Prandin

Prandin is a prescription medication used to treat type 2 diabetes. Prandin belongs to a group of drugs called meglitinides, which help lower blood sugar levels by causing the pancreas to secrete more insulin. 

This medication comes in tablet form and is taken before each meal. If you skip a meal you must skip the Prandin dose.

Common side effects include headaches, low blood sugar levels, and upper respiratory infections.

Prandin is a prescription medication used with diet and exercise to treat type 2 diabetes.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Take Prandin exactly as prescribed by your doctor. Follow the directions on your prescription label carefully.

The Prandin dose your doctor recommends will be based on the following:

• other medical conditions you have
• other medications you are taking
• how you respond to the medication

The recommended dose range of Prandin for the treatment of type 2 diabetes is 0.5 mg to 4 mg before meals. The maximum daily dose is 16 mg.

Serious side effects have been reported with Prandin including:

• loss of blood sugar control. This may result in low blood sugar episodes, high blood sugar episodes, or both.

  • Tell your healthcare provider right away if you have some or all of the following symptoms of low blood sugar:

    • hunger
    • shakiness
    • dizziness
    • confusion
    • difficulty speaking
    • feeling anxious or weak

  • Tell your healthcare provider right away if you have some or all of the following symptoms of high blood sugar:

    • coma
    • convulsions
    • confusion
    • increased thirst
    • fever
    • frequent urination
    • nausea
    • lethargy
    • weight loss
    • weakness

• heart problems.  Tell your healthcare provider right away if you have some or all of the following symptoms of a heart problem:

  • chest pain
  • high blood pressure
  • abnormal heart beat

• thrombocytopenia. This is a condition in which your blood has a lower than normal number of blood cell fragments called platelets. Tell your healthcare provider right away if you have the following signs and symptoms of thrombocytopenia:

  • mild to serious bleeding
  • purple, brown, and red bruises (purpura)
  • small red or purple dots on your skin (petechiae)
  • prolonged bleeding, even from minor cuts
  • bleeding or oozing from the mouth or nose, especially nosebleeds or bleeding from brushing your teeth
  • abnormal vaginal bleeding (especially heavy menstrual flow)
  • blood in the urine or stool or bleeding from the rectum. Blood in the stool can appear as red blood or as a dark, tarry color. Taking iron supplements also can cause dark, tarry stools.
  • headaches and other neurological symptoms. These problems are very rare, but you should discuss them with your doctor.

• leukopenia. This is a condition when there are a low number of white blood cells in your body. These cells help fight infections. Those who develop leukopenia are more likely to have fevers and infections.

• elevated liver enzymes in liver function tests.

• hypersensitivity (severe allergic reaction). Tell your healthcare provider about any signs or symptoms of hypersensitivity, which include the following:

  • chest pain
  • swelling of the face, eyes, lips, tongue, arms, or legs
  • difficulty breathing or swallowing
  • fainting
  • rash

Do not take Prandin if you:

• are allergic to any of its ingredients
• have a condition called diabetic ketoacidosis
• have type 1 diabetes
• take a medication called gemfibrozil (Lopid)

Serious side effects have been reported with Prandin.  See the “Drug Precautions” section.

Common side effects include:

• headaches
• low blood sugar levels
• upper respiratory infections
• diarrhea
• constipation
• back pain
• muscle pain

This is not a complete list of Prandin side effects.  Ask your doctor or pharmacist for more information.

Call your doctor for medical advice about side effects.  You may report side effects to the FDA at 1-800-FDA-1088.

Tell your doctor about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements.  Especially tell your doctor if you take:

