Introduction
Reglin is used to lower blood sugar levels in adults with type 2 diabetes mellitus. It is usually prescribed along with other diabetes medicines to achieve adequate blood sugar control. It also prevents serious complications of diabetes like kidney damage and blindness.
Reglin is normally prescribed when diet and exercise alone or other medicines have not been enough to control your blood sugar level. It works best when taken before meals. The dose will depend on your condition, and blood sugar levels, but you should use it as advised by your doctor.
You should take it regularly, at the same time each day, to get the most benefit and you should not stop unless your doctor recommends it. It is controlling your blood sugar levels and helping to prevent serious complications in the future. It is important to stay on the diet and exercise program recommended by your doctor while taking this medicine. Your lifestyle plays a big part in controlling diabetes.
The most common side effect of taking this medicine is low blood sugar level (hypoglycemia). You can carry sugar or glucose candy to control low blood sugar level. Other side effects that may be seen while taking this medicine include dizziness, back pain and flu-like symptoms. Contact your doctor if the side effects worry you or if they do not go away.
Before taking this medicine, let your doctor know if you have ever had kidney disease, heart or pancreas problems, or if you drink a lot of alcohol. Pregnant or breastfeeding women should also consult their doctor before taking it. Some other medicines you are taking may interfere with it so make sure your doctor knows about all the other medicines you are using. Limit your alcohol intake while taking this medicine because it can increase your risk of developing low blood sugar levels. You may need regular tests such as kidney function and blood glucose levels to check that the medicine is working properly.
Side effects of Reglin
Common
- Joint pain
- Dizziness
- Back pain
- Diarrhea
- Flu-like symptoms
- Upper respiratory tract infection
How to use Reglin
Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Reglin is to be taken empty stomach.
How Reglin works
Reglin is an anti-diabetic medication. It increases the amount of insulin released by the pancreas which prevents blood glucose from rising very high after meals.
What if you forget to take Reglin?
If you miss a dose of Reglin, skip it and continue with your normal schedule. Do not double the dose.
Administration
Take 15 minutes before meal; no more than 4 meals/day
Adult Dose
Oral
Type 2 diabetes mellitus
Adult: Usual initial dose: 0.5 mg before main meals.
Initial doses of 1 or 2 mg may be used in patients who have had previous hypoglycaemic treatment.
May adjust dose at intervals of 1-2 wk, up to 4 mg before meals.
Max dose: 16 mg daily.
Hepatic impairment: May require longer intervals between dosage adjustments.
Child Dose
Safety and efficacy not established
Renal Dose
Renal Impairment
CrCl 40-80 mL/minute: No adjustments necessary
CrCl 20-40 mL/minute: 0.5 mg with meals; titrate slowly and monitor
CrCl < 20 mL/minute: Data not available
Contraindication
Diabetic ketoacidosis; severe hepatic impairment, type 1 diabetes; hypersensitivity. Lactation.
Mode of Action
Repaglinide stimulates release of insulin from pancreatic beta-cells by inhibiting K efflux via closure of ATP regulated K channels. This results in depolarization of the cell and opening of voltage-dependent Ca channels, which increases influx of Ca into the beta cells and causes release of insulin.
Precaution
Myocardial infarction, coma, trauma during surgery, elderly, malnourished and debilitated patients. Hepatic or severe renal impairment. Pregnancy.
Side Effect
Hypoglycaemia, nausea, diarrhoea, constipation, vomiting, dyspepsia, arthralgia, sinusitis, rhinitis, back pain; rash, pruritus, urticaria; visual disturbances.
Interaction
Cytochrome P450 3A4 inducers eg. rifampicin, barbiturates and carbamazepine may increase repaglinide metabolism. NSAIDs and other highly protein bound drugs eg, salicylates, sulphonamides, phenylbutazone, oral anticoagulants and hydantoins may potentiate action of repaglinide. Ketoconazole, fluconazole, itraconazole and erythromycin may increase plasma conc of repaglinide. Antagonistic effect with drugs causing hyperglycaemia. Concurrent use with gemfibrozil may lead to enhanced and prolonged blood glucose lowering effect.
Potentially Fatal: Increased risk of myocardial infarction when used with isophane insulin.