Repaglinide+metformin
About
Repaglinide+metformin belongs to a class of medicine known as an antidiabetic. It is a combination of two antidiabetic drugs: Repaglinide and Metformin. Type 2 diabetes is a chronic or lifelong condition affecting how your body processes glucose. People with type 2 diabetes either do not produce enough insulin or if the insulin is produced, it cannot perform its function in the body (insulin resistance). Due to this, the blood glucose level increases, and symptoms such as frequent urination, increased thirst, and increased hunger start. It can lead to serious complications like skin infection, eye problems (retinopathy), nerve damage (neuropathy), diabetic foot (foot ulcer), kidney disease (nephropathy), high blood pressure, and even stroke.
Repaglinide acts by increasing the amount of insulin released by the pancreas. It starts acting so quickly on controlling blood sugar levels immediately after a meal. On the other hand, Metformin, which is a 'biguanide', acts by lowering the liver's glucose production, delaying glucose absorption from the intestines, and increasing the body's response to insulin. In a nutshell, the two medicines prevent blood glucose levels from rising to very high levels, thus keeping your Diabetes under control. Repaglinide+metformin act together to keep your blood sugar levels under check. The strict control of blood sugars is essential to mention the many disabling side effects of Diabetes. Repaglinide+metformin shows optimum effects when taken along with healthy lifestyle changes like weight loss, regular exercise, healthy diet, etc.
Repaglinide+metformin should be taken with food to avoid an upset stomach. Repaglinide+metformin should be taken at the same time of the day each time for the best results. Your doctor will decide what dose should be taken for better advice, which can change quickly depending on your condition. A common side effect of Repaglinide+metformin is hypoglycaemia (low blood glucose levels), characterized by dizziness, sweating, palpitations, hunger pangs, dry mouth, skin, etc. So, to avoid hypoglycaemia, you should not miss meals and also should carry some form of sugar along with you. Other side effects include taste change, nausea, diarrhoea, stomach pain, headache, and upper respiratory symptoms.
You should not take Repaglinide+metformin if you have renal impairment, metabolic acidosis, including diabetic ketoacidosis (excess acids in your blood), and receiving gemfibrozil (used to treat abnormal blood lipid levels). Repaglinide+metformin should not be stopped even if you feel better, without consulting your doctor as your sugar level keeps changing. If you stop taking Repaglinide+metformin abruptly, it may increase your sugar levels which could further increase the risk of eyesight loss (retinopathy), kidney (nephropathy), and nerve damage (neuropathy). Repaglinide+metformin should not be taken if you have type 1 diabetes mellitus or severe kidney or liver disease. Please inform your doctor if you have any heart disease, are planning to get pregnant, or are breastfeeding.
Uses of Repaglinide+metformin
Medicinal Benefits
Repaglinide+metformin should be taken with food to avoid an upset stomach. Repaglinide+metformin should be taken at the same time of the day each time for the best results. Your doctor will decide what dose should be taken for better advice, which can change quickly depending on your condition. A common side effect of Repaglinide+metformin is hypoglycaemia (low blood glucose levels), characterised by dizziness, sweating, palpitations, hunger pangs, dry mouth, skin, etc. To avoid hypoglycaemia, you should not miss meals and should carry some form of sugar along with you. Other side effects include taste change, nausea, diarrhoea, stomach pain, headache, and upper respiratory symptoms.
Directions for Use
Storage
Side Effects of Repaglinide+metformin
- Dizziness
- Sweating
- Palpitations
- hunger pangs
- Dry mouth and skin
- Hypoglycaemia (low blood glucose level)
In-Depth Precautions and Warning
Drug Warnings
Some diabetic patients taking Repaglinide+metformin may develop a rare but serious condition called lactic acidosis. In this condition, too much lactic acid is accumulated in the blood. So, your liver and kidney's proper functioning is required to eliminate excess lactic acid from the blood. You should not take Repaglinide+metformin if you have kidney disease, as measured by a blood test. Repaglinide+metformin may lower vitamin B12 levels, so try to have blood tests for annual blood and vitamin. Repaglinide+metformin, when used with or without insulin, tends to lower the blood sugar level extremely. So, the doctor may lower the dose of insulin. Repaglinide+metformin may lower your thyroid-stimulating hormone (TSH), so an annual check-up of TSH is suggested.
