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In this Article

• What is metformin and repaglinide (Prandimet)?
• What are the possible side effects of metformin and repaglinide (Prandimet)?
• What is the most important information I should know about metformin and repaglinide (Prandimet)?
• What should I discuss with my doctor before taking metformin and repaglinide (Prandimet)?
• How should I take metformin and repaglinide (Prandimet)?
• What happens if I miss a dose (Prandimet)?
• What happens if I overdose (Prandimet)?
• What should I avoid while taking metformin and repaglinide (Prandimet)?
• What other drugs will affect metformin and repaglinide (Prandimet)?
• Where can I get more information?

What should I discuss with my doctor before taking metformin and repaglinide (Prandimet)?

This medication may cause lactic acidosis (the build up of lactic acid in the body). Lactic acidosis can start slowly and gradually get worse. Symptoms include muscle pain or weakness, numb or cold feeling in your arms and legs, trouble breathing, stomach pain, nausea with vomiting, slow or uneven heart rate, dizziness, or feeling very weak or tired. Get emergency medical help if you have any of these symptoms of lactic acidosis, even if they are only mild. Early signs of lactic acidosis generally get worse over time and this condition can be fatal.

You may be more likely to develop lactic acidosis if you have liver disease, kidney disease, or congestive heart failure, or if you drink large amounts of alcohol. Talk with your doctor about your individual risk.

You should not use this medication if you are allergic to metformin or repaglinide, or if you have:

• type 1 diabetes;
• kidney disease;
• if you also take gemfibrozil (Lopid) and itraconazole (Sporanox); or
• if you are in a state of diabetic ketoacidosis (call your doctor for treatment with insulin).

Before taking metformin and repaglinide, tell your doctor if you are allergic to any medications, or if you have liver disease. You may need a dose adjustment or special tests to safely take this medication.

FDA pregnancy category C. It is not known whether this medication is harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

It is not known whether metformin and repaglinide passes into breast milk or if it could be harmful to a nursing baby. Do not take metformin and repaglinide without telling your doctor if you are breast-feeding a baby.

How should I take metformin and repaglinide (Prandimet)?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription label.

Your dose needs may change if you are ill, if you have a fever or infection, or if you have surgery or a medical emergency. Do not change your dose of metformin and repaglinide without first talking to your doctor.

Metformin and repaglinide is usually taken 2 or 3 times daily, within 15 minutes before eating a meal. Follow your doctor's instructions. If you skip a meal, do not take your dose of metformin and repaglinide. Wait until your next meal.

Take care not to let your blood sugar get too low, causing hypoglycemia. You may have hypoglycemia if you skip a meal, exercise too long, drink alcohol, or are under stress.

Know the signs of low blood sugar (hypoglycemia) and how to recognize them. Always keep a source of sugar available in case you have symptoms of low blood sugar. Sugar sources include orange juice, glucose gel, candy, or milk. Severe hypoglycemia may cause loss of consciousness, seizures, or death. If you have severe hypoglycemia and cannot eat or drink, use an injection of glucagon. Your doctor can give you a prescription for a glucagon emergency injection kit and tell you how to give the injection.

Your doctor may have you take extra vitamin B12 while you are taking metformin and repaglinide. Take only the amount of vitamin B12 that your doctor has prescribed.

To be sure this medication is helping your condition, you will need to check your blood sugar at home. Your blood will also need to be tested by your doctor on a regular basis. It is important that you not miss any scheduled visits to your doctor.

If you need to have any type of x-ray or CT scan using a dye that is injected into a vein, you may need to temporarily stop taking metformin and repaglinide. Be sure the doctor knows ahead of time that you are using this medication.

Metformin and repaglinide is only part of a complete program of treatment that may also include diet, exercise, and weight control. Follow your diet, medication, and exercise routines very closely. Changing any of these factors can affect your blood sugar levels.

It is important to take metformin and repaglinide regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

Store metformin and repaglinide at room temperature away from moisture and heat.