Prandin: Rapid Post-Meal Glucose Control for Type 2 Diabetes
| Product dosage: 1mg | |||
|---|---|---|---|
| Package (num) | Per pill | Price | Buy |
| 30 | $1.40 | $42.14 (0%) | 🛒 Add to cart |
| 60 | $1.25 | $84.28 $74.82 (11%) | 🛒 Add to cart |
| 90 | $1.19 | $126.42 $107.50 (15%) | 🛒 Add to cart |
| 120 | $1.17 | $168.56 $140.18 (17%) | 🛒 Add to cart |
| 180 | $1.14 | $252.84 $205.54 (19%) | 🛒 Add to cart |
| 270 | $1.12 | $379.26 $303.58 (20%) | 🛒 Add to cart |
| 360 | $1.11
Best per pill | $505.68 $400.76 (21%) | 🛒 Add to cart |
| Product dosage: 2mg | |||
|---|---|---|---|
| Package (num) | Per pill | Price | Buy |
| 30 | $2.29 | $68.80 (0%) | 🛒 Add to cart |
| 60 | $2.15 | $137.60 $129.00 (6%) | 🛒 Add to cart |
| 90 | $2.11 | $206.40 $190.06 (8%) | 🛒 Add to cart |
| 120 | $2.09 | $275.20 $250.26 (9%) | 🛒 Add to cart |
| 180 | $2.07 | $412.80 $372.38 (10%) | 🛒 Add to cart |
| 270 | $2.05
Best per pill | $619.20 $552.98 (11%) | 🛒 Add to cart |
| 360 | $2.05 | $825.60 $737.88 (11%) | 🛒 Add to cart |
Synonyms | |||
Prandin (repaglinide) is a rapid-acting oral antidiabetic medication specifically designed to manage postprandial (after-meal) blood glucose levels in adults with type 2 diabetes mellitus. As a meglitinide analog, it stimulates the pancreas to release insulin quickly in response to meals, mimicking the body’s natural prandial insulin response. This targeted mechanism makes it a valuable therapeutic option, particularly for individuals with irregular meal schedules or those who experience significant glucose spikes following food intake. Prandin is typically used in conjunction with diet and exercise, and may be prescribed as monotherapy or in combination with other glucose-lowering agents like metformin when glycemic targets are not achieved with a single medication.
Features
- Active ingredient: Repaglinide
- Drug class: Meglitinide derivative (glinide)
- Administration: Oral tablet
- Available strengths: 0.5 mg, 1 mg, and 2 mg tablets
- Onset of action: Rapid, within 15-30 minutes of ingestion
- Duration of action: Short, approximately 2-4 hours
- Metabolism: Primarily hepatic, via CYP2C8 and CYP3A4 enzymes
- Excretion: Primarily via the bile into feces
Benefits
- Provides rapid and flexible mealtime glucose control, allowing patients to adjust dosing based on meal composition and timing.
- Effectively lowers postprandial hyperglycemia, a key contributor to overall glycemic control as measured by HbA1c.
- Reduces the risk of prolonged hypoglycemia between meals due to its short duration of action.
- Offers a therapeutic option for patients with renal impairment, as it is not primarily renally excreted (use with caution in hepatic impairment).
- Can be a suitable alternative for patients who are intolerant to or have contraindications for sulfonylureas.
Common use
Prandin is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. It is most appropriately prescribed for patients who experience significant postprandial glucose excursions. Its flexibility makes it particularly useful for individuals with irregular eating habits or shift work, as the dose is taken only in direct relation to main meals. If a meal is skipped, the dose for that meal is also skipped, reducing the risk of inter-meal hypoglycemia. It is not indicated for the treatment of type 1 diabetes mellitus or diabetic ketoacidosis.
Dosage and direction
The dosage of Prandin is highly individualized based on metabolic needs, blood glucose response, and target HbA1c levels.
- Initial Dose: For patients not previously treated with glucose-lowering drugs or whose HbA1c is <8%, the recommended starting dose is 0.5 mg before each main meal.
- Dose Titration: The preprandial dose may be doubled at weekly intervals until adequate glycemic control is achieved. The recommended dose range is 0.5 mg to 4 mg taken with meals. The maximum recommended daily dose is 16 mg.
- Dosing Schedule: Prandin should be taken within 30 minutes before starting a meal (2-5 minutes before is also effective). It is typically administered two, three, or four times daily, corresponding to the number of main meals. If a meal is missed, the scheduled dose of Prandin for that meal must be omitted to prevent hypoglycemia.
- Combination Therapy: When used in combination with metformin, the dose of each drug should be adjusted based on blood glucose measurements to achieve optimal control.
Precautions
- Hypoglycemia: The most common adverse reaction is hypoglycemia. Patients must be educated to recognize its signs and symptoms (e.g., dizziness, tremor, sweating, confusion).
- Hepatic Impairment: Prandin is extensively metabolized by the liver. Use with caution and initiate therapy at the 0.5 mg dose in patients with impaired liver function. Dose titration and maintenance doses should be conservative.
