Uses

Used as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus who are not adequately controlled on metformin or repaglinide alone.

Do not use if

Metformin is contraindicated in patients with eGFR below 30 mL/min/1.73m², hepatic impairment, or acute illness at risk of lactic acidosis. Repaglinide is contraindicated in type 1 diabetes and diabetic ketoacidosis.

Side effects

Common side effects include hypoglycemia, diarrhea, nausea, vomiting, and abdominal discomfort. Lactic acidosis is a rare but serious risk with metformin. Repaglinide may cause weight gain.

Warnings

Withhold metformin before iodinated contrast procedures and restart only after renal function is confirmed adequate. Monitor renal function regularly. Risk of hypoglycemia is increased with repaglinide especially when meals are skipped.

How it works

Metformin reduces hepatic glucose production and improves peripheral insulin sensitivity without causing hypoglycemia. Repaglinide is a meglitinide that stimulates insulin secretion by closing ATP-sensitive potassium channels in pancreatic beta cells in a glucose-dependent manner.

Storage

Store at room temperature (15–30°C), away from moisture and heat. Keep in original container.