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.
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.
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.
Always consult a registered doctor before taking any medicine. This information is for general knowledge only.
Repaglinide is contraindicated in patients with: Diabetic ketoacidosis, with or without coma. Type 1 diabetes mellitus and Known hypersensitivity to the drug or its inactive ingredients.
The dose of Dianorm may need to be adjusted, if taken with other medications. The possible interactions of Dianorm with other drugs are: Inhibitors of the cytochrome P450 enzyme system (azole antifungals and macrolides) may lead to lower Dianorm clearance and longer half life. Inducers of the cytochrome P450 enzyme system (Rifampin, Phenobarbital, Carbamazepine, Troglitazone, etc.) may accelerate Dianorm metabolism and shorten its effect. Cimetidine has no significant effect on Dianorm absorption or clearance. Dianorm has no significant effect on Digoxin, Theophyllin, or Warfarin. Highly protein bound drugs (e.g., NSAIDs) may increase the plasma level of unbound Dianorm and potentiate its glucose lowering effect. Thus, co-administration of these drugs with Dianorm may increase the risk of hypoglycaemia. The risk of hypoglycaemia may also be increased when hypoglycaemic agents are co-administered with certain drugs such as salicylates, sulphonamides, Chloramphenicol, coumarins, Probenecid, monoamine oxidase (MAO) inhibitors, and adrenergic blockers.
Insulin should be substituted during concurrent illness (such as myocardial infarction, coma, infection, and trauma) and during surgery. All oral blood glucose-lowering drugs are capable of producing hypoglycemia. Dianorm should be administered with meals to lessen the risk of hypoglycemia.