Prandin 1 mg Tablets

Brand Name

This pharmaceutical product is known commercially as Prandin, a name often utilized in prescriptions for addressing specific metabolic health needs.

International Nonproprietary Name (INN)

The active component is globally identified as repaglinide, a standardized designation recognizing its therapeutic essence across different markets.

Form of Release

The medication comes in tablet form, crafted for oral intake, providing a straightforward way for patients to manage their daily health routines.

Composition

The core substance driving its effects is repaglinide, supported by additional ingredients like microcrystalline cellulose, calcium hydrogen phosphate dihydrate, maize starch, polacrilin potassium, povidone, glycerol, magnesium stearate, and occasionally meglumine or iron oxide for coloring. These auxiliary elements stabilize the tablet, aid its breakdown in the digestive system, and ensure efficient release of the active agent for absorption.

Pharmacologic Properties

Pharmacodynamics

This drug stimulates insulin release from pancreatic beta cells, a vital step in managing blood sugar after eating. As a meglitinide, it binds to ATP-sensitive potassium channels on these cells, closing them to depolarize the membrane. This triggers calcium entry, prompting insulin secretion. The result is better glucose uptake by tissues and reduced sugar spikes after meals, ideal for those with working beta cells needing quick insulin boosts.

Its effects are short and tied to meals, setting it apart from longer-acting options. The fast onset aligns insulin with food intake, keeping excess glucose in check. Its action focuses on the pancreas, with minimal impact on tissue insulin sensitivity, targeting immediate sugar control.

Pharmacokinetics

After swallowing, the medication absorbs rapidly from the gut, hitting peak blood levels in about one hour. Eating with it may slow absorption slightly, but overall availability stays steady. Once in the bloodstream, repaglinide binds moderately to plasma proteins, mainly albumin, shaping its spread through the body.

The liver handles its breakdown, using cytochrome P450 enzymes like CYP2C8 and CYP3A4 to form mostly inactive metabolites. Its half-life is brief, around 1 hour, matching its short action window. Over 90% clears through bile into feces, with little exiting via urine, ensuring efficient removal.

Indications for Use

Conditions and Disorders

The drug is prescribed for adults with type 2 diabetes mellitus to control blood sugar, especially after meals. It’s used when diet and exercise alone don’t manage glucose well, targeting patients whose pancreas can still make insulin but needs help with meal-related loads. By boosting insulin, it curbs high sugar, aiding metabolic balance. Doctors may use it alone or with other therapies to tailor treatment.

Contraindications

Prohibited Conditions

Certain states make this treatment unsuitable to avoid risks. It’s not for those allergic to repaglinide or tablet ingredients, as reactions could happen. Type 1 diabetes or diabetic ketoacidosis patients should avoid it, as it relies on working beta cells, missing in these cases. Severe liver issues also rule it out, given its liver-based breakdown. Acute conditions like infections or surgery may make it inappropriate unless sugar is otherwise stable.

Method of Administration and Dosage

Administration Guidelines

The tablets are taken by mouth, ideally 15 to 30 minutes before main meals to match insulin release with eating. Swallowing them whole with water ensures they reach the stomach properly. Timing matters, and skipping a meal means skipping the dose to prevent excess insulin.

Dosage for Adults and Children

For adults, the starting dose is typically low, adjusted based on sugar response and meal habits, guided by a doctor. Changes may be made to fine-tune control. It’s not approved for kids under 18, as research hasn’t confirmed its safety or effectiveness in this group.

Dose Adjustment in Specific Conditions

Mild to moderate kidney issues often allow its use without changes, as clearance isn’t heavily renal-based. Severe kidney problems need caution due to possible metabolic shifts. Mild liver issues may permit use with checks, but severe liver trouble calls for avoidance, as the liver processes it. Regular reviews ensure dosing fits organ health.

Side Effects

Potential Adverse Reactions

Some users may notice unwanted effects during treatment. Low sugar is common, showing as trembling, sweating, or confusion, especially if meals are late or missed. Stomach issues like pain, nausea, or diarrhea can occur but are usually mild. Headaches or dizziness are less frequent. Rare cases might see liver enzyme rises or skin reactions like rash, needing a doctor’s look if they persist.

Overdose

Symptoms of Excess Intake

Taking too much can cause clear signs, mainly severe low sugar. This might look like a fast pulse, irritability, heavy sweating, or fainting if levels drop sharply. In extreme cases, seizures or long confusion could follow without quick help. Severity ties to the amount and the person’s state.

First Aid Measures

If an overdose happens, getting medical help fast is key. For alert patients, a quick sugar source like juice or glucose tablets can lift sugar while waiting. Serious cases may need IV glucose or glucagon from pros. Close watch and support are vital to stabilize and avoid worse outcomes.

Drug Interactions

Effects on Other Medications

This treatment can affect other drugs through metabolism or action. It might boost insulin or other sugar-lowering agents, raising low sugar risks when mixed. Drugs slowing CYP2C8 or CYP3A4, like gemfibrozil or clarithromycin, could increase its levels, while rifampicin might lower them by speeding breakdown. Sharing all medications with a doctor helps manage these safely.

Compatibility with Alcohol and Food

Light alcohol is usually fine, but heavy use can increase low sugar odds or slow recovery. Food is key to its action, as it’s taken before meals to sync insulin with glucose. Missing meals throws this off, so a steady eating pattern helps it work.

Special Precautions

Use During Pregnancy and Breastfeeding

Data on its safety in pregnancy is limited, and it’s often avoided due to possible fetal risks like low sugar or growth issues. Insulin is typically favored instead. In breastfeeding, repaglinide might enter milk, risking infant low sugar, so other options are usually chosen unless needed.

Impact on Driving and Machinery Operation

It doesn’t usually affect focus or movement, so driving or machinery use is okay in most cases. If low sugar brings dizziness or confusion, these should wait until levels recover.

Considerations for Elderly and Pediatric Patients

Older adults can use it but may face higher low sugar risks from age-related changes, needing close checks. In kids, it lacks enough data, so other treatments are preferred for those under 18.