Brand Name: Prandin
Generic Name: repaglinide (oral)

Pronunciation: (re PAG li nide)

Prandin, repaglinide (oral) full prescribing information

What is Prandin and why is it prescribed?

Prandin is an oral diabetes medicine that helps control blood sugar levels. This medication lowers blood sugar by causing the pancreas to produce insulin.

Prandin is used together with diet and exercise to treat type 2 (non-insulin dependent) diabetes. Other diabetes medicines are sometimes used in combination with repaglinide if needed.

Prandin may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about Prandin?

Do not use this medication if you are allergic to repaglinide, if you have type 1 diabetes, or if you are in a state of diabetic ketoacidosis (call your doctor for treatment with insulin). You should not use Prandin together with NPH insulin (such as isophane insulin).

Take care not to let your blood sugar get too low, causing hypoglycemia. You may have hypoglycemia if you skip a meal, exercise too long, drink alcohol, or are under stress.

Know the signs of low blood sugar (hypoglycemia) and how to recognize them. Always keep a source of sugar available in case you have symptoms of low blood sugar. Sugar sources include orange juice, glucose gel, candy, or milk. Severe hypoglycemia may cause loss of consciousness, seizures, or death. If you have severe hypoglycemia and cannot eat or drink, use an injection of glucagon. Your doctor can give you a prescription for a glucagon emergency injection kit and tell you how to give the injection. If your blood sugar gets too high (hyperglycemia), you may feel very thirsty or hungry. You may also urinate more than usual. Call your doctor right away if you have any symptoms of hyperglycemia.

Prandin is only part of a complete program of treatment that also includes diet, exercise, and weight control. Follow your diet, medication, and exercise routines very closely. Changing any of these factors can affect your blood sugar levels.

It is important to take Prandin regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

What should I discuss with my doctor before taking Prandin?

Do not use this medication if you are allergic to repaglinide, if you have type 1 diabetes, or if you are in a state of diabetic ketoacidosis (call your doctor for treatment with insulin). You should not use Prandin together with NPH insulin (such as isophane insulin).

Before taking Prandin, tell your doctor if you are allergic to any medications, or if you have liver disease. You may need a dose adjustment or special tests to safely take this medication.

FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether Prandin passes into breast milk or if it could be harmful to a nursing baby. Do not take Prandin without telling your doctor if you are breast-feeding a baby.

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How should I take Prandin?

Take Prandin exactly as it was prescribed for you. Do not take the medication in larger or smaller amounts, or take it for longer than recommended by your doctor. Follow the directions on your prescription.

Your dose needs may change if you are ill, if you have a fever or infection, or if you have surgery or a medical emergency. Do not change your dose of Prandin without first talking to your doctor. Take this medicine with a full glass of water.

Prandin is usually taken 2 to 4 times daily, within 30 minutes before eating a meal. Follow your doctor's instructions. If you skip a meal, do not take your dose of Prandin. Wait until your next meal.

Take care not to let your blood sugar get too low, causing hypoglycemia. You may have hypoglycemia if you skip a meal, exercise too long, drink alcohol, or are under stress.

Know the signs of low blood sugar (hypoglycemia) and how to recognize them. Always keep a source of sugar available in case you have symptoms of low blood sugar. Sugar sources include orange juice, glucose gel, candy, or milk. Severe hypoglycemia may cause loss of consciousness, seizures, or death. If you have severe hypoglycemia and cannot eat or drink, use an injection of glucagon. Your doctor can give you a prescription for a glucagon emergency injection kit and tell you how to give the injection.

To be sure this medication is helping your condition, you will need to check your blood sugar at home. Your blood will also need to be tested by your doctor on a regular basis. It is important that you not miss any scheduled visits to your doctor.

Prandin is only part of a complete program of treatment that also includes diet, exercise, and weight control. Follow your diet, medication, and exercise routines very closely. Changing any of these factors can affect your blood sugar levels.

