Repaglinide is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. 

Diabetes

There is no set dosage regimen for treating diabetes with Repaglinide or any other hypoglycemic agent. In addition to the usual monitoring of urinary glucose, the patient's blood glucose must be monitored on a regular basis to determine the patient's minimum effective dose.

Starting Dose: For patients not previously treated or whose HbA1c is < 8%, the starting dose should be 0.5 mg with each meal.  For patients previously treated with blood glucose-lowering drugs and whose HbA1c is > 8%, the initial dose is 1 or 2 mg with each meal preprandially (before each meal).

Dose Adjustment: The dose range is 0.5 mg to 4 mg, taken with meals. In response to changes in the patient's meal pattern, Repaglinide may be dosed preprandially 2, 3, or 4 times per day. The maximum daily recommended dose is 16 mg.

Side effects associated with the drug are uncommon. The following adverse reactions have been reported-

• Hypoglycemia
• Weight gain
• Upper respiratory infections
• Nausea
• Diarrhea
• Sinusitis

Hypoglycemia (Low Sugar)	Weight Gain	URTI (Upper Respiratory Tract Infection)
Nausea	Diarrhea	Constipation

• Repaglinide is not indicated for use in combination with NPH-insulin.
• There have been no clinical studies demonstrating conclusive evidence of Glimepiride or any other anti-diabetic drug lowering macrovascular risk.
• All meglitinide medications can cause severe hypoglycemia. To avoid hypoglycemic episodes, proper patient selection, dosage, and instructions are essential. Repaglinide levels in the blood may be elevated due to renal or hepatic insufficiency, and the latter may also reduce gluconeogenic capacity, both of which increase the risk of serious hypoglycemic reactions.
• When a patient stabilized on any diabetic regimen is exposed to stress such as fever, trauma, infection, or surgery, a loss of control may occur. At such times, it may be necessary to discontinue Repaglinide and administer insulin.