Drug Interactions
Drug-Drug Interactions: Repaglinide+metformin may interact with insulin, high blood pressure-lowering pills (hydrochlorothiazide, amlodipine), water pills/diuretics (furosemide), heart failure-related medicines (digoxin), anti-hypertensive (metoprolol), steroids (prednisolone), thyroid hormones etc. So, tell your doctor if you are using these drugs before taking Repaglinide+metformin.
Drug-Food Interactions: Taking Repaglinide+metformin with alcoholic beverages may increase the risk of a rare but serious and potentially life-threatening condition known as lactic acidosis (build-up of lactic acid in the blood) or hypoglycemia.
Drug-Disease Interactions: Repaglinide+metformin should be avoided in patients with vitamin B12 deficiency, kidney problems, liver problems, cardiovascular disease (heart-related issues), and low blood sugar level (hypoglycemia) may worsen the condition.
Drug-Drug Interactions Checker List:
Safety Advice
Alcohol
unsafeYou are recommended not to consume alcohol along with Repaglinide+metformin to avoid unpleasant side effects.
Pregnancy
unsafeAs the data around the use of Repaglinide+metformin in pregnant women is limited, the use of Repaglinide+metformin in pregnancy is restricted. It is highly recommended to consult your doctor before taking this drug in case you are pregnant.
Breast Feeding
cautionCaution should be exercised, and it is advisable to consult a doctor before using it.
Driving
cautionRepaglinide+metformin may cause hypoglycemia (low blood sugar levels), whose symptoms include unusual sleepiness, shivering, palpitations, sweating, etc. This may affect your ability to drive. Use caution while driving or doing anything that requires concentration.
Liver
cautionRepaglinide+metformin to be taken with caution, especially if you have a history of liver diseases/conditions. The dose may have to be adjusted by your doctor.
Kidney
cautionRepaglinide+metformin to be taken with caution, especially if you have a history of Kidney diseases/conditions. The dose may have to be adjusted by your doctor.
Children
unsafeThe safety and efficacy of Repaglinide+metformin in children have not been established. Repaglinide+metformin is not recommended in children.
Habit Forming
Diet & Lifestyle Advise
- Fill your half plate with starchy veggies, a quarter with proteins, and a quarter with whole grains.
- Eat at regular intervals. Do not take the long gap between a meal or snack.
- Monitor your blood sugar level regularly, especially when there are a lot of fluctuations.
- Invest in at least 150 minutes of moderate-intensity physical activity and 15 minutes of high-intensity exercise weekly.
- Lose weight gradually to achieve a healthy body mass index (18.5 to 24.9).
- Replace refined carbohydrates containing whole-grain foods and increase the intake of fruits, veggies, and other fibre-enriched foods.
- Reduce saturated fat (or hidden fats) intake in food like chips, crisps, pastries, biscuits, and samosas. Choose omega-3 fatty acid-containing oils for daily cooking. For frying, you may use palm oil, mustard oil, groundnut oil, rice bran oil, and safflower oil.
- Do not take stress as it may elevate your blood sugar level. You may adopt stress management techniques like mindfulness, yoga, or meditation to control stress-related blood sugar changes.
- Opt for low-fat dairy products (low-fat yoghurt, fat-free milk, cheese, etc.).
- Keep your blood pressure as normal (120/80) as possible, as it reduces the risk of cardiovascular diseases in diabetes patients.
Special Advise
- Keep taking the drug even if you think your blood sugar levels are under control. If you miss a dose, do not take a larger dose, cons. Consulttreating physician for advice.