It is important to take Prandin regularly to get the most benefit. Get your prescription refilled before you run out of medicine completely.

Store Prandin at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember, but only if you are getting ready to eat a meal. If it is almost time for your next dose, wait until then to take the medicine and skip the missed dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. Overdose symptoms may include hunger, nausea, anxiety, cold sweats, weakness, drowsiness, loss of consciousness, and coma.

What should I avoid while taking Prandin?

Avoid drinking alcohol while taking Prandin. Alcohol can lower your blood sugar.

Prandin side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have any of these serious side effects:

• seizure (convulsions); or
• jaundice (yellowing of the skin or eyes).

Less serious side effects may include:

• runny or stuffy nose, sneezing, cough, cold or flu symptoms;
• diarrhea, nausea;
• back pain, headache;
• dizziness; or
• joint pain.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Prandin?

Before you take Prandin, tell your doctor if you also take gemfibrozil (Lopid) or itraconazole (Sporanox).

You may be more likely to have hyperglycemia (high blood sugar) if you are taking Prandin with other drugs that raise blood sugar. Drugs that can raise blood sugar include:

• isoniazid;
• diuretics (water pills);
• steroids (prednisone and others);
• phenothiazines (Compazine and others);
• thyroid medicine (Synthroid and others);
• birth control pills and other hormones;
• seizure medicines (Dilantin and others); and
• diet pills or medicines to treat asthma, colds or allergies.

You may be more likely to have hypoglycemia (low blood sugar) if you are taking Prandin with other drugs that lower blood sugar. Drugs that can lower blood sugar include:

• probenecid (Benemid);
• some nonsteroidal anti-inflammatory drugs (NSAIDs);
• aspirin or other salicylates (including Pepto-Bismol);
• sulfa drugs (Bactrim, Gantanol, Septra, and others);
• a monoamine oxidase inhibitor (MAOI); or
• beta-blockers (Tenormin and others).

This list is not complete and there may be other drugs that can interact with Prandin. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Where can I get more information?

• Your pharmacist can provide more information about Prandin.
• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

last updated: 06/2009

Prandin, repaglinide (oral) full prescribing information

Detailed Info on Signs, Symptoms, Causes, Treatments of Diabetes

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Living with Obsessive-Compulsive Disorder or OCD can be torturous, filled with recurrent, unwanted thoughts (obsessions) and/or repetitive behaviors (compulsions). Unfortunately, OCD isn't easy to treat.

If you saw the movie "As Good As It Gets" with Jack Nicholson you, like me, probably laughed at the antics of the lead character when he compulsively engaged in behaviors that seemed strange and thus funny at the time. In the movie it was comical, but in real life the obsessive thoughts and compulsive behaviors suffered by those with obsessive-compulsive disorder (OCD), is anything but funny. In fact, OCD is a disorder that causes severe distress and impairment.

What is OCD?

Obsessive-Compulsive Disorder, technically categorized as an anxiety disorder, is characterized by repetitive thoughts that the person realizes are unreasonable, but cannot stop thinking. Examples might be:

• "I will get a disease and die, or give the disease to someone else in my family"
• "I am contaminated in some way because I touched something"
• "I will cause damage or harm to someone, or have already done so."
• "My house will burn down; someone will rob me, my house will be flooded because I left the faucet on."

Although the sufferer realizes that these thoughts are unrealistic (and certainly unwanted), they feel helpless to stop thinking them. The only way to handle the obsessive thoughts, is to engage in repetitive behaviors called compulsions, that the person feels driven to perform. These compulsions are the other symptom of OCD and may include:

• counting
• checking
• handwashing
• performing the same action over and over
• counting in certain ways
• making sure everything is in a certain place in certain order

or other behaviors that the person feels compelled to perform --- over and over.

Obsessions and Compulsions Seem Uncontrollable

Even though the person realizes that the thoughts and behaviors don't make a lot of sense, they feel powerless to avoid them, and if they attempt to do so they experience overwhelming anxiety, which can only be controlled by re-engaging in the thoughts or behaviors.

