II. Mechanism
- Insulin secretogogue
III. Indication
- Early Type II Diabetes Mellitus Oral Agent
- Elevated postprandial Glucose
- Consider if only used intermittently pre-meal
IV. Contraindications
- Hypersensitivity Reaction to sulfa
V. Category
VI. Mechanism
- Benzoic acid derivative
- Similar to Sulfonylurea
- Binds different sites from Sulfonylureas
- Closes ATP sensitive K+ channels
- Results in Insulin secretion
- Shorter duration of binding and shorter effect
- Predominately effects postprandial Glucose
VII. Advantages
- Low risk of Hypoglycemia (2.4%)
- Effect depends on Ambient Blood Glucose levels
- No significant gastrointestinal side effects
- Minimal weight gain
- No lab monitoring required
- No significant Drug Interactions
- No Lactic Acidosis
- No adjustments needed (other than per meal)
- No adjustment in Congestive Heart Failure
- No adjustment for age
- No adjustment in Renal Insufficiency
VIII. Adverse Effects
- Hypoglycemia (lower risk of Sulfonylureas)
IX. Disadvantages
- Two to three times as expensive as Sulfonylureas
X. Agents
- Repaglinide (Prandin)
- Nateglinide (Starlix)
- Significantly weaker activity compared with Prandin
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Related Studies
repaglinide (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
REPAGLINIDE 0.5 MG TABLET | Generic | $0.11 each |
REPAGLINIDE 1 MG TABLET | Generic | $0.12 each |
REPAGLINIDE 2 MG TABLET | Generic | $0.13 each |
nateglinide (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
NATEGLINIDE 120 MG TABLET | Generic | $0.30 each |
NATEGLINIDE 60 MG TABLET | Generic | $0.27 each |