, exercise, a nd a combination of Prandin and Glucophage all fail to do the job, your doctor may have to start you on insulin."
http://www.healthsquare.com/newrx/PRA1343.HTM

Prandin (Repaglinide) precautions:personalmd:"Tell your doctor your medical history, including kidney or liver disease, adrenal or pituitary gland problems or any allergies. Unusual stresses such as fever, serious infection, trauma or surgery may result in loss of blood sugar control. Consult your doctor or pharmacist. Limit alcohol intake, as it may aggravate drug side effects. This medication should be used only when clearly needed during pregnancy. Insulin therapy may be necessary during pregnancy. Discuss the risks and benefits with your doctor. It is not known whether this drug is excreted into breast milk. Because of the potential risk to the infant, breast-feeding while using this drug is not recommended. Consult your doctor before breast-feeding. Caution is advised when this drug is used in the elderly since side effects may be aggravated and more difficult to recognize."
http://www.personalmd.com/drgdb/2061.htm

Prandin (Repaglinide) description:diabetesmonitor:"Prandin™ is the first approved product in a new chemical class (meglitinide class) of orally administered drugs for the treatment of Type 2 diabetes and was developed to manage meal related (prandial) glucose loads. It is different from other oral anti-diabetic agents in structure and clearance. Its quick onset and short duration of action concentrates its effect around meal time glucose load, which is important to the treatment of Type 2 diabetes. The starting dose of Prandin™ in oral hypoglycemic agent (OHA) naive patient or patients with HbA1c_less than 8% is 0.5 mg before each meal. In OHA treated patients with HbA1c_greater than 8% the starting dose is 1 or 2 mg before each meal. The dose can be adjusted by physicians up to 4 mg before each meal. If a meal is skipped, so is the Prandin™ tablet; if a meal is added during the day, a tablet is added for that meal."
http://www.diabetesmonitor.com/prandin.htm

Who should not take repaglinide (Prandin)?:ahealthyme:"Before taking this medication, tell your doctor if you have kidney or liver disease; have thyroid disease; heart disease; have Type 1 diabetes mellitus (insulin-dependent diabetes); have a serious infection, illness, or injury; or need surgery. You may need a lower dose or special monitoring during treatment if you have any of the conditions listed above. Repaglinide is in the FDA pregnancy category C. This means that it is not known whether repaglinide will harm an unborn baby. Insulin is usually the drug of choice for controlling diabetes during pregnancy. Do not take repaglinide without first talking to your doctor if you are pregnant. It is not known whether repaglinide passes into breast milk. Do not take repaglinide without first talking to your doctor if you are breast-feeding a baby."
http://www.ahealthyme.com/topic/topic100591482

Side effects of Prandin (repaglinide):nlm.nih.gov:"Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.Check with your doctor immediately if any of the following side effects occur: More common: Convulsions (seizures); unconsciousness. Check with your doctor as soon as possible if any of the following side effects occur:More common: Cough; fever; low blood sugar, including anxious feeling, behavior change similar to being drunk, blurred vision, cold sweats, confusion, cool pale skin, difficulty in thinking, drowsiness, excessive hunger, fast heartbeat, headache, nausea, nervousness, nightmares, restless sleep, shakiness, slurred speech, or unusual tiredness or weakness; pain in the chest; runny or stuffy nose; shortness of breath; sinus congestion with pain; sneezing; sore throat. Less common: Bloody or cloudy urine; burning, painful, or difficult urination; chest pain; chills; frequent urge to urinate; problems with teeth; skin rash, itching, or hives; tearing of eyes; tightness in chest; trouble in breathing; vomiting; wheezing. Rare: Black, tarry stools; blood in stools; fast or irregular heartbeat; hoarseness; lower back or side pain; pinpoint red spots on skin; unusual bleeding or bruising."
http://www.nlm.nih.gov/medlineplus/druginfo/repaglinidesystemic203463.html#SXX25

Prandin Lessens Risk Of Hypoglycaemia Associated With Missed Meals:pslgroup:"Because Prandin is short acting and taken only at mealtimes, a patient's blood glucose levels are maintained even when a meal is missed.The study in Diabetes Care evaluated the effect of a skipped meal on blood glucose levels in 83 patients with type II diabetes who were well controlled on either Prandin or glyburide treatment. The results found patients treated with Prandin maintained blood glucose control and reported no hypoglycaemic events, even when a meal had been skipped. In comparison, those treated with glyburide, a long-acting SU, experienced a decrease in blood glucose levels when they did not eat a scheduled meal and reported a total of six hypoglycaemic events"
http://www.pslgroup.com/dg/FF7DE.htm

Action/Kineticsof Prandin (Repaglinide):nursespdr:"Action/Kinetics: Lowers blood glucose by stimulating release of insulin from pancreas. Action depends on functioning beta cells in pancreatic islets. Drug closes ATP-dependent potassium channels in beta-cell membrane due to binding at sites. Blockade of potassium channel depolarizes beta cell which leads to opening of calcium channels. This causes calcium influx which induces insulin secretion. Rapidly and completely absorbed from GI tract. Peak plasma levels: 1 hr. Completely metabolized in liver with most excreted in feces."
http://www.nursespdr.com/members/database/ndrhtml/repaglinide.html

Prandin (Rapaglinide) drug class and mechanism:focusondiabetes:"Like Sulfonylureas, e.g. glyburide (Diabeta; Glynase; Micronase), glipizide (Glucotrol), glimepiride (Amaryl), tolbutaminde (Orinase), and tolazamide (Tolinase), repaglinide stimulates cells in the pancreas to produce insulin. Glyburide may be more potent than repaglinide at increasing insulin release in persons with low or high blood glucose levels, whereas repaglinide may be more potent in persons with moderate blood glucose levels. Repaglinide is unusual in that it has a rapid onset of action and a short duration of action."
http://www.focusondiabetes.com/script/main/Art.asp?li=MNI&ArticleKey=9530

Precautions while taking Prandin (Rapaglinide):rxlist:"All oral blood glucose-lowering drugs are capable of producing hypoglycemia. Proper patient selection, dosage, and instructions to the patient are important to avoid hypoglycemic episodes. Hepatic insufficiency may cause elevated repaglinide blood levels and may diminish gluconeogenic capacity, both of which increase the risk of serious hypoglycemia. Elderly, debilitated, or malnourished patients, and those with adrenal, pituitary, or hepatic insufficiency are particularly susceptible to the hypoglycemic action of glucose-lowering drugs. Hypoglycemia may be difficult to recognize in the elderly and in patients taking beta-adrenergic blocking drugs. Hypoglycemia is more likely to occur when caloric intake is deficient, after severe or prolonged exercise, when alcohol is ingested, or when more than one glucose-lowering drug is used. The frequency of hypoglycemia is greater in patients with Type 2 diabetes who have not been previously treated with oral blood glucose-lowering drugs (naive) or whose HbA1c is less than 8%. Prandin should be administered with meals to lessen the risk of hypoglycemia."
http://www.rxlist.com/cgi/generic/prandin_wcp.htm



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Last updated by Andrew Lopez, RN on Wednesday, September 29, 2010


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