Meglitinide – short-acting oral insulin secretagogue
ATC code: A10BX02 (Repaglinide)
Brand names
NovoNorm, Prandin, Repaglinida Cinfa
A benzoic acid derivative. Blocks ATP-dependent potassium channels in pancreatic β-cells, causing membrane depolarization, calcium channel opening, and insulin release. Binds a different sulfonylurea receptor site than sulfonylureas – rapid and short action. CYP3A4 and CYP2C8 metabolism. Half-life 1 hour – lower hypoglycemia risk than long-acting sulfonylureas.
Second line
Second-line in T2D per / 2024 and SED 2023. Used in patients with irregular meals or intolerance to or sulfonylureas. Dose 0.5–4 mg before each meal. Particularly useful in CKD – no accumulation with reduced eGFR (advantage over sulfonylureas). Skip the dose if a meal is skipped – lower hypoglycemia risk.
The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.
Not recommended
Repaglinide is a meglitinide, a short-acting antidiabetic that stimulates insulin secretion. It is prescribed for type 2 diabetes (AEMPS Ficha Técnica). In people without diabetes, repaglinide is not used for weight loss: the drug causes hypoglycemia (life-threatening in people with normal blood sugar) and weight gain (paradoxically, via insulin stimulation). If repaglinide was prescribed for weight loss without diabetes, seek a second opinion immediately.
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In pregnant T2D patients, insulin is base therapy; oral antidiabetics are usually discontinued.
Not used during lactation.
Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.
Repaglinide is evaluated for the following indications with varying evidence strength: Type 2 diabetes mellitus (evidence tier B), Weight loss (evidence tier F). See the full indication matrix with dosing and citations above on this page.
Common side effects of Repaglinide (≥ 1 in 100): Hypoglycemia, Weight gain, Nausea, Abdominal pain, Diarrhea. See the Safety section for uncommon and serious reactions.
FDA category C. In pregnant T2D patients, insulin is base therapy; oral antidiabetics are usually discontinued.
Not used during lactation.
Repaglinide is contraindicated in: Repaglinide hypersensitivity; Type 1 diabetes; Diabetic ketoacidosis; Severe hepatic impairment; Concomitant gemfibrozil or itraconazole. Full list in the Safety section.