The thoughts and behaviors of OCD take up a great deal of time and often cause the person to be late to appointments or to miss them altogether. Many OCD sufferers have learned coping techniques which may be worse than the obsessions and compulsions (for example, using drugs or alcohol to decrease the thoughts or need for behaviors). These ineffective "coping strategies" can then develop into another psychiatric condition complicating the treatment of the OCD.

The thoughts and behaviors that result from OCD are different than those in people who are just meticulous or driven to be "clean or ordered" in their lives. People with OCD may be ordered or clean, but are driven by unrealistic thoughts and will clean once, and then again and again and again.

OCD Treatments

Treatments for OCD include psychotherapy, called exposure and response prevention, as well as medications and other biologic treatments. It can be treated, but is often difficult to treat because of the extreme anxiety caused by not engaging in the thoughts or behaviors.

On the HealthyPlace TV show, we will talk specifically about the symptoms, consequences and treatments for OCD - Tuesday June 30 (5:30p PT, 7:30 CT, 8:30 ET live and on-demand on our website).

Dr. Harry Croft is a Board-Certified Psychiatrist and Medical Director of HealthyPlace.com. Dr. Croft is also the co-host of the HealthyPlace TV Show.

next: Child Abuse: Possible Long-Term Results
~ other mental health articles by Dr. Croft

Child abuse and child neglect can have not only psychological aftermath, but produce biological consequences as well.

Child abuse comes in several different varieties: physical abuse, sexual abuse, verbal abuse, psychological abuse and neglet or rejection - to mention a few. Children often are unaware that the abuse they are experiencing is even abnormal, because, for them, it might be the only behavior they know from the very people that they depend upon for care. It is often not until later in life that they become cognisant of the fact that the care they received is not the same as that of others they know, and in reality was abusive.

Impact of Child Abuse on Children

I will talk about the psychological and behavioral consequences of childhood abuse later in this blog. Recent research has shown that child abuse and/or child neglect can have not only psychological aftermath, but produce biological consequences as well. Researchers have shown that victims of neglect or abuse in childhood often develop brain changes with decrease in actual structure of certain brain components. In addition, as a result of these changes, those victims of child abuse are more prone to develop depression, anxiety disorders, and are even more likely to attempt suicide.

Psychologically, early child abuse lends itself to later behavioral problems such as aggression, sexual promiscuity, substance abuse, and withdrawal and isolation. Those with a history of early childhood trauma are more likely, later in life. to suffer from a variety of psychiatric disorders including: borderline personality disorder, anxiety disorders and depression. Later on in life, those who witness physical and verbal abuse may themselves engage in the very behaviors they swore as children they would never do. Worst of all, many abusers suffer in silence as they "protect" the family secret. Fearing to reveal the abuse, they allow the internal feelings to "fester" and remain alive psychologically.

Treatment of Child Abuse

Once they become aware of the impact the child abuse is having on their adult lives, many of the abused can be helped in psychotherapy. Both individual and group therapy can be useful for these people. But having "success" in therapy means learning new ways of coping and dealing with the feelings of fear, anger, resentment -- and the notion that "I must have in some way caused the abuse to occur." The end result of therapy should be recovery from the impact of the abuse and for the person to come from a "victim" to a "survivor" mentality.

On the HealthyPlace TV show, we will explore the causes, impact, and recovery from childhood abuse - Tuesday June 16 (5:30p PT, 7:30 CT, 8:30 ET live and on-demand on our website).

Dr. Harry Croft is a Board-Certified Psychiatrist and Medical Director of HealthyPlace.com. Dr. Croft is also the co-host of the HealthyPlace TV Show.

next: Borderline Personality Disorder: Symptoms to Treatment
~ more mental health articles by Dr. Croft

Treatment of Borderline Personality Disorder can be a difficult process. Learn about the symptoms, causes and treatment of Borderline Personality Disorder.

