Generic Prandin

Introduction

Prandin (repaglinide) is a short‑acting oral hypoglycaemic agent used to improve blood‑glucose control in adults with type 2 diabetes mellitus (T2DM). In the United Kingdom it is prescribed when diet, exercise and first‑line agents such as metformin do not achieve target glycaemic levels. The active compound, repaglinide, belongs to the meglitinide class of drugs, which act on pancreatic β‑cells to stimulate rapid insulin release after meals. The medication is manufactured primarily by Boehringer Ingelheim, the current holder of the original Prandin brand, and is also available from several reputable generic suppliers.

What is Prandin?

Prandin is the brand‑name formulation of the oral meglitinide repaglinide. It was originally developed by Pharmacia & Upjohn and later marketed worldwide by Boehringer Ingelheim. Repaglinide is also sold under other recognized brand names, including Repaglinide Mylan and Repaglinide Teva, and it is widely available as a generic tablet. The drug is indicated for the reduction of post‑prandial hyperglycaemia in adults with T2DM.

How Prandin Works

Repaglinide binds to the sulfonylurea‑type 1 (SUR1) receptor subunit of the ATP‑sensitive potassium (K_ATP) channel on pancreatic β‑cells. This binding closes the K_ATP channel, leading to depolarisation of the cell membrane, influx of calcium ions, and rapid exocytosis of pre‑formed insulin granules. Because repaglinide has a short plasma half‑life of approximately 1 hour, its insulin‑stimulating effect peaks within 30–60 minutes and wanes after 2–3 hours. This kinetic profile aligns the drug’s action with the timing of meals, providing targeted reduction of post‑prandial glucose without prolonged insulin exposure.

Conditions Treated with Prandin

• Type 2 Diabetes Mellitus (T2DM): Primary indication for adult patients who need additional post‑prandial glucose control beyond metformin or lifestyle measures.
• Adjunctive Therapy: Used together with other glucose‑lowering agents (e.g., DPP‑4 inhibitors, SGLT‑2 inhibitors) when combination therapy is required.

In the UK, over 4 million adults live with T2DM, and post‑prandial hyperglycaemia contributes significantly to overall HbA1c elevation. Repaglinide’s rapid on‑set makes it useful for patients whose glucose spikes are most pronounced after meals.

Who is Prandin For?

• Adults with T2DM whose glycaemic targets are not met by metformin alone or who are intolerant to sulfonylureas.
• Patients requiring flexible dosing: Repaglinide can be taken up to three daily, timed to each main meal, which benefits those with irregular eating patterns.
• Individuals who prefer a short‑acting agent to minimise risk of prolonged hypoglycaemia, especially the elderly or those with renal impairment where longer‑acting sulfonylureas pose higher risk.

Contra‑indications / cautions:

• Known hypersensitivity to repaglinide or any tablet excipients.
• Type 1 diabetes mellitus or diabetic ketoacidosis.
• Severe hepatic impairment (Child‑Pugh C).
• Pregnancy or lactation – repaglinide is classified as pregnancy Category C; safer alternatives are recommended.

Risks, Side Effects, and Interactions

Common

• Hypoglycaemia (especially when meals are skipped or carbohydrate intake is reduced).
• Upper respiratory tract infection symptoms (nasal congestion, sore throat).
• Gastro‑intestinal discomfort (nausea, abdominal pain, diarrhoea).

Rare

• Elevated hepatic enzymes (ALT, AST) – routine liver function monitoring is advised in patients with existing liver disease.
• Skin reactions (rash, pruritus).
• Peripheral oedema – reported infrequently, usually mild.

Serious

• Severe hypoglycaemia that may cause loss of consciousness, seizures, or require emergency assistance.
• Anaphylactic reactions (rare) – characterised by difficulty breathing, swelling of the face or throat, and urticaria.
• Pancreatitis – acute abdominal pain with elevated lipase/amylase; immediate discontinuation is required.

Drug–Drug Interactions

• CYP2C8 inhibitors (e.g., gemfibrozil, clopidogrel) increase repaglinide plasma concentrations, raising hypoglycaemia risk.
• CYP3A4 inducers (e.g., rifampicin, carbamazepine) may reduce efficacy.
• Concurrent use with other insulin secretagogues (e.g., sulfonylureas) can cause additive hypoglycaemia.
• Beta‑blockers may mask adrenergic warning signs of hypoglycaemia.

Patients should disclose all prescribed, over‑the‑counter and herbal products to their healthcare professional before initiating Prandin.

Practical Use: Dosing, Missed Dose, Overdose

• Starting dose: .5 mg taken orally 15–30 minutes before each main meal.
• Dose titration: Based on fasting and post‑prandial glucose readings, the dose may be increased in .5 mg increments up to a maximum of 4 mg per meal (total maximum 12 mg per day).
• Renal impairment: For eGFR < 30 mL/min/1.73 m², the usual dose is .5 mg before each meal; higher doses are not recommended.- Hepatic impairment: Initiate with .5 mg before meals; avoid dose escalation beyond 2 mg per meal.

