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Metformin / Repaglinide Dosage

Applies to the following strengths: 500 mg-2 mg; 500 mg-1 mg

Usual Adult Dose for Diabetes Type 2

Individualize based on current therapy, effectiveness, and tolerability

Initial dose:
Patients inadequately controlled on metformin monotherapy: repaglinide 1 mg/metformin 500 mg orally twice a day with meals
Patients inadequately controlled on meglitinide monotherapy: current meglitinide dose with metformin 500 mg orally twice a day with meals
Patients receiving individual components concomitantly: current or similar dose of individual components without exceeding current dose

Titrate gradually based on glycemic control and tolerability
Maximum single dose: repaglinide 4 mg/metformin 1000 mg
Maximum daily dose: repaglinide 10 mg/metformin 2500 mg

Comments:


Use: As an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus who are already being treated with a meglitinide and metformin or who have inadequate glycemic control on a meglitinide alone or metformin alone.

Renal Dose Adjustments

Contraindicated in patients with renal disease (e.g. males with serum creatinine levels of 1.5 mg/dL or greater, females with serum creatinine of 1.4 or greater, or abnormal creatinine clearance).

New Metformin Renal Dosing: Obtain eGFR prior to initiating therapy:



IODINATED CONTRAST PROCEDURE:

Liver Dose Adjustments

Hepatic impairment: Avoid use

Dose Adjustments

Debilitated or malnourished patients: Initial and maintenance doses should be conservative with careful dose titration.

Temporarily discontinue this drug in patients receiving iodinated contrast for radiological studies.

Dose adjustments may be necessary with concomitant use of CYP450 2C8 and CYP450 3A4 inhibitors and inducers.

Concomitant use with gemfibrozil is contraindicated.

This drug is not indicated for use in combination with NPH-insulin.

Precautions

US BOXED WARNING: Lactic Acidosis


Safety and efficacy have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:


General:

Monitoring:

Patient advice:

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.