Meglitinides - Uses and Benefits

Type of Drug:

Oral nonsulfonylurea blood-glucose-lowering drugs for management of type 2 diabetes mellitus (previously known as non-insulin-dependent diabetes mellitus [NIDDM]).

How the Meglitinides Works:

Meglitinides lower blood glucose levels by stimulating the release of insulin from functioning beta cells of the pancreas.

Uses of Meglitinides:

To treat high blood glucose, in addition to diet and exercise, in patients with type 2 diabetes mellitus whose blood sugar cannot be controlled by diet and exercise alone.

To treat high blood glucose in combination with mentoring (Glucophage) when blood sugar cannot be controlled by exercise, diet, and either a meglitinide or metformin alone.

Diet and exercise: Diet and exercise are the primary managements of type 2 diabetes. Meglitinides are used with, not as a substitute for, diet and exercise .

Heart problems: Meglitinides may increase the risk of heart problems, compared with treatment with diet alone or diet plus insulin.

Pregnancy: There are no adequate and well-controlled studies in pregnant women. Use only if clearly needed and the potential benefits to the mother outweigh the possible hazards to the fetus.

Breastfeeding: It is not known if meglitinides appear in breast milk. Consult your doctor before you begin breastfeeding.

Children: Safety and effectiveness in children have not been established.

Lab Tests: Lab tests will be required during treatment. Tests may include blood glucose and glycosylated hemoglobin HbA levels.

Drug Interactions:

Tell your doctor or pharmacist if you are taking or planning to take any over the-counter or prescription medications or dietary supplements while taking a meglitinide. Doses of one or both drugs may need to be modified, or a different drug may need to be prescribed. The following drugs and drug classes interact with meglitinides:

Side Effects of The Meglitinides:

Every drug is capable of producing side effects. Many meglitinide users experience no, or minor, side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy, and individual susceptibility. Possible side effects include:

Digestive Tract: Nausea; diarrhea; constipation; vomiting; indigestion.

Respiratory System: Chest or head congestion; bronchitis; sinus supper respiratory tract infection; cough.

Other: Abnormal skin sensations; changes in blood sugar; joint, chest, to back pain; headache; urinary tract infection; flu-like symptoms; dizziness; accidental trauma; heart problems (eg, high blood pressure, abnormal heart rhythm, pounding in the chest).

Guidelines for Use:

• Dosage is individualized. Take exactly as prescribed.

• Do not change the dose or stop taking this medicine unless advised to do so by your doctor.

• Take nateglinide 1 to 30 minutes before a meal. Take repaglinide 15 to 30 minutes before a meal.

• Meglitinides stimulate pancreatic insulin secretion within 20 to 30 minutes of oral administration. Peak insulin levels are attained about 1 hour after dosing and return to baseline within about 4 hours after dosing.

• When a meglitinide is used to replace therapy with another oral hypoglycemic agent, it may be started the day after the final dose is given. Closely monitor for hypoglycemia because of a potential overlapping drug effect (particularly with long-acting sulfonylureas [eg, chlorpropamide]).

• Treatment may need to be adjusted. Your doctor will monitor your treatment for the first few weeks of therapy.

• Patients who skip a meal (or add an extra meal) should skip (or add) a dose for that meal. Contact your doctor or pharmacist if you miss a dose.

• Repaglinide may be taken in combination with metformin. One or both dosages may need to be adjusted.

• Follow the diet and exercise program exactly as prescribed by your doctor.

• Diabetic patients may experience loss of glucose control. Be prepared to monitor blood sugar more often.

• Monitor blood glucose levels daily. Notify your doctor if symptoms of hypoglycemia occur (eg, fatigue, excessive hunger, profuse sweating, numbness of extremities) or if blood glucose is below 60 mg/dL. Notify your doctor if symptoms of hyperglycemia occur (eg, bad breath, excessive thirst or urination) or if blood glucose is consistently above 200 mg/dL.

• Lab tests are required to monitor treatment. Be sure to keep appointments.

• Store below 77F. Protect from moisture. Keep in tightly closed container.