Borderline Personality Disorder (BPD) is classified as a personality disorder, meaning that it represents an almost lifelong pattern of behavior that may or may not be recognized as abnormal by the sufferer but is clearly perceived as a problem by others coming into contact with the sufferer. Symptoms of Borderline Personality Disorder involve:

• problems with the way patients feel about themselves
• how they relate to others
• how patients actually behave

Sufferers often come across as self-assured, but usually inside feel quite insecure about themselves and their relationships. The end result is that relationships are:

• often quite intense
• difficult to keep going
• often in turmoil

These relationships can be with family, friends, lovers, coworkers and bosses. Patients with the Borderline Personality Disorder often have:

• great and often inappropriate anger which they find difficult to control
• strong emotions that come and go frequently
• suicidal thinking or behavior
• self injury behaviors
• impulsive actions such as engaging in risky sex, gambling, drug abuse, and other potentially self destructive behaviors

It is called borderline because originally the thoughts and behaviors involved with the disorder were thought to be "borderline psychotic." Although the behaviors are intense and difficult to cope with or understand -- they are usually not "psychotic."

Causes of Borderline Personality Disorder

The causes of Borderline Personality Disorder are unclear, even with present understanding, but may include:

• history of childhood abuse (physical, verbal or sexual)
• biological brain changes
• genetics

However, the real "cause" of the disorder is not yet totally understood.

The problem with Borderline Personality Disorder is that while those close to the sufferer may clearly see the behaviors and emotions and their impact, the patients themselves often do not seem to understand that it is them causing their emotions and behaviors. For the patient, the disorder causes them to see the fault of their situations or emotions to be the result of the behavior of others towards them. This is what we call "ego syntonic", which means that the patient feels uncomfortable as a result of what their feelings or behaviors cause, but feels no discomfort about their own thoughts and behaviors.

Treatment of Borderline Personality Disorder

Treatment of Borderline Personality Disorder usually is best accomplished through psychotherapy, especially a therapy called DBT (Dialectical Behavior Therapy) involving teaching the sufferer how to regulate their emotions, improve their relationships and tolerate discomfort resulting from the effects of their own behaviors. Medications are sometimes helpful, but therapy is the mainstay of treatment.

Besides the obvious effects of symptoms of Borderline Personality Disorder (BPD) on relationships, work interactions and family interactions, other negative results can involve: self injury, drug abuse, end result of risky behavior, and even suicide.

We will take a closer look at Borderline Personality Disorder, symptoms causes and treatments on the HealthyPlace TV show - Tuesday June 9 (7:30p CT, 8:30 ET live and on-demand on our website).

Dr. Harry Croft is a Board-Certified Psychiatrist and Medical Director of HealthyPlace.com. Dr. Croft is also the co-host of the HealthyPlace TV Show.

next: Anorexia Nervosa: Development and Treatment
~ other mental health articles by Dr. Croft

Here's what's happening on the HealthyPlace site this week:

• Is It Possible to Treat Borderline Personality Disorder?
• Can Borderline Personality Disorder Be Effectively Treated? on HealthyPlace TV
• Coaching The Inattentive Child
• Coping with Depression

Is It Possible to Treat Borderline Personality Disorder?

Earlier this month, we received an email from one of the viewers of the HealthyPlace TV Show. Tara writes:

I was diagnosed after around 15 years of not knowing why my world seemed so different to other people. I firmly believe that it isn't that we can't be treated, but that so few health professionals actually understand the real implications of how Borderline Personality Disorder affects its sufferers. We are treated as though we try to be problematic, but when you know that people simply cannot understand us, the frustration boils into desperation and anger. My terror of being alone seems so unreasonable to most people. For example, I find 20 reasons to go to a shop when I could have gone once. I know it doesn't make sense. We need more doctors to stop writing us off and to try to help us make more sense of what we go through every day. I was treated at Springfield Hospital, where for the first time I actually found out what was going on.