- Take short, frequent meals, avoid prolonged fasting when taking this drug. Beware of hypoglycaemia symptoms include sweating, dizziness, palpitations, shivering, intense thirst, dry mouth, dry skin, frequent urination, etc. Whenever you experience the above-mentioned symptoms, immediately consume 5-6 candies, three glucose biscuits, or three teaspoons of honey/sugar and get in touch with your physician. Make sure to carry these with you at all times, especially for long travels.
- Before the doctor prescribes this medicine, it is always better that your physician knows about any underlying conditions like kidney or liver disease, prior heart attack, alcohol intake, etc.
- Avoid drinking alcohol while on this drug as it increases the risk of hypoglycaemia (a decrease in blood sugar which might be fatal in some cases) and lactic acidosis (when the lactic acid increases in the body, impacting the functioning of various organs in the body).
- Try to quit smoking and reduce carbohydrate-rich food like potatoes, mangoes, bread, sugar etc.
- Remember, lifestyle modifications are the most important step in controlling blood sugar levels.
Patients Concern
Disease/Condition Glossary
Type 2 diabetes is a condition where the body cannot make sufficient insulin, or the insulin that it makes doesn't work properly or is utilized by our body. This can cause high blood sugar levels (hyperglycaemia). Type 2 diabetes symptoms include increased thirst, frequent urination at night, slow wound healing, increased hunger, fatigue, and blurred vision. There may be weight gain in some cases, while in rare cases, weight loss may be observed. The complication of type 2 diabetes also includes neuropathy (nerve problems), nephropathy (kidney problems), and retinopathy (damaged retina of eyes or blindness), loss of limbs, sexual dysfunction, and an increase in the chance of heart attack or stroke.
FAQs
Diabetes is a lifelong chronic medical condition, so its treatment should also continue for the whole life, so keep taking Repaglinide+metformin unless your doctor advises you to stop the medicine.
If you are going for any surgery or dental treatment, you are advised to tell the person carrying your diabetes and the list of medicines, including the Repaglinide+metformin you are taking. This is because they will suggest you skip your doses for some time.
Your doctor may suggest you go for a regular test for sugar (glucose) in your blood or urine to monitor if diabetes has been controlled or not.
If a person is getting unusually thrust or passing urine frequently more than normal while taking Repaglinide+metformin, they should tell it to their doctor as it may be a sign that there is too much sugar in their blood, and treatment needs to be adjusted. It may also be because of dehydration as Repaglinide+metformin can lead to loss of fluids. Increase intake of fluids; if even then you feel thirsty, please consult your doctor.
Repaglinide+metformin is not allowed to be used in medical conditions, including renal impairment, type 1 diabetes, metabolic acidosis, diabetic ketoacidosis (excess acids in your blood), and receiving gemfibrozil (used to treat abnormal blood lipid levels).
Type-2 diabetes generally does not affect healthy children and teens, but it may affect children who are obese, which is also known as Childhood Obesity.
Hypoglycemia refers to low blood sugar levels, and it is one of the side effects of Repaglinide+metformin. Hypoglycemia can occur if you miss or delay your food, drink alcohol, over-exercise, or take other antidiabetic medicine along with this medicine. It is important to monitor blood sugar levels regularly.
A Repaglinide+metformin should not be used with other anti-diabetic medications as it may cause hypoglycemia (lower blood sugar level).
Yes, long-term usage of Repaglinide+metformin can cause vitamin B12 deficiency as it interferes with the absorption of vitamin B12 in the stomach. The symptoms of vitamin B12 deficiency include fatigue, nerve problems, tingling sensation and numbness in hands and feet, weakness, urinary problems, affected mental status, and difficulty in maintaining balance. These symptoms can be managed by taking Vitamin B12 supplements as advised by your doctor.
If you have symptoms like increased hunger, increased thirst, frequent urination (usually at night), unexplained weight loss, fatigue, blurred vision, slow wound/sores healing, and frequent infections, contact your doctor, as it can be a condition of type 2 diabetes.
If you feel that your blood sugar level is decreasing and you are feeling weak, immediately eat sugar candies or drink sugary beverages. It will help to balance the blood sugar level in your body. So, it is advisable to keep sugar candies with you.
