Brand names: Prandin
Prandin is used to reduce blood sugar levels in people with type 2 diabetes (the kind that does not require insulin shots). It's prescribed when diet and exercise alone fail to correct the problem. A combination of Prandin and a second diabetes drug can be prescribed if either drug alone proves insufficient.
Chronically high glucose levels have been implicated in the kidney failure, blindness, and loss of sensation that plague many people with long-standing diabetes. A low-calorie diet, weight loss, and exercise are your first line of defense against these problems. Medications such as Prandin are prescribed only as a back-up when these other measures still leave sugar too high. If diet, exercise, and a combination of Prandin and a second diabetes drug all fail to do the job, your doctor may have to start you on insulin.
Prandin should be taken shortly before each meal. You can take it 30 minutes ahead of time or wait until just before starting; a 15-minute period is typical. You can take Prandin 2, 3, or 4 times a day, depending on the number of meals you have. If you skip a meal (or add an extra meal), skip (or add) a dose accordingly.
Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Prandin.
If you have type 1 (insulin-dependent) diabetes, you cannot use Prandin. The drug also cannot be used for diabetic ketoacidosis (a life-threatening emergency first signaled by excessive thirst, nausea, fatigue, and fruity-smelling breath). This condition must be treated with insulin.
If you find that Prandin gives you an allergic reaction, you'll be unable to continue using it.
While taking Prandin, you should check your blood sugar regularly. Your doctor will also watch it; and to measure long-term glucose control, he will probably give you the glycosylated hemoglobin (HbA1C) test as well.
Too much Prandin can cause low blood sugar (hypoglycemia), marked by shaking, sweating, and cold-clammy skin. If you develop these symptoms, take some orange juice or suck on a hard candy. The problem is more likely to surface if you are elderly, debilitated, or malnourished, have liver problems, or suffer from poor adrenal or pituitary function.
If Prandin is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Prandin with the following:Airway-opening medicationsAlcohol (excessive amounts can cause low blood sugar)AspirinBarbituratesBeta-blockersBlood thinnersCalcium channel blockersCarbamazepineChloramphenicolClarithromycinErythromycinEstrogensKetoconazoleFurosemideGlucose lowering agentsIsoniazidMajor tranquilizersMAO inhibitorsNiacinNonsteroidal anti-inflammatory drugsOral contraceptivesPhenytoinProbenecidRifampinSteroids such as prednisoneSulfa drugsThyroid medicationsWater pills such as the thiazide diuretics
Additionally, you should not start taking Prandin if you are already taking a triglyceride-lowering medication. Combining the two drugs could lead to a dangerous drop in blood sugar. However, if you're already taking both drugs, the doctor will monitor your blood sugar levels closely and adjust the dosages as needed.
Because abnormal blood sugar during pregnancy can cause fetal defects, your doctor will probably prescribe insulin injections until the baby is born. The effects of Prandin during pregnancy have not been adequately studied.
It is not known whether Prandin appears in breast milk. Discuss with your doctor whether to discontinue breastfeeding or give up Prandin. If the medication is discontinued, and diet alone does not control your blood sugar levels, your doctor may recommend insulin injections.
Take Prandin before each meal. The recommended dose ranges from 0.5 milligram to 4 milligrams. If you have never taken a glucose-lowering medication before, you should start with the 0.5-milligram dose. If you have taken these drugs in the past, the starting dose is 1 or 2 milligrams. Take no more than 16 milligrams a day.
Your dose of Prandin will be adjusted according to your fasting blood sugar levels. If your pre-meal glucose level appears normal and you are still experiencing glucose control problems, your doctor may test your glucose level after you have eaten a meal. Your doctor will wait at least a week after each change in dose to check your response.
Switching to Prandin
When Prandin replaces another oral glucose-lowering medicine, you should start taking it the day after your final dose or the previous drug. Be alert for signs of low blood sugar; effects of the drugs may overlap.
If Prandin is being added to Glucophage therapy, you should begin with a 0.5-milligram dose. Dosage will then be adjusted according to your blood glucose levels.
An overdose of Prandin taken without food can cause low blood sugar (hypoglycemia).
Consuming some sugar will usually correct the problem. If symptoms persist or worsen, contact your doctor.