Metformin-repaglinide

Dosage Forms & Strengths

metformin/repaglinide

tablet

• 500mg/1mg
• 500mg/2mg

Type 2 Diabetes Mellitus

Indicated as adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus who are already treated with a meglitinide and metformin, or who have inadequate glycemic control on a meglitinide alone or metformin alone

Currently using comcomitant repaglinide and metformin

• Start initial PrandiMet dose similar to patient's current repaglinide/metformin dosage, but do not exceed; titrate as necessary to acheive targeted glycemic control

Inadequately controlled with either metformin or a meglitinide monotherapy

• 500 mg/1 mg PO q12hr ac initially
• May gradually increase dose based on glycemic response

Dosage Modifications

Hepatic impairment: Do not administer

Renal impairment

• Obtain eGFR before starting metformin
• eGFR <30 mL/min/1.73 m²: Contraindicated
• eGFR 30-45 mL/min/1.73 m²: Not recommended to initiate treatment
• Monitor eGFR at least annually or more often for those at risk for renal impairment (eg, elderly)
• If eGFR falls below 45mL/min/1.73 m² while taking metformin, risks and benefits of continuing therapy should be evaluated
• If eGFR falls below 30 mL/min/1.73 m²: while taking metformin, discontinue the drug

Oral Administration

May be administered PO q8-12hr

Generally given within 15 minutes prior to meals, but timing can vary from immediately preceding the meal up to 30 minutes before the meal

Not to exceed 1000 mg/4 mg per meal

Not to exceed cumulative daily dose of 2500 mg/10 mg

Safety and efficacy not established; not recommended for use in children

Currently using comcomitant repaglinide and metformin

Start initial PrandiMet dose similar to patient's current repaglinide/metformin dosage, but do not exceed; titrate as necessary to acheive targeted glycemic control

Do not administer to patients >80 years before assessing renal function and determined to be normal

Inadequately controlled with either metformin or meglitinide monotherapy

500 mg/1 mg PO q12hr ac initially

May gradually and conservatively increase dose based on glycemic response

Do not administer to patients >80 years before assessing renal function and determined to be normal

Common Side Effects of PrandiMet

Tell your doctor if any of the following side effects become severe or don't go away:

• Mild nausea, vomiting, or diarrhea
• Headache
• Dizziness

Serious Side Effects of PrandiMet

Tell your doctor immediately if you experience any of the symptoms listed in the PrandiMet Warnings section above, or any of the following serious side effects:

• Chest pain
• Shortness of breath
• Pale skin
• Cold hands or feet
• Severe nausea or vomiting
• Severe peeling, pain, or blistering of the skin
• Pain in the upper part of your stomach
• Yellowing of the skin or eyes
• Dark-colored urine
• Hair loss
• Signs of a severe allergic reaction, which may include hives, difficulty breathing, tightness in the chest, or swelling of the face, lips, tongue, or throat

Tell your doctor about all prescription, nonprescription, illegal, recreational, herbal, nutritional, or dietary drugs you're taking, especially those listed in the PrandiMet Warnings section above, and any of the following:

• Antacids
• Antibiotics, such as Vancocin (vancomycin) or Primsol (trimethoprim)
• Other diabetes treatments
• Antifungal drugs, such as Onmel and Sporanox (itraconazole) or Nizoral (ketoconazole)
• Medication for heart problems or high blood pressure
• Rifadin (rifampin)

PrandiMet and Other Interactions

You may experience dizziness or drowsiness while taking PrandiMet.

Don't drive, operate machinery, or perform other activities that require alertness until you know how this medicine affects you.

PrandiMet and Alcohol

Alcohol can affect your blood sugar levels and may worsen certain side effects of PrandiMet.

Talk to your doctor before drinking alcoholic beverages while taking this medicine.