Repaglinide

Dianorm is indicated as an adjunct to diet and exercise to lower the blood glucose in patients with type 2 diabetes mellitus (NIDDM) whose hyperglycemia cannot be controlled satisfactorily by diet and exercise alone. It is also indicated for use in combination with Metformin to lower blood glucose in patients whose hyperglycemia cannot be controlled by exercise, diet, and either Dianorm or Metformin alone.

For patients not previously treated or whose HbA1c is <8%, the starting dose should be 0.5 mg before each meal.
For patients previously treated with blood glucose-lowering drugs and whose HbA1c is >8%, the initial dose is 1 or 2 mg before each meal.
Repaglinide should be taken immediately or up to 30 minutes before each meal.
Dosage should be adjusted according to response at intervals of 1-2 weeks; up to 4 mg may be given as a single-dose, maximum 16 mg daily.

The most common side effects of Dianorm are hypoglycemia and related symptoms. Others include upper respiratory tract infections, diarrhea, constipation, nausea and vomiting. Hypersensitivity reactions include rashes and urticaria.

Repaglinide binds to specific receptors in the cell membrane leading to the closure of ATP dependent K
+
channels and the depolarisation of cell membrane. This in turn, leads to Ca
++
influx, increased intracellular Ca
++
and the stimulation of insulin secretion.