Repaglinide is indicated in adults with type 2 diabetes mellitus whose hyperglycaemia can no longer be controlled satisfactorily by diet, weight reduction and exercise. Repaglinide is also indicated in combination with metformin in adults with type 2 diabetes mellitus who are not satisfactorily controlled on metformin alone.
Treatment should be initiated as an adjunct to diet and exercise to lower the blood glucose in relation to meals.
For this indication, competent medicine agencies globally authorize below treatments:
Oral
1.5 - 16 mg
From 0.5 To 5.333 mg 3 time(s) per day every day
1.5 mg
Repaglinide is given preprandially and is titrated individually to optimise glycaemic control. In addition to the usual self-monitoring by the patient of blood and/or urinary glucose, the patient’s blood glucose must be monitored periodically by the physician to determine the minimum effective dose for the patient. Glycosylated haemoglobin levels are also of value in monitoring the patient’s response to therapy. Periodic monitoring is necessary to detect inadequate lowering of blood glucose at the recommended maximum dose level (i.e. primary failure) and to detect loss of adequate blood glucose lowering response after an initial period of effectiveness (i.e. secondary failure).
Short-term administration of repaglinide may be sufficient during periods of transient loss of control in type 2 diabetic patients usually controlled well on diet.
The dosage should be determined by the physician, according to the patient’s requirements.
The recommended starting dose is 0.5 mg. One to two weeks should elapse between titration steps (as determined by blood glucose response).
If patients are transferred from another oral hypoglycaemic medicinal product the recommended starting dose is 1 mg.
The recommended maximum single dose is 4 mg taken with main meals.
The total maximum daily dose should not exceed 16 mg.
Repaglinide should be taken before main meals (i.e. preprandially).
Doses are usually taken within 15 minutes of the meal but time may vary from immediately preceding the meal to as long as 30 minutes before the meal (i.e. preprandially 2, 3, or 4 meals a day). Patients who skip a meal (or add an extra meal) should be instructed to skip (or add) a dose for that meal.