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What is Prandin?
Prandin is a short-acting hypoglycemic drug. It quickly reduces the concentration of glucose in the blood by stimulating the secretion of insulin by pancreatic cells. These pills are prescribed for type 2 diabetes mellitus with physical exercise inefficiency, diet therapy. In patients with type 2 diabetes mellitus, it can be used in combination with thiazolidinediones, metformin in cases when it was not possible to achieve glycemic control using monotherapy.
How should I use Prandin?
Prandin is used as a supplement to the diet, physical exertion in order to reduce the amount of glucose in the blood. The use of the medication should be timed to food intake. Tablets are taken internally before the main meals – 2, 3 or 4 times a day. It is recommended to take a pill 15 minutes before the main meal.
Patients who may skip meals or have additional meals should be instructed accordingly about skipping or taking additional medication.
The dose is adjusted depending on glycemia (blood glucose level) and glycosylated hemoglobin.
The recommended starting dose for individuals who have never received oral hypoglycemic drugs before is 0.5 mg before the main meal. Dosage adjustment is carried out once a week or once every 2 weeks. If a patient switches to Prandin from another hypoglycemic oral agent, then the initial dose should be 1 mg before each main meal.
The maximum single dose is 4 mg, the total daily dose is 16 mg.
What are the contraindications of this medicine?
Do not use Prandin in the presence of any of the following conditions:
- allergy to components;
- type 1 diabetes mellitus;
- infectious diseases;
- large surgical interventions, other conditions that require insulin therapy;
- severe disorders of the liver;
- diabetic ketoacidosis;
- diabetic precoma/coma;
- use of gemfibrozil.
Clinical trials of patients over 75 and under 18 years of age have not been conducted.
The drug is used with caution in mild/moderate liver malfunction, malnutrition, chronic kidney failure, alcoholism, febrile syndrome, and a general serious condition.
What are the side effects of Prandin?
The medicine can cause the following side effects:
- Immune disorders: allergic reactions (generalized hypersensitivity, immunological reactions), redness, rash, pruritus, urticaria;
- Exchange disorders: hypoglycemia with loss of consciousness, hypoglycemic coma, hypoglycemia (anxiety, increased sweating, dizziness, tremor, difficulty concentrating, hunger);
- Impaired perception: visual disturbances;
- Digestive disorders: abdominal pain, diarrhea, vomiting, constipation, abdominal pain, abnormal liver function.
What may interact with this medicine?
Do not take Prandin if you are currently using any of the following medications and substances:
- MAO inhibitors;
- non-selective beta-blockers;
- ACE inhibitors;
- anabolic steroids;
- oral hormonal contraceptives;
- thiazide diuretics;
- thyroid hormones;
- drugs that are mainly excreted in the bile;
- CYP3A4 inhibitors (ketoconazole, itraconazole, erythromycin, fluconazole, mibefradil);
- CYP3A4 inductors (including rifampicin, phenytoin)
What should I watch for while using this medicine?
Use during pregnancy and lactation is not recommended as no studies have been conducted.
Signs of overdose: an excessive decrease in the concentration of glucose in the blood, increased sweating, dizziness, headache, tremor. If these symptoms appear, appropriate measures should be taken to increase the level of glycemia (ingest carbohydrate-rich foods, dextrose). In severe hypoglycemia (impaired consciousness, coma), intravenous dextrose is administered.
In diseases of the liver or kidneys, extensive surgery, recent illness or infection, the effectiveness of treatment is possible.
Patients with kidney disease should use this medicine with caution.
In debilitated patients or in patients with malnutrition, the drug should be taken in minimal initial and maintenance doses. To prevent hypoglycemic reactions in this category of patients, the dose should be selected with caution.
The resulting hypoglycemic states are usually reactions of moderate severity and are easily stopped by carbohydrate intake. In severe conditions, it may be necessary to introduce glucose. The likelihood of such reactions depends on the dose, dietary habits, intensity of physical exertion, stress.
Keep in mind that beta-blockers may mask the symptoms of hypoglycemia.
During the period of treatment, patients should refrain from drinking alcohol, because ethanol can enhance and prolong the hypoglycemic effect of repaglinide.
Patients using Prandin should evaluate the feasibility of driving a car and operating complex mechanisms.