单词 | repaglinide |
释义 | repaglinideenUKre·pag·li·nideR0156050 (rĭ-păg′lə-nīd′)repaglinideenUKrepaglinide[rĕ-pag´lĭ-nīd]repaglinidePharmacologic class: Meglitinide Therapeutic class: Hypoglycemic Pregnancy risk category C ActionInhibits alpha-glucosidases, enzymes that convert oligosaccharides and disaccharides to glucose. This inhibition lowers blood glucose level, especially in postprandial hyperglycemia. AvailabilityTablets: 0.5 mg, 1 mg, 2 mg Indications and dosages➣ Adjunct to diet and exercise in type 2 (non-insulin-dependent) diabetes mellitus uncontrolled by diet and exercise alone, or combined with metformin in type 2 diabetes mellitus uncontrolled by diet, exercise, and either repaglinide or metformin alone Adults: 0.5 to 4 mg P.O. before each meal; may adjust at 1-week intervals based on blood glucose response. Maximum daily dosage is 16 mg. Contraindications• Hypersensitivity to drug or its components • Diabetic ketoacidosis • Type 1 (insulin-dependent) diabetes mellitus • Administration with gemfibrozil PrecautionsUse cautiously in: • renal or hepatic impairment; adrenal or pituitary insufficiency; stress caused by infection, fever, trauma, or surgery • concurrent use of CYP2C8 inhibitors (such as trimethoprim, gemfibrozil, montelukast) • concurrent use of CYP3A4 inhibitors (such as ketoconazole, itraconazole, erythromycin) • concurrent use of CYP3A4 or CYP2C8 inducers (such as rifampin, barbiturates, carbamazepine) • elderly or malnourished patients • pregnant or breastfeeding patients • children. Administration• Give 15 to 30 minutes before meals. Administer two, three, or four times daily, if needed, to adapt to patient's meal pattern. Adverse reactionsCNS: headache, paresthesia CV: angina, chest pain EENT: sinusitis, rhinitis GI: nausea, vomiting, diarrhea, constipation, dyspepsia GU: urinary tract infection Metabolic: hyperglycemia, hypoglycemia Musculoskeletal: joint pain, back pain Respiratory: upper respiratory infection, bronchitis Other: tooth disorder, hypersensitivity reaction InteractionsDrug-drug. Barbiturates, carbamazepine, rifampin: decreased repaglinide blood level Beta-adrenergic blockers, chloramphenicol, MAO inhibitors, nonsteroidal antiinflammatory drugs, probenecid, sulfonamides, warfarin: potentiation of repaglinide effects Calcium channel blockers, corticosteroids, estrogens, hormonal contraceptives, isoniazid, phenothiazines, phenytoin, nicotinic acid, sympathomimetics, thyroid preparations: loss of glycemic control Clarithromycin: increased repaglinide area under the curve and Cmax Cyclosporine: increased repaglinide plasma concentration Erythromycin, ketoconazole, miconazole: decreased repaglinide metabolism, increased risk of hypoglycemia Gemfibrozil, itraconazole: significantly increased repaglinide exposure Simvastatin: increased repaglinide level Drug-food. Any food: decreased drug bioavailability Drug-herbs. Aloe gel (oral), bitter melon, chromium, coenzyme Q10, fenugreek, gymnema sylvestre, psyllium, St. John's wort: additive hypoglycemic effects Glucosamine: poor glycemic control Patient monitoring• Monitor blood glucose and glycosylated hemoglobin levels. • Monitor patient's meal pattern. Consult prescriber about adjusting dosage if patient adds or misses a meal. • Assess for angina, shortness of breath, or other discomforts. • Watch for signs and symptoms of bronchitis and upper respiratory, urinary, and EENT infections. Patient teaching• Tell patient to take 15 to 30 minutes before each meal. • Instruct patient to monitor blood glucose level carefully. Teach him to recognize signs and symptoms of hypoglycemia and hyperglycemia. • Advise patient to report signs and symptoms of infection. • As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, foods, and herbs mentioned above. repaglinide(rĭ-păg′lə-nīd′)repaglinideNovoNorm®, Prandin® Endocrinology An oral nonsulfonylurea hypoglycemic for Pts with type 2 DM, whose hyperglycemia does not respond to diet and exercise |
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