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What Is Repaglinide?

Repaglinide is a prescription oral diabetes medication belonging to the meglitinide class, also called a glinide. It is used with diet and exercise to improve blood sugar control in adults with type 2 diabetes. Repaglinide is associated with the brand name Prandin and works by stimulating insulin release from pancreatic beta cells. It is taken before meals rather than on a fixed schedule unrelated to eating. Repaglinide is not intended for type 1 diabetes or diabetic ketoacidosis. Because it increases insulin secretion, low blood sugar is an important treatment risk.

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What Is Repaglinide?

Repaglinide is a prescription oral diabetes medication belonging to the meglitinide class, also called a glinide. It is used with diet and exercise to improve blood sugar control in adults with type 2 diabetes. Repaglinide is associated with the brand name Prandin and works by stimulating insulin release from pancreatic beta cells. It is taken before meals rather than on a fixed schedule unrelated to eating. Repaglinide is not intended for type 1 diabetes or diabetic ketoacidosis. Because it increases insulin secretion, low blood sugar is an important treatment risk.

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How Does Repaglinide Work?

Repaglinide stimulates insulin release by binding to receptors associated with ATP-sensitive potassium channels in pancreatic beta cells. Closing these channels changes electrical activity in the cells, allowing calcium to enter and trigger insulin secretion. The resulting insulin release helps lower blood glucose, particularly after meals. Repaglinide has a relatively short duration of action, making its dosing closely linked to food intake. It requires functioning pancreatic beta cells and is not appropriate as insulin replacement in type 1 diabetes. Excessive insulin release relative to food intake can cause hypoglycemia.

What Condition Does Repaglinide Treat?

Repaglinide is approved as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. It may be considered for patients whose treatment plan benefits from medication taken before individual meals. A clinician evaluates blood glucose results, eating patterns, kidney and liver function, other medications, and hypoglycemia risk before prescribing it. Repaglinide is not approved for treating type 1 diabetes or diabetic ketoacidosis. There is no conclusive clinical evidence that repaglinide independently reduces major cardiovascular events. Regular glucose monitoring remains important throughout treatment.

How Should Repaglinide Be Taken?

Repaglinide is taken orally within 30 minutes before each main meal. Adults with an HbA1c below 8% commonly begin with 0.5 mg before meals, while those with an HbA1c of 8% or higher may begin with 1 mg or 2 mg. The dose may be adjusted from 0.5 mg to 4 mg before meals, up to a maximum of 16 mg daily. Patients should skip the corresponding dose whenever they skip a meal to reduce hypoglycemia risk. Severe kidney impairment requires a lower starting dose. Repaglinide must not be combined with gemfibrozil, and other interactions, including clopidogrel, require specific dose restrictions.

What Are the Side Effects and Warnings of Repaglinide?

Low blood sugar is one of the most important adverse effects of repaglinide. Symptoms can include sweating, shakiness, hunger, confusion, dizziness, and palpitations. Other possible effects include headache, upper respiratory symptoms, and gastrointestinal discomfort. Severe hypoglycemia can cause seizures or loss of consciousness. Repaglinide is contraindicated with gemfibrozil because the combination can substantially increase drug exposure. Combining repaglinide with clopidogrel can also increase hypoglycemia risk and requires a reduced dose when unavoidable. Use with NPH insulin has been associated with serious cardiovascular adverse reactions. Patients should follow their prescribed glucose-monitoring and low-blood-sugar management plan.

Common Questions About Repaglinide

Is repaglinide the same as Prandin?

Yes. Prandin is a brand name for repaglinide, an oral medication used to manage type 2 diabetes in adults.

Should repaglinide be taken when skipping a meal?

No. Patients should skip the corresponding repaglinide dose when they skip a meal to reduce the risk of low blood sugar.

Can repaglinide cause hypoglycemia?

Yes. Repaglinide stimulates insulin release and can cause hypoglycemia, especially when meals are missed or interacting medications are taken.

Can repaglinide be taken with clopidogrel?

The combination can increase repaglinide exposure and hypoglycemia risk. If it cannot be avoided, the repaglinide starting dose and maximum daily dose must be reduced according to the prescribing instructions.

References

DailyMed - REPAGLINIDE tablet. https://www.dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=3b150917-e2fd-4366-af83-ebc1d7297ca9. Date Accessed November 3, 2026.

Repaglinide. LiverTox. https://www.ncbi.nlm.nih.gov/books/NBK548879/. Date Accessed November 3, 2026.

Repaglinide. MedlinePlus. https://medlineplus.gov/druginfo/meds/a600010.html. Date Accessed November 3, 2026.

Repaglinide. PubChem. https://pubchem.ncbi.nlm.nih.gov/compound/Repaglinide. Date Accessed November 3, 2026.

Repaglinide. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK559305/. Date Accessed November 3, 2026.