Many with Borderline Personality Disorder live a life full of frustration and to make matters worse, it's very difficult to even find a therapist who wants to work with someone who has BPD.  But some mental health professionals are beginning to acknowledge that treatment of Borderline Personality Disorder can have a positive impact.

We'll be exploring that more on tonight's HealthyPlace TV show.

"Can Borderline Personality Disorder Be Effectively Treated?" On HealthyPlace TV

Many mental health professionals believe that you can't treat Borderline Personality Disorder. However, our guest says she has recovered from Borderline Personality Disorder and she'll be here to share her story.

This Tuesday night, June 9. The show starts at 5:30p PT, 7:30 CT, 8:30 ET and airs live on our website.

• TV Show Blog with this week's show info
• Dr. Harry Croft's Blog on Borderline Personality Disorder: Symptoms to Treatment

In the second half of the show, you get to ask Dr. Harry Croft, your personal mental health questions.

Also in June on HealthyPlace TV

• Child Abuse and Its Impact Later in Life
• Your Child's Mental Health: What Every Parent Should Know

If you would like to be a guest on the show or share you personal story in writing or via video, please write us at: producer AT healthyplace.com

Click here for a list of previous HealthyPlace Mental Health TV Shows.

More Information on Borderline Personality Disorder

• What is Borderline Personality Disorder
• What Causes Someone To Develop A Personality Disorder
• Treatment of Personality Disorders
• Therapy for Treatment of Personality Disorders
• Diagnosing Borderline Personality Disorder And Finding Treatment That Works
• Living With and Recovering From Borderline Personality Disorder (BPD)
• Transforming Borderline Personality Disorder Into A Healing Experience
• Life on the Border site at HealthyPlace.com

Coaching The Inattentive Child

Do you have a child with ADHD or a child who is extremely inattentive?  In a new article, Parent coach, Dr. Steven Richfield has some suggestions to help your child improve his/her focus and efficiency.

As more becomes known about ADHD, it's now an accepted fact that many ADHD kids grow into ADHD adults. And many of these ADHD adults are not only turning to traditional ADHD treatment methods like medication and therapy, but they are hiring an ADHD coach to help them maximize their potential.

If you're looking for some more tips and success stories on managing and living with ADHD (child and adult), try this link.

Coping with Depression

Whether you are coping with an eating disorder, bipolar disorder, anxiety, or any of the other mental health conditions, depression usually becomes a problem. After all, just the stress and strain of living with a mental health disorder, is enough to cause someone to become depressed and give up hope that their situation will improve. But recent studies reveal that people who seek help for depression experience significant relief.

So what can you do to help treat your depression?

• Where to Get Help for Depression
• Getting the Right Treatment for Depression
• Antidepressant Medications: What You Need to Know
• Alternative Depression Treatments and Alternative Treatments for Depression
• How Psychotherapy Helps People Recover From Depression

Here's a depression screening test. See if you have the signs and symptoms of depression.

back to: HealthyPlace.com Newsletter Index

I think today I felt even worse then the day that I tried to kill myself. I don't understand where these feelings are coming from. I JUST WANT THE PAIN TO STOP!!!!

I went as far today as to think about who I would leave my dog with, what to write in the e-mails and letters that I would send, who to give my important things to. The last time, I didn't think about any of that, I just took the pills. About ten minutes later, I went to my neighbor's house and told her what I had done. I guess that I really didn't want to die that day, but today was so different. I really wanted to end all of this pain, stress, anxiety and depression.

I had planned to take a bottle of vodka and my meds and go down to the river, where I would take the pills, drink the boose and then wait to get tired before going for a swim. I still feel like that sounds like a good plan.

Instead, I  stayed in bed and cried all day. I can't eat, I can't sleep, I don't want to go anywhere or do anything or see anyone. I would be content to just stay in bed till I finally died.

I wrote this little poem today:

Ah, sleep.

beautiful, permanent sleep.

to take away all this pain, all this misery,

can I? should I? will I?

each day brings a different answer.

Ah, to know what tomorrow will bring.