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Precautions and Warnings With Repaglinide and Metformin

Specific Precautions and Warnings With Repaglinide and Metformin

Some warnings and precautions to be aware of prior to taking repaglinide and metformin include the following:
  • Very rarely, metformin (one of the components of repaglinide and metformin) may cause a life-threatening condition called lactic acidosis. Your risk of lactic acidosis increases if you have certain other medical conditions, such as congestive heart failure (CHF), kidney failure, and liver problems (see Metformin and Lactic Acidosis for more information, including possible symptoms of lactic acidosis).
  • Your kidney function needs to be monitored while you are taking repaglinide and metformin. This means that you should have blood tests to check your kidneys before you start the medication and then periodically thereafter. If your kidney function is very poor, you should not take repaglinide and metformin, due to an increased risk of lactic acidosis.
  • Taking metformin (one of the components of repaglinide and metformin) and contrast dye at the same time can increase your risk of kidney damage. Contrast dye is used for certain radiology procedures, including some x-rays, CT scans, and heart catheterizations (see Metformin and Contrast Medium for more information). Also, metformin should be temporarily stopped for most major surgeries and should be restarted when you are eating normally again.
  • Because liver disease can increase your risk of lactic acidosis, you should not take repaglinide and metformin if your liver is not functioning normally.
  • A heart attack or a worsening of congestive heart failure (CHF) can increase the risk of lactic acidosis. You must stop taking repaglinide and metformin if you have cardiovascular collapse (a failure of the circulatory system) due to CHF, a heart attack, or any other cause.
  • Repaglinide and metformin can cause low blood sugar levels (hypoglycemia), which can be very dangerous. To reduce the risk of low blood sugar, repaglinide and metformin should be taken only before meals. If you skip a meal, you should also skip your dose of repaglinide and metformin.
  • Repaglinide and metformin is not licensed for use with NPH insulin (Humulin® N or Novolin N®). In studies, there were reports of heart problems (including heart attacks) in people who took both repaglinide (one of the components of repaglinide and metformin) and NPH insulin.
  • Repaglinide and metformin can decrease your levels of vitamin B12. Your healthcare provider should monitor your vitamin B12 levels, especially if you have a vitamin B12 deficiency (including pernicious anemia).
  • Repaglinide and metformin can potentially interact with many other medications (see Drug Interactions With Repaglinide and Metformin).
  • Repaglinide and metformin is considered a pregnancy Category C medication. This means that it may not be safe for use during pregnancy, although the full risks are not currently known (see PrandiMet and Pregnancy).
  • At least one of the components of repaglinide and metformin does pass through breast milk in humans. Therefore, if you are breastfeeding or plan to start breastfeeding, discuss this with your healthcare provider prior to taking the drug (see PrandiMet and Breastfeeding).
Healthy Eating for People With Diabetes

Repaglinide-Metformin Information

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