Prandin (repaglinide) - previously called NovoNorm

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How does it work?

Prandin tablets contain the active ingredient repaglinide, which is a medicine used to help control blood sugar levels in people with type 2 or non-insulin dependent diabetes (NIDDM).

People with diabetes have a deficiency or absence of a hormone produced by the pancreas called insulin. Insulin is the main hormone responsible for the control of sugar in the blood. In type 2 diabetes the pancreas does not produce sufficient insulin and the cells of the body are resistant to the low levels of insulin circulating in the blood. Insulin would normally make the cells remove sugar from the blood, hence in type 2 diabetes blood sugar levels can rise too high.

Repaglinide is an antidiabetic medicine that is used to help lower blood sugar in people with type 2 diabetes. It works by acting on the cells in the pancreas that produce insulin. These cells are called beta cells. Repaglinide causes the beta cells to produce more insulin.

Repaglinide is taken before meals to enhance insulin production during the meal. The enhanced insulin production starts about 30 minutes after taking the dose of repaglinide. The result is a blood sugar lowering effect throughout the meal, as would occur naturally in non-diabetic people.

Repaglinide is used to treat people with type 2 diabetes whose blood sugar has not been controlled sufficiently by diet, exercise and weight loss alone.

Repaglinide can also be used in combination with another antidiabetic medicine called metformin, for people with type 2 diabetes whose blood sugar is not controlled using metformin alone. Since metformin mainly helps reduce blood sugar levels between meals (fasting blood sugar levels) and repaglinide reduces mealtime blood sugar levels, the combination of the two provides an additive effect on blood sugar control.

What is it used for?

- Type 2 (non-insulin dependent) diabetes.

Warning!

- February 2007: Prandin tablets were previously called NovoNorm tablets and were manufactured by NovoNordisk. However, a company called Daiichi Sankyo has now taken over the manufacture and marketing of NovoNorm and rebranded the medicine as Prandin. This means that when you next have your repaglinide prescription dispensed at a pharmacy, you will be given Prandin instead of NovoNorm. Prandin tablets are exactly the same as NovoNorm tablets, ie they still contain the active ingredient repaglinide and are still available in the same strength tablets and pack sizes. Your dose will not change. The only difference between NovoNorm and Prandin is the new brand name and new packaging. If you are concerned, ask your pharmacist for more information.
- Your doctor may want you to check your blood sugar level from time to time while you are taking this medicine.

Make sure you discuss how to do this and how often with your GP, pharmacist or diabetes specialist.
- Low blood sugar may rarely occur as a side effect of this medicine. This is more likely to occur if you take this medicine in combination with metformin or other antidiabetic medicines. It is important that you are aware of the symptoms of hypoglycaemia (these may include cold sweats, cool pale skin, tremor, anxious feeling, unusual tiredness or weakness, confusion, difficulty in concentration, excessive hunger, temporary vision changes, headache or nausea) and what to do if you experience these symptoms. Discuss this with your GP, pharmacist or diabetes specialist. You should also be aware that the risk of hypoglycaemia is increased by strenuous physical exercise and drinking alcohol.
- People who are taking antidiabetic tablets should only drink alcohol in moderation and accompanied by food. This is because alcohol can make your warning signs of low blood sugar less clear, and can cause delayed low blood sugar, even several hours after drinking.
- Your ability to concentrate or react may be reduced if you have low blood sugar, and this can cause problems driving or operating machinary. You should take precautions to avoid low blood sugar when driving - discuss this with your doctor.
- If you get an infection or fever, have an accident, or are under particular stress you should let your doctor know, because when the body is put under stress this medicine may become less effective at controlling your blood sugar. In these cases your doctor may need to temporarily replace your treatment with insulin. You should also consult your doctor about your diabetes treatment if you are due to have surgery under a general anaesthetic, or if you get pregnant. In these situations blood sugar is normally controlled with insulin.

Use with caution in

.

- Weak or debilitated people.
- Malnutrition.
- Decreased kidney function.

Not to be used in

- Children under 12 years of age.
- Severely decreased liver function.
- Type 1 (insulin dependent) diabetes.
- Diabetic keto-acidosis.
- Pregnancy.
- Breastfeeding.
- The manufacturer has not studied this medicine in children aged under 18 years, elderly people aged over 75 years, or people with impaired liver function. For this reason the medicine is not recommended in these groups of people.

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby.

Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

- The safety of this medicine during pregnancy has not been established, therefore it should not be used by pregnant women. Control of diabetes in pregnancy is usually acheived using insulin, because this provides a more stable control of blood sugar. Seek medical advice from your doctor.
- This medicine may pass into breast milk. It should not be used by breastfeeding mothers. Seek medical advice from your doctor.

Side effects

. Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

- Abdominal pain.
- Nausea.
- Low blood glucose level (hypoglycaemia).
- Allergic skin reactions such as rash and itch.
- Constipation.
- Diarrhoea.
- Vomiting.
- Visual disturbances.
- Alteration in results of liver function tests.

The side effects listed above may not include all of the side effects reported by the drug's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

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