Repaglinide: What It Is and How to Use It

Repaglinide (often known by the brand name Prandin) is a short-acting diabetes pill used to lower blood sugar in adults with type 2 diabetes. It helps the pancreas release insulin right after you eat, so it’s meant to be taken around mealtime. If you want a medicine that works quickly and wears off between meals, repaglinide is one option to discuss with your doctor.

How repaglinide works

Repaglinide prompts the pancreatic beta cells to release insulin by affecting potassium channels in those cells. Because it acts fast — usually within 15–30 minutes — it’s taken just before a meal. Its effect peaks around an hour after dosing and generally lasts about 4–6 hours, which helps control the blood sugar rise after eating.

Unlike longer-acting drugs, repaglinide is focused on controlling post-meal blood glucose. That makes it useful for people whose fasting blood sugar is okay but who spike after meals.

Practical tips & safety

Typical tablets come in 0.5 mg, 1 mg and 2 mg strengths. Your prescriber will tell you the right dose, but common practice is to take repaglinide 0–30 minutes before each main meal. If you skip a meal, skip that dose. If you add an extra meal, ask your provider whether to take an extra dose.

Watch for low blood sugar (hypoglycemia). Signs include sweating, shakiness, hunger, fast heartbeat, confusion or fainting. Carry quick sugar (glucose gel or candies) and check your levels if you feel off. Severe hypoglycemia needs emergency care.

Drug interactions matter. Gemfibrozil can raise repaglinide levels a lot — avoid combining them. Other medicines that affect CYP3A4 or CYP2C8 enzymes (some antifungals, antibiotics, or seizure drugs) can change repaglinide’s effect. Don’t use it at the same time as sulfonylureas or insulin without clear medical direction; that increases hypoglycemia risk.

Use caution with liver problems — the drug is processed by the liver, and reduced function can raise drug levels. Kidney disease doesn’t usually require big dose changes, but your doctor will monitor you more closely. Pregnant or breastfeeding people should talk to their clinician; insulin is often preferred during pregnancy.

Common side effects are low blood sugar and weight gain. Less common issues include headache or stomach upset. If you notice yellowing skin, dark urine, severe stomach pain, or any sign of an allergic reaction, stop taking the drug and contact a clinician right away.

Store tablets at room temperature away from moisture. Keep an accurate record of blood sugars and bring them to appointments so your provider can adjust dosing safely. If you’re buying meds online, use verified pharmacies and keep your prescriber in the loop.

Questions about switching from another diabetes drug, timing your doses around exercise, or combining repaglinide with other treatments are best handled with your healthcare team — they’ll tailor advice to your blood sugars and overall health.