Repaglinide

Repaglinide is used to treat individuals with type 2 (non-insulin-dependent) diabetes mellitus; it is in the meglitinide class of anti-diabetic drugs. It may be used as an adjunct to diet and exercise either alone or in combination with other anti-diabetic medications.

Summary of Interactions with Vitamins, Herbs, and Foods
(for details about the summarized interactions, read the full article)

Avoid: Adverse interaction—Avoid these supplements when taking this medication because taking them together may cause undesirable or dangerous results.	Ginkgo biloba Willow*
Check: Other—Before taking any of these supplements or eating any of these foods with your medication, read this article in full for details.	Vitamin B3
Depletion or interference	None known
Side effect reduction/prevention	None known
Supportive interaction	None known
Reduced drug absorption/bioavailability	None known

Interactions with Dietary Supplements

Vitamin B3 (niacin)
Supplementation with large amounts of niacin (also called nicotinic acid) can increase blood glucose levels in diabetics, which might interfere with the blood-sugar-lowering effects of repaglinide.¹ The form of vitamin B3 known as niacinamide does not have this effect. People who start or stop supplementing niacin while on repaglinide should carefully monitor their blood sugar levels and consult their prescribing doctor about making adjustments in the daily amount of drug taken.

Interactions with Herbs

Willow (Salix alba)
Willow bark contains salicin, which is related to aspirin. Both salicin and aspirin produce anti-inflammatory effects after they have been converted to salicylic acid in the body. Taking aspirin together with repaglinide enhances the blood-sugar-lowering effects of the drug,² which might result in unwanted side effects. Controlled research is needed to determine whether taking willow bark together with repaglinide might produce similar effects.

Ginkgo biloba
In a preliminary trial, administration of Ginkgo biloba extract (120 mg per day) for three months to patients with type 2 diabetes who were taking oral anti-diabetes medication resulted in a significant worsening of glucose tolerance. Ginkgo did not impair glucose tolerance in individuals whose diabetes was controlled by diet.³ Individuals taking oral anti-diabetes medication should consult a doctor before taking Ginkgo biloba.

Interactions with Foods and Other Compounds

Food
Taking repaglinide with food can result in decreased absorption of the drug.⁴ Consequently, to achieve the best results, repaglinide should be taken on an empty stomach.

References

1. Sifton DW, ed. Physicians Desk Reference. Montvale, NJ: Medical Economics Company, Inc., 2000, 2071–3.

2. Sifton DW, ed. Physicians Desk Reference. Montvale, NJ: Medical Economics Company, Inc., 2000, 2071–3.

3. Kudolo GB. The effect of 3-month ingestion of Ginkgo biloba extract (EGb 761) on pancreatic beta-cell function in response to glucose loading in individuals with non-insulin-dependent diabetes mellitus. J Clin Pharmacol 2001;41:600–11.

4. Sifton DW, ed. Physicians Desk Reference. Montvale, NJ: Medical Economics Company, Inc., 2000, 2071–3.

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The information presented in Healthnotes is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over-the-counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires March 2005.