Repaglinide is an antidiabetic drug in the class of medications known as meglitinides, and was invented in 1983. Repaglinide is an oral medication used in addition to diet and exercise for blood sugar control in type 2 diabetes mellitus. The mechanism of action of repaglinide involves promoting insulin release from β-islet cells of the pancreas; like other antidiabetic drugs, a main side effect concern is hypoglycemia. It is sold by Novo Nordisk under the name of Prandin in the United States, GlucoNorm in Canada, Surepost in Japan, Repaglinide in Egypt by EIPICO, and NovoNorm elsewhere. In Japan it is produced by Dainippon Sumitomo Pharma. Medical uses
Repaglinide is an oral medication used in addition to diet and exercise for blood sugar control in type 2 diabetes mellitus. Contraindications
Repaglinide is contraindicated in people with:

Diabetic ketoacidosis, with or without coma
Type 1 diabetes
Co-administration with gemfibrozil
Known hypersensitivity to drug or inactive ingredients

Adverse events
Common adverse events include:Metabolic 

Hypoglycemia (31%)Respiratory

Upper respiratory infection (16%)
Sinusitis (6%)
Rhinitis (3%)Gastrointestinal

Nausea (5%)
Diarrhea (5%)
Constipation (3%)
Vomiting (3%)Musculoskeletal

Arthralgia (6%)
Back Pain (5%)Other

Headache (11%)
Paresthesia (3%)Serious adverse events include:
Cardiac ischemia (2%)
Angina (1.8%)
Deaths due to cardiovascular events (0.5%)

Special populations
Pregnancy category C: safety in pregnant women has not been established. Data is limited, and there is only one case report that notes no complications with the use of repaglinide during pregnancy.Caution should be taken in people with liver disease and decreased kidney function when using this medication. Drug interactions
Repaglinide is a major substrate of CYP3A4 and should not be administered concomitantly with gemfibrozil, clarithromycin or azole antifungals such as itraconazole or ketoconazole.
Administration of both repaglinide and one or more of these drugs results in an increase in plasma concentration of repaglinide and may lead to hypoglycemia. Co-administration of repaglinide and clopidogrel (a CYP2C8 inhibitor) may lead to a significant decrease in blood glucose levels due to a drug-drug interaction. In fact, using these drugs together for even one day can cause repaglinide levels to increase over 5-fold...and may lead to significant hypoglycemia. Repaglinide should not be combined with sulfonylurea, because they have the same mechanism of action. Pharmacology
Mechanism of action
Repaglinide lowers blood glucose by stimulating the release of insulin from the beta islet cells of the pancreas. It achieves this by closing ATP-dependent potassium channels in the membrane of the beta cells. This depolarizes the beta cells, opening the cells calcium channels, and the resulting calcium influx induces insulin secretion. Pharmacokinetics
Absorption: repaglinide has a 56% bioavailability when absorbed from the gastrointestinal tract. Bioavailability is reduced when taken with food; the maximum concentration decreases by 20%. Distribution: The protein binding of repalglinide to albumin is greater than 98%. Metabolism: repaglinide is primarily metabolized by the liver - specifically CYP450 2C8 and 3A4 - and to a lesser extent via glucuronidation. Metabolites of repaglinide are inactive and do not display glucose-lowering effects. Excretion: repaglinide is 90% excreted in the feces and 8% in the urine. 0.1% is cleared unchanged in the urine. Less than 2% is unchanged in the feces.