Missed dose: If a meal is delayed more than 30 minutes, skip the dose and resume the next scheduled dose with the following meal. Do not double‑dose to compensate for a missed tablet.

Overdose: Symptoms may include profound hypoglycaemia, dizziness, tremor, or loss of consciousness. Immediate treatment involves ingestion of fast‑acting carbohydrate (e.g., glucose tablets) followed by medical evaluation. In severe cases, intravenous dextrose is administered under clinical supervision.

Food and alcohol: Repaglinide must be taken with or shortly before food; taking it on an empty stomach diminishes its effect. Alcohol can potentiate hypoglycaemia and should be consumed cautiously.

Buying Prandin from Our Online Pharmacy

Prandin can be obtained conveniently from our online pharmacy in the UK.

• Affordability: Prices are set close to manufacturer cost, delivering substantial savings compared with retail chain pharmacies.
• Verified quality: All tablets are sourced from GMP‑certified suppliers that meet MHRA standards.
• Reliable delivery: Discreet, tracked parcels are dispatched within 24 hours; standard delivery arrives in 3‑5 working days, with an express 7‑day option available.
• International access: As a pharmacy‑broker service, we partner with licensed overseas wholesalers, enabling access to medications not routinely stocked in local pharmacies while maintaining strict safety oversight.

Our service respects patient privacy, provides secure packaging, and offers a straightforward ordering platform for qualifying adults seeking a cost‑effective generic alternative to brand‑name repaglinide.

FAQ

• Is Prandin suitable for people following a low‑carbohydrate diet?
  Yes, because repaglinide’s insulin‑secretory effect is meal‑triggered, it can be coordinated with low‑carbohydrate meals. However, dose adjustment may be required to prevent hypoglycaemia, and glucose monitoring is advisable.

• Can I travel internationally with Prandin tablets?
  Prandin may be carried in personal luggage for personal use, provided the quantity does not exceed a three‑month supply. Carry a copy of the prescription and the medication label to satisfy customs authorities if requested.

• What do the tablets look like, and are there any identifiable markings?
  Generic repaglinide tablets commonly appear round, white to off‑white, and are scored for easy splitting. They often bear the imprint “R‑2 mg” or “R‑4 mg,” but exact markings vary between manufacturers.

• Does Prandin require refrigeration?
  No, the tablets are stable at room temperature (15‑30 °C). They should be stored in a dry place away from direct sunlight and humidity.

• Are there any known differences between the UK and US formulations?
  Both regions use the same active ingredient, repaglinide, but excipients may differ (e.g., filler or binder types). These variations are generally clinically insignificant, though patients with specific excipient allergies should review the ingredient list.

• Can Prandin be used in patients with mild to moderate asthma?
  Repaglinide does not have a known impact on bronchial tone, so it can be used in asthmatic patients. Nevertheless, beta‑blockers used concomitantly for other conditions may mask hypoglycaemia symptoms, so caution is warranted.

• What is the current evidence for cardiovascular safety of repaglinide?
  Large observational studies and meta‑analyses have not demonstrated an increased risk of major adverse cardiovascular events compared with other oral agents. Nonetheless, long‑term data are less extensive than for metformin, and therapy should be individualized.

• How does repaglinide compare with sulfonylureas regarding weight gain?
  Repaglinide is associated with a modest weight gain (≈.5–1 kg) similar to sulfonylureas, but its short‑acting nature may result in slightly less adipogenic effect because insulin exposure is limited to post‑prandial periods.

• Is there a risk of drug testing positivity from Prandin?
  Repaglinide is not screened for in standard workplace or sports drug tests, and it is not listed by the World Anti‑Doping Agency (WADA).

• Can Prandin be crushed for patients with dysphagia?
  While the tablet can be split, crushing is not recommended without pharmacist guidance, as it may alter absorption kinetics and increase hypoglycaemia risk. A liquid formulation is not commercially available.

Glossary

β‑cell

The insulin‑producing cell located in the pancreatic islets of Langerhans.

K_ATP channel

An ATP‑sensitive potassium channel that regulates membrane potential and insulin release in β‑cells.

Post‑prandial glucose

Blood‑glucose level measured after eating, typically 1–2 hours after a meal.

Hypoglycaemia

A condition where blood‑glucose falls below normal (<3.9 mmol/L), presenting with symptoms such as shakiness, sweating, and confusion.

⚠️ Disclaimer

The information provided about Prandin is for general knowledge only. It does not replace professional medical consultation. All treatment decisions should be made under the supervision of a qualified healthcare provider. We assume all readers are responsible adults capable of making informed decisions about their health. Our online pharmacy offers access to Prandin for individuals who may have limited availability through traditional pharmacies, prescription‑based insurance schemes, or who are seeking affordable generic alternatives. Always consult your doctor before starting, changing, or discontinuing any medication.