- Renal Impairment: Although not primarily renally excreted, patients with renal impairment may be at increased risk of hypoglycemia. Careful dose titration is essential.
- Concomitant Illness: Stress from fever, trauma, infection, or surgery may cause a loss of glycemic control, potentially necessitating temporary insulin therapy.
- Hemolytic Anemia: Use with caution in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency, as other drugs in this class have been associated with hemolytic anemia.
Contraindications
Prandin is contraindicated in patients with:
- Known hypersensitivity to repaglinide or any excipient in the formulation.
- Type 1 diabetes mellitus.
- Diabetic ketoacidosis, with or without coma.
- Concomitant use with gemfibrozil (strong CYP2C8 inhibitor), due to a significant risk of severe hypoglycemia.
Possible side effect
As with all medications, Prandin can cause side effects, although not everybody gets them. Side effects can include:
- Very Common (≥1/10): Hypoglycemia.
- Common (≥1/100 to <1/10): Abdominal pain, diarrhea, nausea, vomiting, constipation.
- Uncommon (≥1/1,000 to <1/100): Acute coronary syndrome (e.g., angina, myocardial infarction), hypersensitivity reactions, visual disturbances.
- Rare (≥1/10,000 to <1/1,000): Severe hypoglycemic reactions, hepatic dysfunction (e.g., elevated liver enzymes, hepatitis), thrombocytopenia.
- Frequency not known: Hemolytic anemia in patients with G6PD deficiency.
Drug interaction
Prandin’s metabolism is highly susceptible to drug interactions due to its pathway through CYP2C8 and CYP3A4 enzymes.
- Contraindicated Interaction: Gemfibrozil - Co-administration is contraindicated. It drastically increases repaglinide plasma levels, leading to a high risk of prolonged and severe hypoglycemia.
- Interactions Requiring Dose Adjustment/Close Monitoring:
- Strong CYP2C8 Inhibitors (e.g., clopidogrel, deferasirox): Increase repaglinide exposure. Avoid concomitant use or consider a Prandin dose reduction.
- Strong CYP3A4 Inhibitors (e.g., ketoconazole, itraconazole, clarithromycin): Increase repaglinide exposure. Consider a Prandin dose reduction.
- Strong CYP3A4 Inducers (e.g., rifampin, carbamazepine, St. John’s Wort): Decrease repaglinide exposure, potentially reducing its efficacy. Consider a Prandin dose increase.
- Other Glucose-Lowering Agents (e.g., metformin, thiazolidinediones, insulin): May increase the risk of hypoglycemia. Blood glucose monitoring and potential dose adjustment of both agents are required.
- Beta-blockers may mask the tachycardia (fast heart rate) that often serves as a warning sign of hypoglycemia.
Missed dose
- If a dose is forgotten before a meal, and the meal has already started or been completed, skip the missed dose.
- Do not take a double dose to make up for a forgotten one, as this significantly increases the risk of hypoglycemia.
- Simply resume the regular dosing schedule with the next main meal.
Overdose
An overdose of Prandin, as with other glucose-lowering agents, will lead to pronounced hypoglycemia.
- Symptoms: Symptoms can include hunger, nausea, tremor, sweating, dizziness, drowsiness, confusion, seizures, loss of consciousness, and coma.
- Management:
- Mild Hypoglycemia: Treat immediately with oral carbohydrates (e.g., glucose tablets, fruit juice, sugar). The patient must then be closely monitored, as the hypoglycemia may recur due to the drug’s duration of action.
- Severe Hypoglycemia/Unconsciousness: Administer intravenous glucose (50%) or intramuscular glucagon. Hospitalization and close monitoring for at least 24-48 hours are mandatory, as hypoglycemia may recur after initial treatment. Hemodialysis is not effective due to Prandin’s high protein binding.
Storage
- Store Prandin tablets at room temperature between 20°C to 25°C (68°F to 77°F).
- Keep the bottle tightly closed to protect from moisture and light.
- Keep all medicines out of the sight and reach of children.
- Do not use Prandin after the expiration date printed on the bottle.
Disclaimer
This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or before starting any new treatment. Never disregard professional medical advice or delay in seeking it because of something you have read here. The information provided is not exhaustive and may not cover all possible uses, directions, precautions, interactions, or adverse effects.
Reviews
- “As a physician, I find Prandin to be an excellent tool for patients with erratic schedules. The meal-dependent dosing provides flexibility that sulfonylureas cannot, and we see fewer reports of afternoon hypoglycemia.” – Dr. A. Chen, Endocrinologist
- “Managing my diabetes was difficult with my rotating shifts. Since switching to Prandin, I only take it when I actually eat a large meal. It has given me much better control over my post-lunch numbers without the fear of a low blood sugar at 3 PM.” – Patient M., 54
- “The clinical data is robust for its effect on postprandial glucose. It serves a specific niche in our therapeutic arsenal, particularly for those where that is the primary glycemic defect.” – Clinical Pharmacist Review
- “The potential for drug interactions, especially with gemfibrozil, is a critical counseling point that requires vigilance from the entire healthcare team to ensure patient safety.” – Pharmacy Director