• aspirin and other NSAIDs (nonsteroidal anti-inflammatory drugs) such as:
  • celecoxib (Celebrex)
  • diclofenac (Cambia, Cataflam, Flector, Voltaren, Zipsor and others)
  • etodolac (Lodine)
  • ibuprofen (Advil, Motrin, Nuprin)
  • indomethacin (Indocin, Indocin SR)
  • ketoprofen (Orudis, Actron, Oruvail)
  • ketorolac (Toradol)
  • meloxicam (Mobic)
  • nabumetone (Relafen)
  • naproxen (Naprosyn)
  • naproxen sodium (Aleve, Anaprox, Naprelan)
  • oxaprozin (Daypro)
  • piroxicam (Feldene)
• azole antifungals (ketoconazole, itraconazole, posaconazole, voriconazole)
• beta blockers such as:
  • metoprolol (Toprol XL, Lopressor)
  • carvedilol (Coreg)
  • bisoprolol (Zebeta)
  • betaxolol (Kerlone)
  • nebivolol (Bystolic)
  • propranolol (Inderal)
• birth control pills (oral contraceptives)
• calcium channel blockers such as:
  • nifedipine (Adalat, Nifedical, Procardia)
  • amlodipine (Norvasc)
  • verapamil (Calan, Isoptin, Covera-HS, Verelan)
  • diltiazem (Cardizem)
• carbamazepine (Tegretol, Equetro, Carbatrol)
• chloramphenicol (Chloromycetin)
• clarithromycin (Biaxin)
• conivaptan (Vaprisol)
• cyclosporine (Neoral, Gengraf, Sandimmune)
• darifenacin (Enablex)
• deferasirox (Exjade)
• delavirdine (Rescriptor)
• dihydroergotamine (Migranal)
• diuretics such as:
  • acetazolamide (Diamox)
  • amiloride (Midamor)
  • bumetanide (Bumex)
  • chlorothiazide (Diuril)
  • chlorthalidone (Thalitone)
  • ethacrynic acid (Edecrin)
  • furosemide (Lasix)
  • hydrochlorothiazide (Microzide, HCTZ)
  • metolazone (Zaroxolyn)
  • torsemide (Demadex)
  • triamterene (Dyrenium, Dyazide, Maxzide)
• eletriptan (Relpax)
• estrogens
• fentanyl (Abstral, Fentora, Onsolis, Actiq)
• fluvoxamine (Luvox)
• gemfibrozil (Lopid)
• HCV protease inhibitors (boceprevir, telaprevir)
• HIV protease inhibitors (indinavir, nelfinavir, ritonavir, saquinavir)
• isoniazid
• ketoconazole (Nizoral)
• lovastatin (Mevacor)
• macrolide antibiotics (clarithromycin, telithromycin)
• monoamine oxidase inhibitors such as:
  • tranylcypromine (Parnate)
  • phenelzine (Nardil)
  • selegiline (Eldepryl, Zelapar)
  • isocarboxazid (Marplan)
  • rasagiline (Azilect)
• nefazodone (Serzone)
• nicotinic acid medications such as niacin (Niacor, Niaspan, Slo-Niacin) and vitamin B3
• nimodipine (Nimotop)
• phenobarbital
• phenothiazines such as:
  • chlorpromazine (Thorazine)
  • thioridazine (Mellaril)
  • fluphenazine (Prolixin)
  • perphenazine (Triavil)
  • prochlorperazine (Compazine)
  • trifluoperazine (Stelazine)
• phenytoin (Dilantin)
• pimozide (Orap)
• probenecid (Probalan)
• quetiapine (Seroquel)
• quinidine (Cardioquin, Duraquin, Quinact)
• rifampin 
• sildenafil (Viagra, Revatio)
• simvastatin (Zocor)
• sirolimus (Rapamune)
• steroids such as:
  • prednisone (Cortan, Deltasone, Orasone, Sterapred)
  • budesonide (Entocort)
  • dexamethasone (Decadron)
  • triamcinolone (Kenacort, Aristocort)
  • flunisolide (AeroBid. Aerospan)
  • ciclesonide (Alvesco)
  • mometasone (Asmanex, Dulera)
  • fluticasone (Flovent)
  • methylprednisolone (Medrol, Solu-Medrol)
  • fludrocortisone (Florinef)
  • hydrocortisone (Cortef, Cortril, Hydrocortone)
• St. John's wort
• sulfonamides such as:
  • trimethoprim/sulfamethoxazole (Septra, Bactrim)
  • sulfasalazine (Azulfidine)
  • dapsone (DDS)
  • hydrochlorothiazide (Microzide)
  • sumatriptan (Imitrex, Sumavel Dosepro)
  • zonisamide (Zonegran)
  • acetazolamide (Diamox)
  • celecoxib (Celebrex)
• tacrolimus (Prograf)
• terfenadine (Seldane)
• thyroid drugs such as levothyroxine (Synthroid, Levothroid)
• warfarin (Coumadin)

This is not a complete list of Prandin drug interactions.  Ask your doctor or pharmacist for more information.

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Prandin falls into category C. In animal studies, pregnant animals were given this medication and had some babies born with problems. No well-controlled studies have been done in humans. Therefore, this medication may be used if the potential benefits to the mother outweigh the potential risks to the unborn child.

Tell your doctor if you are breastfeeding or plan to breastfeed.

It is not known if Prandin crosses into human milk. Because many medications can cross into human milk and because of the possibility for serious adverse reactions in nursing infants with use of this medication, a choice should be made whether to stop nursing or stop the use of this medication. Your doctor and you will decide if the benefits outweigh the risk of using Prandin.

Take repaglinide before each meal, up to a half hour before meals.

If you skip a meal you must skip the repaglinide dose.

If you eat an extra meal, take an extra dose before that meal.

If you take your repaglinide dose and then do not eat a meal within a half an hour, eat something as soon as possible. Taking repaglinide without a meal can cause low blood sugar (hypoglycemia).

Repaglinide can cause low blood sugar. Know the signs and symptoms of low blood sugar.