Metformin; Repaglinide tablets

What is this medicine?

METFORMIN; REPAGLINIDE (met FOR min; re PAG lin ide) is used to treat type 2 diabetes. Treatment is combined with diet and exercise. This medicine helps your body to use insulin better.

How should I use this medicine?

Take this medicine by mouth. Swallow it with a drink of water. Follow the directions on the prescription label. Take this medicine before meals. It should be taken no earlier than 30 minutes before meals. If a meal is skipped, skip the dose for that meal. Do not take more often than directed.

Talk to your pediatrician regarding the use of this medicine in children. Special care may be needed.

Elderly patients over 65 years old may have a stronger reaction and need a smaller dose.

What side effects may I notice from receiving this medicine?

Side effects that you should report to your doctor or health care professional as soon as possible:

• allergic reactions like skin rash, itching or hives, swelling of the face, lips, or tongue

• breathing problems

• chest pain

• feeling faint or lightheaded, falls

• muscle aches or pains

• redness, blistering, peeling or loosening of the skin, including inside the mouth

• signs and symptoms of infection like fever or chills; cough; sore throat; pain or trouble passing urine

• signs and symptoms of low blood sugar such as feeling anxious, confusion, dizziness, increased hunger, unusually weak or tired, sweating, shakiness, cold, irritable, headache, blurred vision, fast heartbeat, loss of consciousness

• signs and symptoms of liver injury like dark yellow or brown urine; general ill feeling or flu-like symptoms; light-colored stools; loss of appetite; nausea; right upper belly pain; unusually weak or tired; yellowing of the eyes or skin

• slow or irregular heartbeat

• swelling of the ankles, feet, hands

• unusual bleeding or bruising

• unusual stomach pain or discomfort

• unusually tired or weak

• vomiting

Side effects that usually do not require medical attention (report to your doctor or health care professional if they continue or are bothersome):

• back pain

• diarrhea

• headache

• heartburn

• joint pain

• metallic taste in mouth

• nausea

• runny or stuffy nose

• stomach gas, upset

What may interact with this medicine?

Do not take this medicine with any of the following medications:

• certain contrast medicines given before X-rays, CT scans, MRI, or other procedures

• dofetilide

• gemfibrozil

This medicine may also interact with the following medications:

• acetazolamide

• alcohol

• barbiturates like phenobarbital or primidone

• carbamazepine

• certain antivirals for HIV or hepatitis

• certain medicines for blood pressure, heart disease, irregular heart beat

• certain medicines for fungal infections like ketoconazole and itraconazole

• cimetidine

• clopidogrel

• clarithromycin

• cyclosporine

• deferasirox

• dichlorphenamide

• digoxin

• diuretics

• erythromycin

• female hormones, like estrogens or progestins and birth control pills

• glycopyrrolate

• isoniazid

• lamotrigine

• memantine

• methazolamide

• metoclopramide

• midodrine

• niacin

• phenothiazines like chlorpromazine, mesoridazine, prochlorperazine, thioridazine

• phenytoin

• ranolazine

• rifampin

• simvastatin

• steroid medicines like prednisone or cortisone

• stimulant medicines for attention disorders, weight loss, or to stay awake

• thyroid medicines

• topiramate

• trospium

• vandetanib

• zonisamide

What if I miss a dose?

If you miss a dose before a meal, skip that dose. If it is almost time for your next dose, take only that dose with the next scheduled meal as directed. Do not take double or extra doses.

Where should I keep my medicine?

Keep out of the reach of children.

Store at temperatures less than 25 degrees C (77 degrees F). Protect from light. Throw away any unused medicine after the expiration date.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:

• anemia

• dehydration

• diabetic ketoacidosis

• heart disease

• if you often drink alcohol

• kidney disease

• liver disease

• polycystic ovary syndrome

• serious infection or injury

• vomiting

• an unusual or allergic reaction to metformin, repaglinide, other medicines, foods, dyes, or preservatives

• pregnant or trying to get pregnant

• breast-feeding

What should I watch for while using this medicine?

Visit your doctor or health care professional for regular checks on your progress.

A test called the HbA1C (A1C) will be monitored. This is a simple blood test. It measures your blood sugar control over the last 2 to 3 months. You will receive this test every 3 to 6 months.

Learn how to check your blood sugar. Learn the symptoms of low and high blood sugar and how to manage them.

Always carry a quick-source of sugar with you in case you have symptoms of low blood sugar. Examples include hard sugar candy or glucose tablets. Make sure others know that you can choke if you eat or drink when you develop serious symptoms of low blood sugar, such as seizures or unconsciousness. They must get medical help at once.

Tell your doctor or health care professional if you have high blood sugar. You might need to change the dose of your medicine. If you are sick or exercising more than usual, you might need to change the dose of your medicine.

Do not skip meals. Ask your doctor or health care professional if you should avoid alcohol. Many nonprescription cough and cold products contain sugar or alcohol. These can affect blood sugar.

This medicine may cause ovulation in premenopausal women who do not have regular monthly periods. This may increase your chances of becoming pregnant. You should not take this medicine if you become pregnant or think you may be pregnant. Talk with your doctor or health care professional about your birth control options while taking this medicine. Contact your doctor or health care professional right away if you think you are pregnant.

If you are going to need surgery, a MRI, CT scan, or other procedure, tell your doctor that you are taking this medicine. You may need to stop taking this medicine before the procedure.

Wear a medical ID bracelet or chain, and carry a card that describes your disease and details of your medicine and dosage times.

This medicine may cause a decrease in folic acid and vitamin B12. You should make sure that you get enough vitamins while you are taking this medicine. Discuss the foods you eat and the vitamins you take with your health care professional.